Prostate cancer-specific mortality was low for patients presenting with clinically localized prostate cancer irrespective of the treatment assigned, with no significant difference among treatments, while patient-reported outcomes after treatment revealed patterns of severity, recovery, and decline in urinary, bowel, and sexual function and associated quality of life that differed among the 3 groups. This according to separate but related studies that compared 10-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer as well as patient-reported outcomes. Researchers found:

• At median of 10 years, there was no significant difference in prostate cancer mortailtiy among treatments.
• At median of 10 years, surgery and radiotherapy were associated with lower incidences of disease progression and metastases than was active monitoring.
• Metastases developed in more men in the active-monitoring group (6.3 events per 1,000 person-years) than in the surgery group (2.4 per 1,000 person-years) or the radiotherapy group (3.0 per 1,000 person-years; p=0.004 for the overall comparison).
• In patient-reported outcomes, prostatectomy had the greatest negative effect of the 3 treatments on sexual function and urinary continence.
• The rate of use of absorbent pads increased from 1% at baseline to 46% at 6 months in the prostatectomy group, as compared with 4% at 6 months in the active-monitoring group and 5% at 6 months in the radiotherapy group.
• At baseline, 67% of men reported erections firm enough for intercourse, but by 6 months this rate fell to 52% in the active-monitoring group, to 22% in the radiotherapy group, and to 12% in the prostatectomy group.
• No significant differences were reported among the groups in measures of anxiety, depression, or general health-related or cancer-related quality of life.