A recent study conducted by researchers at Vanderbilt University Medical Center has shed light on the varying long-term side effects experienced by men with prostate cancer, depending on their chosen treatment. The findings of this study provide crucial information that can help men and their healthcare teams make more informed decisions regarding their treatment options.

Prostate cancer, the most common cancer among men in the United States, usually has a favorable prognosis. Survival rates indicate that most men diagnosed with prostate cancer will still be alive 15 years after their initial diagnosis. With numerous treatment choices available for men whose cancer remains confined to the prostate, considering the potential long-term side effects becomes paramount.

The side effects associated with prostate cancer treatments can include bladder and bowel problems, as well as difficulties with sexual functioning. Factors such as the risk of cancer spreading beyond the prostate gland influence the choice of treatment. In low-risk cases, surgical removal of the entire prostate or radiation therapy are common options. Alternatively, some men may opt for active surveillance, closely monitoring the cancer's growth and only initiating treatment if necessary. For higher-risk cases, surgery or a combination of radiation therapy and hormone-suppressing therapy are typically recommended.

While previous studies have shown that survival rates remain similar regardless of treatment choice, the extent to which long-term side effects differ among these treatments has remained unclear. To address this discrepancy, Drs. Bashir Al Hussein Al Awamlh and Daniel Barocas, alongside their research team, undertook a comprehensive study. Nearly 2,500 men, aged 80 or younger and representing diverse racial backgrounds, were recruited from various regions across the country. These men had all received treatment for prostate cancer between 2011 and 2012, and were followed for a period of 10 years after treatment to track their side effects.

The study, partly funded by the National Institutes of Health (NIH), revealed that survival rates were similar across the two groups, regardless of the treatment received. Out of the participants, 0.4% of men with low-risk cancer and 5% of men with high-risk cancer succumbed to the disease over the subsequent 10 years.

Overall, men reported similar levels of physical and mental health regardless of their treatment choice. However, the researchers observed notable differences in specific side effects among the treatments. Men with low-risk cancer who underwent surgery were more likely to report problems with sexual functioning during the first five years following treatment, compared to those who had radiation therapy or chose active surveillance. Interestingly, significant differences between the groups diminished by the 10-year mark.

Regarding urinary issues, 14% of men who had surgery for low-risk cancer experienced problems with leaking urine after 10 years, compared to 4% of those who received radiation therapy and 10% of men who initially chose active surveillance. On the other hand, the study found that 8% of men who had radiation therapy reported serious bowel problems after a decade, compared to 3% of those who underwent surgery.

For men with high-risk cancer, there were no noticeable differences in sexual functioning between those who underwent surgery and those who received radiation therapy along with hormone therapy. However, a quarter of men who had surgery reported urinary leakage after 10 years, compared to 11% of those who received radiation therapy. Additionally, 7% of men who had radiation therapy combined with hormone therapy reported serious bowel problems, compared to 2% to 5% of men who opted for surgery.

Dr. Al Hussein Al Awamlh emphasizes the significance of these findings, stating, "Many men with localized prostate cancer survive for 15 years or more, with minimal differences in survival among various treatment strategies." He further emphasizes that considering the adverse effects of treatments becomes crucial when making treatment choices, given the similar long-term survival rates.

Understanding the disparities in long-term side effects among different methods of prostate cancer treatment allows men and their healthcare providers to have more informed discussions regarding the overall impact on their quality of life. Ultimately, this study contributes valuable knowledge to improve the decision-making process for prostate cancer treatment.