It has been found that regular tracking for prostate cancer can lead to a high quality of existence for men.
Monitoring for prostate cancer instead of surgery or radiotherapy seems to be a better method of prevention. For those with a low risk of prostate cancer, this approach worked very well. In fact, it was the ideal form of treatment. The quality of life of these men improved immensely. It might seem unbelievable but the quality of life was the same as it was for men who didn’t have prostate cancer. Prostate cancer is very common in males. There are 400,000 cases of prostate cancer in Europe annually.
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Most patients are treated via surgical means or radiotherapy. However, both methodologies lead to side effects such as urinary incontinence or erectile dysfunction. Active surveillance seems to be the ideal way ahead. This way the chances for prostate cancer spreading is checked and any signs of a flare-up are avoided too. Via a regular monitoring of the cancer, the option of seeking a cure is always kept on the sidelines. The quality of life is improved since many times such a stage is never reached that curative options have to be exercised.
427 patients had questionnaires handed out to them. They were 66 to 69 years of age. All of them were at a low risk of contracting prostate cancer. For five years to a decade afterwards, these patients were constantly tracked with reference to their disease. 121 chose active surveillance while 74 had surgery. 232 received radiotherapy as a form of treatment. 204 others who had no symptoms of prostate cancer were studied as well. The group that was on active surveillance reported higher quality of life than those who had undergone surgical procedures.
They had better urinary functions. Their urinary incontinence levels were low and their sexual health was ideal too. As compared with those who underwent radiotherapy, they also showed more sexual satisfaction. The men on active surveillance in fact showed a quality of life that was almost equal to that of men who had no prostate cancer. This was the first such study which managed to gauge the various groups and it found that sometimes being least therapeutic was the best way of being most therapeutic. Treatment was a last resort and even if it was undertaken, there were some pretty nasty side effects. So, the best thing was to undergo active surveillance.
Dr Lionne Venderbos, of the department of Urology, Erasmus University Medical Center (Rotterdam) who led the research commented: "This is the first study to look at long-term outcomes in these four different groups. We found that men on active surveillance experienced better prostate-related health than men who underwent radical prostatectomy and radiotherapy. This showed up as better urinary function, less urinary incontinence and better sexual function. Furthermore, we found that the quality of life of men on active surveillance was similar to a group of men without prostate cancer. This is interesting because men on active surveillance still live with untreated cancer as compared to men in the reference group who do not have cancer. The monitoring combined with information on the low-risk nature of men their disease may partly explain the similar quality of life.
"When choosing treatment, it is important that men think about the potential side-effects that are related to immediate curative treatment, like becoming incontinent or losing the ability to have an erection. When considering active surveillance they should try to imagine whether living with untreated cancer would cause any stress, or that the follow-up visits lead to stress instead of reassurance. Balancing the advantages and disadvantages per type of treatment, will make that a man chooses that type of treatment that fits his wishes and preferences best.
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Commenting Dr Alberto Briganti (Milano),Section Editor of European Urology Focus and member of EAU Scientific Congress Committee, said: "This is an interesting study which corroborates the notion that active surveillance is not only safe but well accepted by patients as possible initial management of low risk prostate cancer. While we could have been anticipated overall lower sexual and urinary function in men treated with surgery or radiation therapy as compared to men receiving AS, it is interesting to note that long-term quality of life of men on AS was comparable to that of men without prostate cancer. Proper patient counseling about safety of AS is key to maintain both good quality of life, and intact psychological and functional well-being over time. We also need to note that it is possible that patients choosing AS may be less disposed to accept any form of treatment, and this might be difficult to uncover via the retrospective comparisons of validated questionnaires."