Patient Reported Outcomes and Treatment-Associated Complications as a Consideration in Selecting Localized Prostate Cancer Management

Tivoli Nguyen,1 Christine Lightfoot,1,* David May,1,* Jacob W Greenberg,1 Louis Spencer Krane2 1Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA; 2Section of Urology, Southeast Louisiana Veterans Healthcare System, New Orleans, LA, USA*These authors contributed equally to this workCorrespondence: Louis Spencer Krane, Section of Urology, Southeast Louisiana Veterans Healthcare System, New Orleans, LA, USA, Email [email protected]: Localized prostate cancer (PCa) remains the most common noncutaneous cancer in men, with numerous management options tailored to individual patient needs. This review examines the role of patient-reported outcomes (PROs) in guiding the management of localized PCa, focusing on the impact of various treatments on long-term quality of life. Standard therapies, including radical prostatectomy, radiotherapy, and active surveillance, are discussed alongside emerging focal therapies. Each treatment modality presents distinct risks, notably urinary incontinence, erectile dysfunction, bowel issues, and cancer recurrence. Understanding these adverse effects in terms of PROs is critical for patients and healthcare providers to engage in shared decision-making, enabling personalized treatment plans based on clinical outcomes and patient values. The incorporation of PROs into treatment selection emphasizes the significance of balancing oncologic control with functional outcomes, such as sexual, bowel, and urinary health. The importance of patient counseling is underscored, ensuring patients are fully informed about potential complications and long-term implications. This review advocates for personalized, evidence-based management strategies that align therapeutic decisions with individual patient preferences, optimizing both survival and quality of life. Enhanced communication between patients and clinicians, informed by PROs, is critical for minimizing decisional regret and maximizing satisfaction in the management of localized PCa.Keywords: prostate cancer, treatment, radical prostatectomy, radiotherapy, focal therapy, patient reported outcomes, complications