Improving Quality of Life with Brachytherapy for Urological Malignancies

Brachytherapy for localised prostate, muscle-invasive bladder and penile cancer is well established, providing high tumour dose delivery and minimising normal tissue doses compared with external beam techniques. In prostate cancer, the main impact on quality of life relates to diminished sexual function and irritative or obstructive urinary symptoms, which are seen up to 15 years after treatment. Significant changes in bowel function are rare. Compared with radical prostatectomy or external beam radiotherapy, irritative or obstructive urinary symptoms are more prominent, whereas incontinence is less than after radical prostatectomy and bowel changes are less than after external beam radiotherapy. For muscle-invasive bladder cancer, when compared with radical cystectomy, although no difference is seen for urinary symptoms or fatigue, role and social functioning scores are higher and there is better post-treatment sexual function in both men and women. Compared with surgical treatment for penile cancer, brachytherapy results in better erectile function scores than after glansectomy and partial penectomy and high quality of life scores, with good satisfaction ratings for cosmetic appearance. & COPY; 2023 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Automated summary

Brachytherapy is an established treatment for localized prostate, muscle-invasive bladder, and penile cancer, providing high tumor dose delivery and minimizing normal tissue doses. It has a positive impact on quality of life, with improvements in sexual function and urinary symptoms for prostate cancer patients, and better post-treatment sexual function and social functioning scores for muscle-invasive bladder cancer patients. It also leads to better erectile function scores and high quality of life scores for penile cancer patients compared to surgical treatment.