Quality of life and management of localized disease

Quality of life for the prostate cancer survivor has evoked an increasing amount of interest during the last decade [1, 2]. Attention has mainly been directed toward the documentation of quality of life and symptoms after radical therapy for localized disease since none of the common treatment modalities - radical prostatectomy, external beam radiation, or brachytherapy - has been found to be superior regarding long-term survival, so the choice between them has often been based on future quality of life issues. It has been reported that after curative treatment for prostate cancer (prostatectomy, brachytherapy, or external beam radiation), survivors have on the average 5.1 new symptoms caused by the therapy [3]. The importance of quality of life issues after radical therapy for prostate cancer is highlighted due to the high number of patients that must be treated to prevent one death from prostate cancer [4] and because of the possible negative consequences on basic functions such as sexual, urinary, and bowel functions resulting from treatment [1, 2]. There exist no randomized studies comparing outcomes between radical prostatectomy and radiation therapy, so comparison concerning symptoms and self-assessed quality of life between these treatment modalities is based on observational data.