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Impaired insuline sensitivity Hyperinsulinemia, new onset diabetes, worsening existing

Body composition Increase in fat mass, decrease in muscle mass, increased

Bone metabolism Loss of BMD, skeletal events (fractures), increased morbidity&mortality

Lipid profile alterations Increased: overall cholesterol, TAG, LDL, HDL

Cardiovascular disease Increased risk of CV morbidity and mortality (?)

Cognitive functions Impaired spatial cognition, reaction time, other (?)

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**17** 

Sunao Shoji

*Japan* 

**A Review of Quality of Life Following** 

*Department of Urology, Tokai University Hachioji Hospital* 

**Treatments for Localized Prostate Cancer** 

Recently, a number of alternative, less invasive treatments have been developed for patients with localized prostate cancer, who are not indicated for surgery, or who do not want to experience the potential side effects of surgery. Laparoscopic radical prostatectomy, robotic assisted laparoscopic radical prostatectomy (RALP), 3-dimensional conformal radiotherapy (3D-CRT), brachytherapy, intensity-modulated external beam radiotherapy (IMRT), highintensity focused ultrasound (HIFU) and cryoablation of the prostate have all been applied

QOL measurements for prostate cancer therapy have become an essential component of clinical trial evaluations, and should be integrated into comprehensive cancer care. Health-related QOL (HRQOL) concerns, urinary function, and potency rate after treatment are important to patients when selecting treatment options for clinically localized prostate cancer, and they also play a critical role in evaluating outcome

Many studies have been carried out with the aim of improving QOL, urinary function, and potency rate after treatment for localized prostate cancer with many modalities. Clinicians have an obligation to assess the impacts these treatments have on QOL, and use this

There are few changes in general HRQOL after a retropubic radical prostatectomy (RRP) or interstitial brachytherapy.1-3 However, disease-specific QOL, especially bowel function and urinary irritative symptoms, is worse in the interstitial brachytherapygroup, and urinary incontinence and sexual function are worse in the RRP group.1 Hamada *et al.* evaluated QOL immediately before surgery and at several points during the 6-month period after retropubic radical prostatectomy (RRP). They reported that a radical prostatectomy aggravates the Social/Family well-being score and the FACT-P score.4 Other studies have also showed that prostatectomy and interstitial brachytherapy continuously decreased health-related QOL.5-8 Hanlon *et al.* showed that external beam radiotherapy for localized prostate cancer aggravates bowel function.9 Hubosky *et al.* reported that HRQOL showed patients undergoing cryoablation on average achieved urinary and bowel domain scores

**2. QOL changes after treatment for localized prostate cancer** 

**1. Introduction** 

to treat this group of patients.

following intervention.

knowledge in an overall evaluation of efficacy.

