In my last post I examined, from a high-level, what life is like after prostate cancer. In this post, I want to focus on the specifics of what to expect depending on your treatment option:
- radical prostatectomy (surgical removal of the prostate);
- external-beam radiation which targets the prostate as much as possible (trying to avoid the rectum and the bladder);
- brachytherapy which sees tiny radioactive seeds implanted in the prostate.
While each is relatively effective at treating early-stage prostate cancer, each offers different outcomes for bowel, urinary and sexual function. Perhaps more important, however, is that there are differences in how much of an impact men perceive to their lifestyle from each option. For example, in one study done by Mark Litwin, MD, MPH, and reported in the June 1, 2007 issue of the journal Cancer, the following conclusions were reached, based on men's self-perceptions:
- external-beam radiation therapy led to the best outcomes for urinary control and sexual function (however, the differences experienced by potent men undergoing radical prostatectomy was reduced by bilateral nerve-sparing surgery);
- brachytherapy caused more obstructive and irritative symptoms;
- radical prostatectomy led to the least bowel dysfunction.
However, the study's author noted that national outcomes vary widely from practitioner to practitioner: "One indication of really good quality care in prostate cancer is that a surgeon or radiologist tracks his or her own outcomes and can say, 'Here is my track record.'" (Life After Prostate Cancer by Daniel J. DeNoon. WebMD Health News.)
You need to have a very frank conversation with your doctor about which side effects will bother you the most, and what their personal experience with outcomes and dysfunctions has been based on the treatment they have provided to other patients.
