Urinary, bowel, sexual function, and quality of life among men with localized prostate cancer may vary depending on treatment with monitoring, surgery, or radiotherapy, according to a study published in The New England Journal of Medicine.1

Through the Prostate Testing for Cancer and Treatment (ProtecT) Trial, researchers examined patient-reported outcomes of 1643 men who had completed questionnaires before diagnosis, at 6 and 12 months after randomization, and then annually after the first 12 months. At 5 years, the researchers assessed for cancer-related quality of life.

Questionnaire completion upon follow-up was higher than 85% for most observed measures.

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Prostatectomy had the greatest negative effect on sexual function and urinary continence, which remained worse among the 3 groups throughout the trial.

Radiotherapy had a negative effect on sexual function, which was greatest at 6 months, although it recovered soon after and remained stable. Little effect on urinary continence with radiotherapy was observed; bowel function was, however, worse at 6 months.

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Among patients treated with active monitoring, sexual and urinary function gradually declined.

Quality of life among patients reflected the reported changes in function, with no significant differences observed among the groups in measures of anxiety, depression, or general health- or cancer-related quality of life.


  1. Donovan JL, Hamdy FC, Lane JA, et al. Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer. N Engl J Med.  2016 Sep 14. doi: 10.1056/NEJMoa1606221 [Epub ahead of print]