Many men with a tumor localized in the prostate gland and not forming metastases are being treated for surgery as a first-line therapy. Although radiotherapy has the same effect as surgery, and is accompanied by a lower frequency of occurrence of enuresis and impotence. In this regard, at the annual conference of the German Society for Radio-Oncology (DEGRO), it was discussed how the effect of modern radiation therapy, both first-line therapy, and for patients and treating doctors, can be reinforced by the working group of the scientific medical community.
Annually in Germany, about 63,000 men are diagnosed with prostate cancer. Not only the disease is appalling for patients, many patients find it difficult to make a quick decision in the choice of treatment.
In patients with early stages of the disease, not accompanied by metastases, there is a choice between surgery, radiation therapy and “waiting” under regular supervision (“active follow-up”: active therapy begins when the tumor begins to grow). The attending doctor advises patients and explains the advantages and disadvantages of all treatment methods that are considered to be equivalent from a medical point of view.
In Germany, most of the patients decide to undergo surgical intervention, which is not related to the insufficiently comprehensive explanation of the doctor, but, first, due to the psychological factor – the patient gets trusted by the doctor, whom he knows for several years, who acquainted him with the diagnosis and discusses with him possible ways of performing the therapy – and most likely, that the patient chooses that form of therapy that this doctor can conduct himself. “This must be the reason why radiotherapy, like first-line therapy for prostate cancer, is not represented, although it shows the same positive results and is accompanied by fewer side effects and consequences than surgery, as recently the ProtecT study showed.
In the ProtecT study, 1.643 patients were included and randomized. Ten years later, it turned out that early intervention (surgery or radiation therapy) to prevent the development of the disease and metastatic spreading was for the benefit of patients. Regarding the effectiveness between surgery and radiotherapy, there is no significant difference, but the operation is fraught with a strong disorder of the genitourinary system. Six years later, 17% of the patients undergoing surgery still suffered from incontinence (compared with 4% of patients undergoing radiation therapy), 22% did not get an erection (compared to 12% of patients who underwent radiation therapy). Both enuresis and impotence are consequences of treatment that can harm the quality of life of patients and occur to a much lesser degree after radiation therapy. It is necessary to discuss with patients the emerging side effects on the intestine, more often associated with irradiation.
Study: radiation therapy has the same effect
Therefore, Professor Dr. Stephanie E. Combs, authorized person for public relations of the German Society for Radio-Oncology (DEGRO), sees the need to inform the public about the radiation treatment of cancer. “Radiation therapy, like the first-line therapy of tumors localized on the prostate that does not form a metastasis, is underestimated. Very few patients know that it is effective as surgery, but is accompanied by less complications”.
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