Exploration unveils post-treatment consequences for prostate cancer patients in men
A diagnosis of prostate cancer affects one in eight men in their lifetime, necessitating a choice of treatment that often involves limited information regarding long-term effects on sexual and overall health. A decade-long study coordinated by Vanderbilt University Medical Center (VUMC) aims to empower men with prostate cancer, especially those with a favorable prognosis, to make informed decisions about their treatment options and the potential side effects.
The study, which is part of the CEASAR (Comparative Effectiveness Analysis of Surgery and Radiation for Localized Prostate Cancer) research, recently concluded its follow-up on 2,500 men diagnosed with localized prostate cancer between 2011 and 2012. These men were categorized into favorable and unfavorable prognosis groups.
Men with a favorable prognosis have several treatment options, including:
- Active Surveillance: where the tumor is closely monitored, with treatment initiated later if necessary. This is also known as watchful waiting.
- Nerve-sparing prostatectomy: a surgical procedure used when the prostate is removed, with the nerves involved in erectile function left undamaged to maintain sexual function.
- External beam radiation therapy (EBRT): an approach that uses daily radiation to eliminate cancer cells.
- Low-dose-rate brachytherapy: utilizes the implantation of radioactive seeds in the prostate instead of daily treatment.
According to the study's findings, men who opted for a prostatectomy experienced worse sexual function three to five years post-procedure compared to those who chose other treatments. Additionally, men who had a prostatectomy were more likely to experience urinary issues, with a quarter reporting "leakage" up to ten years after the procedure. This is noteworthy considering that only 4-11% of men who chose EBRT instead of prostatectomy experienced similar issues.
Men with an unfavorable prognosis generally have fewer treatment options, with prostatectomy and EBRT plus androgen-deprivation therapy (ADT) being the main alternatives. While surgery caused urinary issues, researchers observed that the combination of EBRT and ADT led to worse outcomes for bowel and hormonal issues at the ten-year post-treatment mark. Sadly, ADT also elevates the risk of Alzheimer's and dementia. Notably, no differences in sexual function were observed among unfavorable prognosis patients, regardless of whether they underwent a prostatectomy or received EBRT/ADT.
Dr. Daniel Barocas, the study's senior author and professor at VUMC, emphasizes the importance of counseling men with an unfavorable prognosis differently than those with a favorable prognosis, focusing on the expected long-term functional outcomes. Researchers plan to develop a personalized prediction tool using their findings, offering functional estimates for ten years based on different treatment strategies, to aid patients in making informed decisions.
Outside of conventional medical treatments, maintaining a prostate-friendly lifestyle may contribute positively to the battle against prostate cancer. This includes following the Prostate Diet, staying active, consuming green tea, and eating cruciferous vegetables. Cruciferous vegetables, such as broccoli, kale, and Brussels sprouts, contain phytochemicals like DIM and I3C, which have been shown effective in inhibiting prostate cancer cell growth and inducing cell suicide while not affecting healthy cells.
- The decade-long study, focusing on men with prostate cancer, especially those with a favorable prognosis, has revealed that men who opted for a prostatectomy, a surgical procedure, experienced worse sexual function three to five years post-procedure compared to those who chose other treatments like active surveillance, nerve-sparing prostatectomy, external beam radiation therapy (EBRT), or low-dose-rate brachytherapy, contributing to the health-and-wellness discourse in men's health.
- In the context of health-and-wellness and medical-conditions like prostate cancer, maintaining a prostate-friendly lifestyle, including following the Prostate Diet, staying active, consuming green tea, and eating cruciferous vegetables, may potentially contribute positively to the battle against prostate cancer, given that cruciferous vegetables contain phytochemicals like DIM and I3C, which have been shown effective in inhibiting prostate cancer cell growth and inducing cell suicide while not affecting healthy cells, making them an essential aspect of science and health-and-wellness.
