About Prostate Cancer
Comparison of Treatment Results and Side Effects
Making a decision about which prostate cancer treatment option to move forward with can be extremely confusing. There are a lot of treatment options available and it is sometimes hard to understand what the pros and cons of each are. The good news is, if you are focused on your biochemical disease free rate (PSA) suggesting return of cancer, or the chance you will not have cancer after your procedure is complete, most therapy options are pretty equal:
- HIFU (Focal Gland): 83%1
- HIFU (Full Gland): 83%2
- Radical Prostatectomy (Robotic): 80%3
- IMRT: 81%4
Most men however, are as equally worried about their level of quality of life after their prostate cancer procedure. They ask, “Will I regain the same erection and urinary function (continence control) I had before my procedure?” This is where the choice made on which prostate cancer treatment option to move forward with matters the most because there is such a wide range of incidence between them.
Impotence rates, or erectile disfunction, can range from the following:
- HIFU (Focal Gland): 11%1
- HIFU (Full Gland): 24%2
- Radical Prostatectomy: 87%5
- Radiation Therapy: 93.9%5
Incontinence rates, or urinary leakage, amongst the different treatment options can range from:
- HIFU (Focal Gland): 0%1
- HIFU (Full Gland): 0.6%6
- Radical Prostatectomy: 18.3%5
- Radiation Therapy: 9.4%5
Potential Side Effects of HIFU Treatment
Retained Prostate Tissue
All men with a total prostate ablation will be sent home with a supra-pubic catheter. After the treatment the patient may see sloughed whitish prostate tissue coming through the catheter. Sometimes all of the dead prostate tissue is not sloughed. If that is the case, the "trials of voiding" will be unsuccessful. To correct this problem your local urologist may have to scope you in order to scrape out the dead tissue.
Urethral Stricture or Bladder Neck Contracture
Sometimes because of the heating or destruction of any tissue the body may heal with a scar. Most people expect to see this scar on the outside if they have had surgery. Occasionally (1% to 3%) after the HIFU treatment some individuals will heal inside with either a scar at the bladder neck (contracture) or in the urinary passage (stricture). If this occurs it can usually be easily corrected by your local urologist by stretching (dilating) the narrowed areas easily under local anaesthetic.
Urinary Tract Infections
Whenever an instrument is placed in the bladder (catheter) there is a risk of introducing infection. The HIFU patient will be given antibiotics before the treatment and prescribed antibiotics after the treatment that should be started the day before the removal of the catheter. Both sets of antibiotics are given to prevent the development of a urinary tract infection.
If at anytime after the treatment the patient develops fever, chills, significant burning when voiding or persistent blood in the urine, he should speak to his local urologist or physician.
All prostate cancer treatment options and potential outcomes and complications should be discussed with the specialist who will be delivering the treatment.
- Ahmed, HU. (2012). The Lancet Oncology. Focal Therapy for Localized Unifocal and Multifocal Prostate Cancer: A Prospective Development Study, 2045(12), 70121-3.
- Uchida, T. (2012). 11th International Symposium on Therapeutic Ultrasound. AIP Conf. Proc. Twelve Years’ Experience with High-Intensity Focused Ultrasound (HIFU) Using Sonablate Devices for the Treatment of Localized Prostate Cancer. 1481, 401-406.
- Novara, G. (2012). European Urology. Systematic Review and Meta-analysis of Studies Reporting Oncologic Outcome After Robot-assisted radical8Prostatectomy. 62, 382-404.
- Alicikus, Z. (2011). Cancer. Ten-Year Outcomes of High-Dose Intensity-Modulated Radiotherapy for Localized Prostate Cancer. 1429-1437.
- Resnick, M. (2013). The New England Journal of Medicine. Long-Term Functional Outcomes after Treatment for Localized Prostate Cancer. 368, 436-45.
- Ahmed, HU. (2009). BJC. High-intensity-focused ultrasound in the treatment of primary prostate cancer: the first UK series, 101, 19-26.