Current evidence-based best practices recommend an active surveillance (AS) protocol for men with low-risk prostate cancer (LRPC).
We evaluated quality of life (QOL) at baseline and at 2 years after diagnosis among men with LRPC in a prospective, population-based cohort of 1049 Black and White men from 2 cancer registries (metropolitan Detroit and Georgia). General and prostate cancer-specific QOL domains were assessed using the Short Form-12 and Expanded Prostate Cancer Index Composite-26 scales at baseline and 2-year follow-up. We compared changes in QOL between men who remained on AS and men who underwent curative treatment, overall and stratified by race.
At 2-year follow-up, 475 (45%) men underwent curative treatment with surgery or radiation and 574 (55%) remained on AS. At baseline, there were no meaningful differences in quality-of-life measures between men selecting curative treatment vs AS. At 2-year follow-up, men who underwent curative treatment reported significant declines in sexual function and urinary incontinence; men who remained on AS reported minimal to no decline in these domains (-27.6 vs -4.9 P < .001 for sexual function and -12.6 vs -0.4 P < .001 for urinary incontinence). QOL patterns were similar by race.
In a contemporary, diverse cohort, men who underwent curative treatment of LRPC had worse urinary and sexual function compared with men who remained on AS. These quality-of-life differences should inform the patient-physician treatment planning discussions for LRPC.
Urology practice. 2025 Feb 21 [Epub ahead of print]
Cathryn H Bock, Emma L Streveler, James Janisse, Justin Woo, Rami Yacoub, Kevin B Ginsburg, Michael Goodman, Jinping Xu
Department of Oncology and Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan., Wayne State University School of Medicine, Detroit, Michigan., Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan., Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia., Wayne State University School of Medicine, Department of Urology and Karmanos Cancer Institute, Detroit, Michigan.