Quality-of-life outcomes for men treated with cryosurgery for localized prostate carcinoma

BACKGROUND. Cryosurgery was introduced as an alternative to radiotherapy or radical prostatectomy in the mid-1960s. Although it met the primary object ive of achieving local control, it was largely abandoned due to a high inci dence of complications. Technologic advances in the areas of imaging and ur ethral warming have renewed interest in this treatment methodology. The aim of the current study was to determine the quality of life of men enrolled in a Phase II clinical trial of cryosurgery for the treatment of localized prostate carcinoma. METHODS, Men were administered the Functional Assessment of Cancer Treatmen t-Prostate (FACT-P) prior to their treatment and at 6 weeks and 3, 6, and 1 2 months posttreatment. RESULTS. By 12 months after cryosurgery, most of the FACT-P subscales had r eturned to pretreatment levels, following a decline in well-being immediate ly after cryosurgery. There were two exceptions to this general trend: At 1 2 months, impairments in social/family veil-being and sexual function still remained. The average time to return to work after therapy was 3 weeks. St ay in hospital after treatment was limited to 1 day for 94% of the particip ants. Compared with men who received the Standard treatments of radical pro statectomy and radical radiotherapy, men treated with cryosurgery appeared to have a similar quality of life, with perhaps the exception of decreased sexual function. CONCLUSIONS, The quality-of-life outcomes of this study support the current renewed interest in cryosurgery. The severe impairments reported in other studies were not seen in this sample. In fact, it appeared that all aspects of the participants' well-being had returned to pretreatment levels by 12 months, with the exception of sexual function. (C) 1999 American Cancer Soc iety.