Great paper on long-term side effects of various treatments for PCa..

[Don_1213]

You may need to create a guest account to view this - but it's worth it: jamanetwork.com/journals/ja...

It's a paper (2024) of a study of long term side effects, treatment effectiveness and mortality based on 4 different treatments (2 only for high-risk treatments.)

The study is interesting - but make certain to look at the illustrations full size.. the differences between RP and RT in side effects, both immediate and long term are really telling. The only advantage RP had over RT was long term rectal issues, and even then the difference was small.

There was a fairly large difference in long term overall-mortality, where RT patients were more likely to die before 10 years passed, but I believe that can be accounted for by how doctors recommend different treatments. Typically urologists will not recommend RP for anyone with comorbidities, heart issues or over 75. There are some exceptions, but they're rare - so the high-risk people selecting RT over RP would be more likely to die even if they didn't have PCa. There was very little difference in death from PCa - which illustrates the point I made above.

It's worth a bit of time to look at - brachy was included in the lower-risk category, the high risk category comparisons were limited to RP or RT with ADT - standards of care. Why the limitation - I didn't read the rather dense selection process, but my WAG is there aren't enough high-risk patients doing other treatments to provide enough data to make a valid comparison.

Look at the graphs - discussion is invited!

BTW - if there is enough interest I can always do some screen captures of the graphs and post them here for discussion.

BTW-II - I just signed in using non-guest account access - unfortunately only a summary of the paper can be seen and the graphs cannot be seen. I forget how I got guest access to JAMA, but it couldn't have been too difficult if I did it. The summary does present some rather selective points as conclusions, basically ignoring the other facts that were obvious in their graphs.

Let me know what sort of info you'd like to see and I'll capture it for here. The type of info they have is on sexual performance in various categories, urinary and rectal issues, survival, etc. Of particular interest to me was the high-risk results since that's what I am, and the RT/ADT treatment was what I did.