Seeds vs. prostatectomy: Long- and short-term side effects differ slightly

For men with prostate cancer, radiation seed implants may yield a better short-term side effect profile than surgery, but surgery may offer slightly better long-term outcomes, new research from French radiation oncologists indicates. The results were published in the International Journal for Radiation Oncology*Biology*Physics (2007; 67:812-22).

This comparative study of 435 men with early-stage prostate cancer measured male quality of life, treatment-specific side effects, and cost of treatment based on the type of treatment used: prostate brachytherapy or radical prostatectomy. Men were surveyed before and immediately after treatment, as well as at designated follow-up periods. Data were obtained from 11 French hospitals.

The findings indicated that surgery produced more immediate and significant side effects post-treatment, but those side effects subsided and actually improved after 2 years. With brachytherapy, although patients saw consistently moderate side effects, the side effects persisted over time. For those who received surgery, urinary incontinence and impaired sexual function were common side effects. Urinary irritation was more common in those receiving brachytherapy.

Although brachytherapy may cost more initially, follow-up costs associated with surgery balance out the initial expense of brachytherapy, according to co-author Jean-Marc Cosset, MD, of the Institut Curie in Paris.