Research Compares Treatment of Early Prostate Cancer

In the news recently are two interesting studies comparing various treatments of early stage prostate cancer. One, conducted in France, compared the effects of two treatments frequently prescribed for localized prostate cancer: 1) radioactive seed implantation (brachytherapy) and 2) surgery to remove the prostate (prostatectomy).
Another study, based on data collected in the United States between 1980 and 1997, compares the long-term survival of men with localized prostate cancer who underwent 1) active surveillance or 2) radiation or surgery.

Quality of Life & Symptoms after Brachytherapy or Prostatectomy
The French study involved 435 men with localized, low-risk prostate cancer. The men, who were being treated at 11 different hospitals, completed a quality of life questionnaire designed by the Quality of Life Group of the European Organization for the Research and Treatment of Cancer. Men completed the survey at 2, 6, 12, 18, and 24 months after treatment.

Immediately after treatment, men who were treated with radioactive seed implantation reported a less pronounced drop in health-related quality of life than did men treated with surgery. However, at 6 months and continuing on until 24 months after treatment, men treated with surgery reported a slightly more favourable quality of life than did men treated with brachytherapy.

Men who underwent surgery experienced impotence and urinary incontinence to a greater extent, and urinary frequency, urgency, and pain upon urination were more frequent after radioactive seed implantation.

For more information, consult the following online citation.
Buron, C., Le Vu, B., Cosset, J-M., and others. (2007, March). “Brachytherapy versus prostatectomy in localized prostate cancer: Results of a French multicenter prospective medico-economic study,” International Journal of Radiation Oncology – Biology – Physics, 67(3), 812-822.

Long-Term Survival and Treatment of Early Prostate Cancer
It must be stressed that the US study comparing the long-term survival rates of early stage prostate cancer patients treated either conservatively (with active surveillance) or more aggressively (with radiation or surgery) is retrospective, based on data collected between 1980 and 1997. Clinical trials and the analysis of more current data are needed to directly compare the effectiveness of these two treatment approaches, in particular because of recent improvements in monitoring and assessing prostate cancer during active surveillance.

Nevertheless, the study’s findings are worth noting. Researchers collected data on 3,159 men 75 years or younger who were diagnosed with localized prostate cancer between 1980 and 1997. Here are some of the results:

• The overall survival rate at 15 years was 35% for men treated through active surveillance, 50% for those who underwent radiation therapy, and 65% for those who had a radical prostatectomy.


• The corresponding cancer-specific survival rates were 79% (active surveillance), 87% (radiation therapy), and 92% (surgery).


• Patients undergoing radiation or radical prostatectomy had lower overall mortality than patients undergoing active surveillance.


• The increase in the survival duration was 4.6 years with radiation therapy and 8.6 years with radical prostatectomy.

Simply put, the study suggests that, at least between 1980 and 1997, surgery and radiation therapy improved survival compared to active surveillance when used to treat men with localized prostate cancer.

For more information, consult the following online citation.
Tewari, A., Raman, J. D., Chang, P., and others. (2006, December). “Long-term survival probability in men with clinically localized prostate cancer treated either conservatively or with definitive treatment (radiotherapy or radical prostatectomy).” Urology, 68(6), 1268-1274.

Please remember that CPCN makes information such as this available in order to help men discuss treatment options with medical professionals. Doctors, oncologists, surgeons, and other members of your medical team are the trained experts who will help you toward the best treatments, given your particular circumstances.