Quality of life outcomes after brachytherapy for early stage prostate cancer

Purpose: We compare general and disease specific health related quality of life in men undergoing brachytherapy for early stage prostate cancer to tho se undergoing radical prostatectomy and age matched healthy controls. Materials and Methods: Cohorts consisted of 48 men treated with brachythera py with and without pretreatment external beam radiation therapy (brachythe rapy group), 74 who underwent radical prostatectomy (prostatectomy group) a nd age matched healthy controls from the literature. The RAND 36-item gener al health survey, University of California Los Angeles Prostate Cancer Inde x, American Urological Association symptom index, validated Cancer Interfer ence with Life and Family Scales, and sociodemographic and co-morbidity que stionnaires were completed 3 to 17 months after treatment. Results: General health related quality of life did not differ greatly amon g the 3 groups. Urinary function (leakage) was worse in the brachytherapy g roup than in controls but better than in the prostatectomy group. Brachythe rapy group patients had more irritative urinary symptoms and worse bowel fu nction than controls. Sexual function and bother were worse in prostatectom y and brachytherapy groups than in healthy controls. Physical function, bod ily pain, urinary function, and bother and American Urological Association symptom index scores improved with time after brachytherapy. Patients who u nderwent brachytherapy after external beam radiation performed worse in all general and disease specific health related quality of life domains compar ed to those who did not undergo pretreatment radiation therapy, Conclusions: At an average of 7.5 months after treatment the general health related quality of life of patients undergoing brachytherapy with and with out: pretreatment external beam radiation was similar to age matched contro ls, although urinary, bowel and sexual problems were reported. These proble ms appeared to improve during the first year after treatment. Much of the i mpairment in disease specific health related quality of life among patients undergoing brachytherapy may be attributed to pretreatment radiation.