Cystoprostatectomy provides effective palliation for prostate cancer

Radical cystoprostatectomy is an effective means of palliation of the debilitating symptoms brought on by prostate cancer invasion into the bladder, according to a new report.

Symptoms of invasion of the bladder include urinary urgency, pelvic pain and hematuria, which occasionally can become life threatening, Dr. Louis L. Pisters of the University of Texas M.D. Anderson Cancer Center, Houston and colleagues note in the December issue of the Journal of Urology.There are few reports on whether cystoprostatectomy can help relieve these symptoms, which reduce the quality of life. To investigate, the Dr. Pisters’ team evaluated the effect of the procedure in 38 patients with clinical T4 prostate cancer.Before surgery, 34 of the patients reported local symptoms, while after cystoprostatectomy only 8 patients had local symptoms. Ultimately, the surgery rendered 30 of the patients free of local symptoms indefinitely.Following cystoprostatectomy, the median time to biochemical progression was 8 months. For metastasis, the corresponding interval was 18 months and for systemic symptoms, it was 26 months. The median disease-specific survival was 31 months.There were no perioperative deaths. However, five patients suffered rectal injury, which was more common with patients who had radiation therapy. Approximately one in five patients required repeat surgery to correct problems brought about by the primary procedure.Nevertheless, most of the patients had durable disease control and the researchers conclude that “the symptomatic benefit achieved in well-selected patients outweighs the risks and morbidity associated with palliative cystoprostatectomy.”(Source: J Urol 2005;174:2186-2190: Reuters Health: Oncolink: December 2005.)