Quality of life by maintaining continence
It was shown that incontinence and urinary retention have the greatest influence on the quality of life of those affected. Urinary tract complications are one of the problems most feared by patients with prostate cancer after treatment,"says Dr. Stephan Neubauer from the West German Prostate Center in Cologne. Not without reason, as clearly demonstrated by an examination of the health insurance fund Barmer GEK1. For example, 16 percent of patients who have had their prostate removed during surgery can no longer hold the urine and are dependent on templates.
Several studies have already impressively demonstrated that incontinence and urinary retention occur more frequently after prostate surgery than after brachytherapy. The scientists investigated side effects and quality of life in 580 patients whose prostate cancer was treated either by radical prostate removal, external radiotherapy or brachytherapy. In addition to standardised tests to record side effects, they also used techniques from game theory to analyse the quality of life and satisfaction of the patients surveyed. For example, the so-called "time-trade-off" test showed that patients who underwent surgery would trade in five percent of their remaining lifetimes if they no longer had to endure the side effects of the treatment. After brachytherapy, on the other hand, the number of people who would be willing to reduce the lifespan was significantly lower.
Urinary tract complications are perceived as very stressful
The study was also able to show that incontinence and urinary retention in particular severely impair the quality of life of those affected. This makes it all the more important to inform patients in advance about the side effects of the various treatment options,"said Dr. Neubauer. "Especially since many men with prostate cancer still undergo unnecessary surgery." According to the recommendation of the guidelines, for example, in men with a low risk prostate carcinoma, it can often be sufficient to closely monitor the tumor (Active Surveillance). If treatment should nevertheless become necessary, however, it is important to focus more intensely on achieving optimal healing rates with minimal side effects," summarizes the urologist from Cologne.
Barmer GEK Hospital Report 2012
Ferrer M., Estimating preferences for treatments in patients with localized prostate cancer, EAU, Madrid, 2015