Treatment Comparison Chart
|
Treatment |
Description
|
Selected Risks |
Recovery |
Selected Outcomes |
|
HIFU (high intensity focused ultrasound)
|
Minimally invasive use of intersecting, precision-focused ultrasound waves to ablate diseased tissue |
In approved countries Incontinence: 0 – 2% Impotence: 20 – 30% |
Temporary catheter worn for approximately 2-3 weeks; resume normal lifestyle almost immediately |
94% biochemical disease-free survival rate at 4 years; 87% negative biopsy rate at 6 months |
|
Cryotherapy |
Minimally invasive procedure using controlled freeze and thaw cycles to destroy cancerous cells |
Incontinence: 4 – 27% Impotence: 40 – 100% |
2-3 hour procedure with possible overnight stay; return to normal activities within a few days |
78% biochemical disease-free survival at 1 year; 60% at 5–7 years; 88% negative biopsy rate at 5 years |
|
Radical Prostatectomy |
Major surgery to remove prostate; can be open retropubic, or laparoscopic or robotic |
Incontinence: 4 - 34% Impotence: 51 – 80% |
2-3 day hospital stay; catheter for 2-3 weeks for open surgery; shorter hospitalization and fewer postoperative complications for robotic procedures |
85–91% biochemical disease-free survival at 2 years; 68–72% biochemical disease-free survival at 10 years |
|
External Beam Radiation |
6 to 8 week treatment, beaming radiation through healthy tissues |
Incontinence: 4 – 7% Impotence: 41 – 62 % Bowel problems more common than with other treatments |
Five treatments per week for 6 to 8 weeks; up to 2 months fatigue after full course of treatment |
78% survival rate at 5 years; 55–65% biochemical disease-free survival at 5 years; 49% at 10 years |
|
Internal Radiation Seeds (brachytherapy) |
Minimally invasive implants of radiation seeds in the prostate |
Incontinence: 3 – 18% Impotence: 44 – 58% |
1-2 hour procedure with possible overnight stay; return to normal activities within a few days |
85–91% biochemical disease-free survival at 10–12 years |
Data presented are for clinically localized, low-risk primary prostate cancer, generally defined as PSA ≤10
ng/mL, Gleason score ≤6, clinical stage T1 or T2a.
Chart was researched and compiled by Synteract, a third party CRO. The information provided in the chart may not include all potential risk, recovery and outcome information. For further details a complete list of references is provided below.
General references
Thompson I, Thrasher JB, Aus G et al. Guideline for the Management of Clinically Localized Prostate Cancer: 2007 Update. J Urol 177:2106-2131, 2007
Prostate Cancer Treatment Guide™ http://www.prostate-cancer.com/
Prostate Cancer Treatments, Prostate Cancer Institute Online
http://www.prostate-cancer-institute.org/prostate-cancer-treatment/prostate-cancer-treatment.html
HIFU
Uchida T, Ohkusa H, Yamashita H et al. Five years experience of transrectal high-intensity focused ultrasound using the Sonablate device in the treatment of localized prostate cancer. Intl J Urol 13:228-233, 2006
Uchida T, Ohkusa H, Nagata Y et al. Treatment of localized prostate cancer using high-intensity focused ultrasound. BJU Int 97:56-61, 2005
Cryosurgery
Cooperberg M, Carroll P, Shinohara K. Prostate Cancer: Cryotherapy. http://www.emedicine.com/med/TOPIC3539.HTM
Mouraviev V and Polascik TJ. Update on cryotherapy for prostate cancer in 2006. Current Opinion Urol 16:152-156, 2006
Bahn DK, Lee F, Badalament R et al. Targeted cryoablation of the prostate: 7-year outcomes in the primary treatment of prostate cancer. Urology 60 (Suppl 2A):3-11, 2002
Han KR, Cohen JK, Miller RJ et al. Treatment of organ confined prostate cancer with third generation cryosurgery: preliminary multicenter experience. J Urol 170:1126-1130, 2003
Long JP, Bahn D, Lee F et al. Five-year retrospective, multi-institutional pooled analysis of cancer-related outcomes after cryosurgical ablation of the prostate. Urology 57:518-523
Lam JS, Shvarts O and Belldegrun AS. Cryotherapy for PCa: the next generation. Contemporary Urol 16:2-12, 2004
Radical Prostatectomy
Han M, Partin AW, Zahurak M et al.: Biochemical (prostate specific antigen) recurrence probability following radical prostatectomy for clinically localized prostate cancer. J Urol 169: 517-523, 2003
Madalinska JB, Essink-Bot M-L, de Koning HJ et al. Health-related Quality-of-Life effects of radical prostatectomy and primary radiotherapy for screen-detected or clinically diagnosed localized prostate cancer. J Clin Oncol 19:1619-1628, 2001.
Potosky AL, Davis WW, Hoffman RM et al.: Five-year outcomes after prostatectomy or radiotherapy for prostate cancer: the Prostate Cancer Outcomes Study. J Natl Cancer Inst 96(18):1358-1367, 2004
Roehl KA, Han M, Ramos CG et al.: Cancer progression and survival rates following anatomical radical retropubic prostatectomy in 3,478 consecutive patients: long-term results. J Urol 172:910-914, 2004
Ung JO, Richie JP, Chen M-H et al.: Evolution of the presentation and pathologic and biochemical outcomes after radical prostatectomy for patients with clinically localized prostate cancer diagnosed during the PSA era. Urology 60:458-463, 2002
Catalona WJ, Basler JW: Return of erections and urinary continence following nerve sparing radical retropubic prostatectomy. J Urol 150 (3): 905-7, 1993.
External Beam Radiation Therapy
Madalinska JB, Essink-Bot M-L, de Koning HJ et al. Health-related Quality-of-Life effects of radical prostatectomy and primary radiotherapy for screen-detected or clinically diagnosed localized prostate cancer. J Clin Oncol 19:1619-1628, 2001.
Potosky AL, Legler J, Albertsen PC et al. Health outcomes after prostatectomy or radiotherapy for prostate cancer: results from the Prostate Cancer Outcomes Study. J Natl Cancer Inst 92:1582-1592, 2000.
Rosser CJ, Chichakli R, Levy LB et al. Biochemical disease-free survival in men younger than 60 years with prostate cancer treated with external beam radiation. J Urol 168:536-541, 2002.
Zietman AL, Chung CS, Cohen JJ et al. 10-Year outcome for men with localized prostate cancer treated with external radiation therapy: results of a cohort study. J Urol 171:210-214, 2004.
Brachytherapy
Grimm PD, Blasko JC, Sylvester JE et al. 10-Year biochemical (prostate-specific antigen) control of prostate cancer with 125I brachytherapy. Int J Radiation Oncology Biol Phys 51:31-40.
Potters L, Morgenstern C, Calugaru E et al. 12-Year outcomes following permanent prostate brachytherapy in patients with clinically localized prostate cancer. J Urol 173:1562-1566, 2005
Talcott JA, Clark JA, Stark PC et al. Long-term treatment related complications of brachytherapy for early prostate cancer: a survey of patients previously treated. J Urol 166:494-499, 2001
