Quality of life outcomes following treatment for localized prostate cancer: is there a clear winner?

Objective: The majority of men treated for localized prostate cancer are cured of their disease. As a result, it is important to discuss long-term quality of life (QoL) expectations when counseling patients regarding treatment options. The varying QoL outcomes for radical prostatectomy, external beam radiotherapy, brachytherapy, and cryotherapy will be reviewed.

Results: Robotic and radical prostatectomy has similar outcomes with significant initial worsening of urinary continence and sexual function. External beam radiation has less impact on continence and sexual function but noteworthy bowel toxicity. Brachytherapy results in the most irritative urinary symptoms, with decreased sexual and bowel QoL as well. Cryotherapy greatly reduces sexual function.

Conclusions: Every patient has unique pretreatment variables, priorities, and preferences. It is crucial to fully explain the range of oncologic and QoL implications when counseling patients regarding treatment for localized prostate cancer.