Treatment options and health related quality of life concerns for men with prostate cancer: a systematic review of the literature

Abstract

Prostate cancer is the second leading cause of cancer death for American men. The treatment of prostate cancer has changed dramatically with the widespread availability of prostate specific antigen screening (PSA). With this widespread PSA screening, early detection of prostate cancer is forcing more men to weigh the difficult treatment options. Men may live many years with the disadvantages of the treatments they receive; therefore it is vital they are well informed about the treatment and management options as well as the associated side effects.

Methodology: The purpose of this systematic literature review is to evaluate the treatment options for men diagnosed with prostate cancer and determine if there is a significant difference in mortality and morbidity between each treatment option.

Results Twenty articles were reviewed using evidence based methods. Little difference was noted in mortality between treatments, except following external beam radiation. Erectile dysfunction was most significant following radical prostatectomy. Urinary symptoms and bother was mostly associated with cryotherapy, external beam radiation and brachytherapy. Complications with bowel function were identified following radiation therapies and cryotherapy.

Conclusions: It is clear that no one treatment is best for every patient. Treatments chosen should be based on age, stage of disease, and co-morbidities. The health related quality of life concerns vary with each treatment, although urinary and bowel function typically improves over time. Erectile dysfunction is common following radical prostatectomy, but nerve sparing improvements in procedures are being developed.