Comparing Treatments
How Do Prostate Cancer Treatments Compare?
There have been no randomized trials comparing the various treatments for prostate cancer. If there is a high probability of Organ Confined Disease, and assuming that general health is very good, local therapy can be considered in hopes of curing the disease.
Men who are in the Low-Risk Category can forgo immediate treatment and simply monitor their situation in a program called Active Surveillance. This consists of regular PSA testing, prostate exams and periodic repeat biopsies.
Men with Intermediate-Risk disease usually start with one kind of treatment, local or systemic. Men with High-Risk prostate cancer generally get two or more kinds of treatment. For instance, the doctor might use testosterone deprivation and radiation.
Regardless of treatment selection, Finding an Expert raises the probability of a good result.
Lower urinary tract symptoms (LUTS) with AUA score of 10 or higher increases morbidity following seeds, EBRT, IMRT, HDR and Cryo. Gland volume of greater than 40 cc may increase risk of urinary symptoms post-radiation therapy (any kind of RT) as well as same problem with cryosurgery.
See the discussion of BPH under Prostate Basics
You can develop a basis for comparing treatments by reviewing the resources below:
PCRI Resources:
- Newly-Diagnosed – the Very Basics
- Newly Diagnosed Prostate Cancer: Evaluating the Options (Part 2)
- Treatment Choices for Early (Localized) Prostate Cancer
- How to Pick the Best Treatment for Prostate Cancer
- Which PC Therapy Has the Best Long Term PSA Control? PDF
You will also find detail articles on each treatment on the PCRI Papers webpage.
Related Resources:
- At the PCRI National Conference in September 2009, Dr John Blasko presented a review by the “Prostate Cancer Results, Study Group” comparing published “freedom from recurrence rates” for surgery, brachytherapy and external radiation.
- Another extensive treatment comparison is found in the AUA Guideline for the Management of Clinically Localized Prostate Cancer: 2007 Update. You should take note of the complications reported in Figures 3-5.
- Is there an optimal management for localized prostate cancer? {Clin Interv Aging. 2010; 5: 187–197 – Singh, et al}
These articles provide patient evaluations of the impact on quality of life by radical prostatectomy, external radiation and brachytherapy.
- Quality of life and satisfaction with outcome among prostate-cancer survivors. {N Engl J Med. 2008 Mar 20;358(12):1250-61 – Sanda MG et al}
- Quality of life after surgery, external beam irradiation, or brachytherapy for early-stage prostate cancer. {Cancer. 2007 Jun 1;109(11):2239-47 – Litwin MS, et al}
Page updated 8/1/11
