Treatment outcomes in localized prostate cancer: a patient-oriented approach.

Although there are many treatment options available to patients with localized prostate cancer, it remains unclear which is superior in terms of overall survival. Patients, therefore, consider a number of other less traditional outcomes when choosing therapy for newly diagnosed disease. In particular, because each treatment can have a unique and highly individual impact on various aspects of the patient's health and daily life, there is a need for a patient-oriented approach to outcomes that accounts for both quantity and quality of life after therapy. Although all therapies can result in some degree of sexual, urinary, or bowel dysfunction, the degree of bother patients experience does not always correlate with the objective degree of symptoms present. Providers must, therefore, make the important distinction between function and bother when presenting the risks for each therapy to patients. Patients should also be aware that if they experience particular bother from their sexual or urinary dysfunction, there are therapies available that will improve erectile function or lower urinary tract voiding dysfunction and result in better quality of life. Finally, when discussing the probability of unwanted outcomes, such as urinary, sexual, or bowel dysfunction after treatment for localized prostate cancer, providers should strive to present risks by using a number of different styles, facilitating understanding, and leading to a truly informed decision that best fits the patient's goals.