A recent study led by Drs. Bashir Al Hussein Al Awamlh and Daniel Barocas from Vanderbilt University Medical Center sheds light on the long-term side effects of various treatments for prostate cancer.
Prostate cancer, the most common cancer in men in the United States, often carries a favorable prognosis, with most individuals expected to live 15 years post-diagnosis.
The study, published in JAMA on January 23, 2024, included nearly 2,500 men, aged 80 or younger, from diverse backgrounds across the country. These men were treated for prostate cancer between 2011-2012, and their side effects were tracked for a decade after treatment, offering valuable insights for informed decision-making.
For men with localized prostate cancer, treatment options include surgery to remove the prostate, radiation therapy, or active surveillance with delayed intervention if necessary. The study aimed to uncover whether the long-term side effects varied significantly among these treatment choices.
Survival rates were found to be similar between the groups, regardless of the chosen treatment. Over the following decade, only 0.4% of men with low-risk cancer and 5% of men with high-risk cancer died from the disease. However, the study did highlight differences in specific side effects between treatments.
In cases of low-risk cancer, men who underwent surgery were more likely to report sexual functioning problems up to 5 years post-treatment compared to those who had radiation or chose active surveillance. However, these differences became non-significant by the 10-year mark. Surgery also correlated with a higher incidence of urinary leakage after 10 years compared to radiation or active surveillance.
Among men with high-risk cancer, there were no significant differences in sexual functioning between surgery and radiation therapy plus hormone therapy. However, surgery was associated with a higher incidence of urinary leakage, while radiation plus hormone therapy correlated with an increased risk of serious bowel problems.
Dr. Al Hussein Al Awamlh emphasized, "Given this long-time horizon and similar survival rates, the choice of treatment for patients may be influenced by the adverse effects of the treatments." The findings provide valuable insights for patients and healthcare professionals in tailoring prostate cancer treatment plans that consider both survival outcomes and potential long-term side effects.