Quality of life among elderly men treated for prostate cancer with either radical prostatectomy or external beam radiation therapy

Purpose: We evaluated the changes of health-related quality of life (HRQOL) during the first 2 years after radical prostatectomy (RP) or external beam radiation therapy (EBRT) in elderly men (70 years old or older) treated for prostate cancer. Patients and methods: Between 2002 and 2005, a total of 319 elderly men who underwent RP or EBRT participated in our study. Patients completed the general and disease-specific HRQOL with the Short Form-36 (SF-36) and University of California, Los Angeles Prostate Cancer Index, respectively. The participants were asked to complete the questionnaire before and 3, 6, 12, 18 and 24 months after treatment. Results: The RP group was younger and had more favorable tumor characteristics than the EBRT group. When compared with the EBRT group, the RP group had higher scores for several SF-36 subscales and sexual function, whereas other domains were comparable. In the EBRT group, there were no significant differences in the general HRQOL scores between the baseline and any of the observation periods. The RP group had a significantly worse urinary function and bother scores postoperatively than the EBRT group. The score for sexual function declined over the 24 months, but more so in the RP group. Similarly, sexual bother scores were significantly lower at each postoperative time point for the RP group. Conclusions: Both aggressive treatments can offer satisfactory functional outcomes from the perspective of HRQOL for selected elderly subjects with localized prostate cancer.