Prostatectomy improves urinary tract symptoms in men with prostate cancer

In addition to malignancy control, radical prostatectomy can improve urinary tract symptoms in men with prostate cancer-if they have moderate to severe symptoms before surgery, recent research shows. In contrast, other treatments, such as brachytherapy and radiotherapy, may actually worsen symptoms.

In agreement with a report released earlier this month, the current findings suggest that when survival outcomes are similar, quality of life issues become paramount in selecting one prostate cancer therapy over another (see Reuters Health report April 21, 2004).The results are based on a study of 50 men who presented with lower urinary tract symptoms and were later found to have clinically localized prostate cancer. All of the patients underwent radical retropubic prostatectomy. A variety of objective and subjective measures of urinary function were evaluated before and after surgery.Dr. V. Kumar, from the Royal Hallamshire Hospital in Sheffield, UK, and colleagues report their findings in the March issue of BJU International. Surgery was associated with significant improvements in the total International Prostate Symptom Score, mean peak flow rate, post-void residual volume, and symptom-associated quality of life in men with moderate to severe symptoms (p < 0.05 for all). In contrast, in men with mild symptoms, no significant changes in any of these parameters were observed. At 6-month follow-up, 39 men were completely continent, 10 had mild leakage, but required no pads, and 1 patient required pads during heavy physical exertion."This study confirms that radical prostatectomy provides major benefits beyond cancer control in men with pre-existing bothersome lower urinary tract symptoms," the authors state. "This is important in counseling patients about treatment options for clinically localized prostate cancer."(Source: BJU Int 2004;93:507-509: Reuters Health: Oncolink: April 2004)