Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer

The choice of treatment for PSA-detected, localized prostate cancer is influenced by effects of the interventions on quality of life. In the ProtecT trial, patterns of side-effect severity, improvement, and decline in urinary, sexual, and bowel function differed among the treatments. As reported in a companion article in the Journal, the U.K. National Institute for Health Research–supported Prostate Testing for Cancer and Treatment (ProtecT) trial has shown no significant difference in prostate-cancer–specific mortality or all-cause mortality among men with prostate cancer detected by prostate-specific antigen (PSA) testing who were randomly assigned to radical prostatectomy, active monitoring (a surveillance strategy), or radical conformal radiotherapy with neoadjuvant hormonal therapy, at a median of 10 years of follow-up; however, the ProtecT trial has shown higher rates of metastases and disease progression among men in the active-monitoring group than among men in the radical-treatment groups. . . .