Burden of focal cryoablation versus brachytherapy versus active surveillance in the treatment of very low‐risk prostate cancer: a preliminary head‐to‐head comprehensive assessment

Focal cryoablation (FC), brachytherapy (B) and active surveillance (AS) were offered to patients diagnosed with very low‐risk prostate cancer (VLRPC) in an equal access protocol. Comprehensive validated self‐report questionnaires accessed patients' erectile (IIEF‐5) and voiding (IPSS) functions, Beck scales measured anxiety (BAI), hopelessness (BHS) and depression (BDI), SF‐36 reflected patients' quality of life added to the emotional thermometers including five visual analogue scales (distress, anxiety, depression, anger and need for help). Kruskal–Wallis or ANOVA tests and Spearman's correlations were obtained among groups and studied variables. Thirty patients were included, median follow‐up 18 months (15–21). Those on AS (n = 11) were older, presented higher hopelessness (BHS) and lower general health perceptions (SF‐36) scores than patients opting for FC (n = 10) and B (n = 9), P = 0.0014, P = 0.0268 and P = 0.0168 respectively. Patients on B had higher IPSS scores compared to those under FC and AC, P = 0.0223. For all 30 included patients, Spearman's correlation (r_s) was very strong between BHS and general health perceptions (r_s = ?0.800, P < 0.0001), and weak/moderate between age and BHS (r_s = 0.405, P = 0.026) and age and general health perceptions (r_s = ?0.564, P = 0.001). The sample power was >60%. To be considered in patients' counselling and care, current study supports the hypothesis that even VLRPC when untreated undermines psychosocial domains.