Health Related Quality of Life for Men Treated for Localized Prostate Cancer With Long-Term Followup

Huang, George J.; Sadetsky, Natalia; Penson, David F.

doi:10.1016/j.juro.2010.02.013

Cited by 108 publications

(90 citation statements)

References 22 publications

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“…Local treatments are associated with distinct constellations of treatment-related morbidity, primarily in domains of sexual, urinary, and bowel health-related quality of life (HRQOL) [2][3][4][5]. Consequently, the anticipated impact of treatment on HRQOL is an important driver of shared decision making.…”

Section: Introductionmentioning

confidence: 99%

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Long-term Health-related Quality of Life After Primary Treatment for Localized Prostate Cancer: Results from the CaPSURE Registry

et al. 2015

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a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e u r o p e a n u r o l o g y . c o m Outcome measurements and statistical analysis: The Medical Outcomes Studies 36-item Short Form and the University of California, Los Angeles, Prostate Cancer Index characterized physical function, mental health, and sexual, urinary, and bowel function and bother. Repeated measures mixed-model analysis assessed change in HRQOL by treatment over time, and logistic regression was used to measure the likelihood of a clinically significant decline in HRQOL. Results and limitations: Among 3294 men, 1139 (34%) underwent nerve-sparing radical prostatectomy (NSRP), 860 (26%) underwent non-NSRP, 684 (21%) underwent brachytherapy, 386 (12%) underwent external beam radiotherapy, 161 (5%) underwent primary androgen deprivation therapy, and 64 (2%) pursued watchful waiting/active surveillance. Median follow-up was 74 mo (interquartile range: 50-102). Most treatments resulted in early declines in HRQOL, with some recovery over the next 1-2 yr and a plateau in scores thereafter. Surgery had the largest impact on sexual function and bother and on urinary function, radiation had the strongest effect on bowel function, and androgen deprivation therapy had the strongest effect on physical function. The main limitation was attrition among the cohort. Conclusions: Although most men experience initial declines in HRQOL in the first 2 yr after treatment, there is little change from 3 to 10 yr and most differences between treatments attenuated over time. Patient summary: Various treatments for prostate cancer result in a distinct constellation of adverse effects on health-related quality of life, which may have a long-term impact. These findings are helpful regarding shared decision making over choice of primary treatment. Article info

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Section: Introductionmentioning

confidence: 99%

“…The largest detriments in HRQOL occur within 1 yr of treatment with some improvement thereafter [2,3,5]. Surgery generally has the largest impact on erectile function and urinary continence, while radiation has the largest impact on bowel and urinary irritation.…”

Section: Introductionmentioning

confidence: 99%

Long-term Health-related Quality of Life After Primary Treatment for Localized Prostate Cancer: Results from the CaPSURE Registry

et al. 2015

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“…However, all treatments (RP, external beam radiotherapy, brachytherapy) adversely affect QoL. 1 The main side effects of RP are urinary incontinence and erectile dysfunction (ED), with ED having a possibly greater adverse impact on patients' QoL in the longer term than urinary disorders and the fear of relapse, especially in younger patients. 2 So far, most studies have focussed on ED rather than on the broader issue of quality of sex life.…”

Section: Introductionmentioning

confidence: 99%

Erectile dysfunction and sexual health after radical prostatectomy: impact of sexual motivation

et al. 2011

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The life expectancy of patients with localized prostate cancer at treatment initiation has increased, and post-treatment quality of life has become a key issue. The aim of this study is to assess the impact of Radical prostatectomy (RP) on patients' sexual health and satisfaction according to sexual motivation using a self-administered questionnaire completed by two groups of RP patients, with high or lower levels of sexual motivation. A total of 63 consecutive patients were included (mean age, 63.9 years), of whom 74.6% were being treated for erectile dysfunction (ED). After RP, patients reported lower sexual desire (52.4%), reduced intercourse frequency (79.4%), anorgasmia (39.7%), less satisfying orgasm (38.1%), climacturia (25.4%), greater distress (68.3%) and/or lower partner satisfaction (56.5%). Among the most sexually motivated patients, 76.0% reported loss of masculine identity, 52% loss of self-esteem and 36.0% anxiety about performance. These rates were lower among less motivated patients (52.6, 28.9, and 18.4%, respectively). Mean overall satisfaction score was 4.8±2.9. The score was significantly lowered in motivated than less motivated patients (3.4 vs 5.8) (P ¼ 0.001). In conclusion, RP adversely affected erectile and orgasmic functions but also sexual desire, self-esteem and masculinity. The more motivated patients experienced greater distress and were less satisfied.

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“…It is very important to consider the long-term side effects of androgen deprivation. 30,31 This is the reason why only Abbreviations: AD, androgen deprivation; ADT, androgen deprivation therapy; LT, local treatment; either prostatectomy or radiotherapy; RT, radical radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Toxicity in patients receiving adjuvant docetaxel + hormonal treatment after radical radiotherapy for intermediate or high-risk prostate cancer: a preplanned safety report of the SPCG-13 trial

Kellokumpu-Lehtinen

Hjälm-Eriksson

Thellenberg‐Karlsson

et al. 2012

Prostate Cancer Prostatic Dis

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and for the SPCG-13 BACKGROUND: Radical radiotherapy (RT) combined with androgen deprivation therapy is currently the standard treatment for elderly patients with localized intermediate-or high-risk prostate cancer (PC). To increase the recurrence-free and overall survival, we conducted an adjuvant, randomized trial using docetaxel (T) in PC patients (Scandinavian Prostate Cancer Group trial 13). METHODS:The inclusion criteria are the following: men 418 and p75 years of age, WHO/ECOG performance status 0--1, histologically proven PC within 12 months before randomization and one of the following: T2, Gleason 7 (4 þ 3), PSA 410; T2, Gleason 8--10, any PSA; or any T3 tumors. Neoadjuvant/adjuvant hormone therapy is mandatory for all patients. The patients were randomized to receive six cycles of T (75 mg m À2 d 1. cycle 21 d) or no docetaxel after radical RT (with a minimum tumor dose of 74 Gy). This study identifier number is NTC 006653848 (http://www.clinicaltrials.org). RESULTS: In this preplanned safety analysis of 100 patients, T treatment induced grade (G) 3 adverse events (AEs) in 15 patients (30%) and G4 AEs in 30 patients (60%), mainly due to bone marrow toxicity. Neutropenia G3--4 was observed in 72% of the patients, febrile neutropenia was found in 24% of patients, neutropenic infection in 10% of patients and G3 infection without neutropenia in 4% of patients. Nonhematological G3 AEs were rare: anorexia, diarrhea, mucositis, nausea, pain (1 patient each) and fatigue (5). Other severe serious AEs related to T were pulmonary embolism and renal failure. However, only three patients discontinued T before completing the planned six cycles. No deaths had occurred. No patients in the control arm experienced G3--4 toxicities at 12 weeks after the randomization. CONCLUSIONS: Adjuvant docetaxel chemotherapy after radiotherapy has a higher frequency of neutropenia than previous studies on patients with metastatic disease. Otherwise, the treatment was quite well tolerated.

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Health Related Quality of Life for Men Treated for Localized Prostate Cancer With Long-Term Followup

Cited by 108 publications

References 22 publications

Long-term Health-related Quality of Life After Primary Treatment for Localized Prostate Cancer: Results from the CaPSURE Registry

Long-term Health-related Quality of Life After Primary Treatment for Localized Prostate Cancer: Results from the CaPSURE Registry

Erectile dysfunction and sexual health after radical prostatectomy: impact of sexual motivation

Toxicity in patients receiving adjuvant docetaxel + hormonal treatment after radical radiotherapy for intermediate or high-risk prostate cancer: a preplanned safety report of the SPCG-13 trial

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