Predictors of Health-related Quality of Life and Adjustment to Prostate Cancer During Active Surveillance

Active surveillance for low-risk prostate cancer: Need for intervention and survival at 10 years

“…Most of the patients were seen in a multidisciplinary oncology clinic by urology, medical oncology, and radiation oncology teams simultaneously. Such a setting is associated with significantly increased acceptance of AS as a management strategy and may lead to decreased withdrawal from AS [21,22]. In our cohort, CSS was 100% at 5 and 10 years and OS was 95% at 5 years and 88% at 10 years.…”

How Does Active Surveillance for Prostate Cancer Affect Quality of Life? A Systematic Review

“…In one study [24], greater decisional conflict (linked to a higher perceived physician role in treatment decision making) or a higher score in emotional instability predicted increased anxiety and distress at 9 mo, whilst better physical health was associated with lower scores. In patients within their first 10 mo of AS, having a partner, multiple physicians during AS selection, and an extended diagnostic biopsy (>18 cores) decreased the risk of experiencing poor QoL [18]. Additionally, AS patients with good coping or adjustment to cancer scores (ie, fighting spirit, anxious preoccupation, and helplessness/hopelessness) had higher QoL scores, whereas low coping scores were associated with the time taken between diagnosis and commencing AS.…”

“…Vanagas et al [25] highlighted that men on AS reported significantly better HRQoL than men who underwent radical treatment in both functional and symptom scales, although these results by treatment group were not subdivided by tumour stage. Bellardita et al [18] found that high levels of HRQoL were predicted by a patient having consulted several physicians about the choice of AS, by the presence of a partner, and a diagnostic biopsy with >18 core specimens. Daubenmier et al [20], comparing two groups of patients undergoing or not a lifestyle intervention, pointed out that participants of both groups reported high HRQoL at baseline; interestingly, those who improved their lifestyle also enhanced their HRQoL further.…”

“…HRQoL was predicted by baseline sociodemographic, clinical, or other characteristics in two AS studies [18,24]. In one study [24], greater decisional conflict (linked to a higher perceived physician role in treatment decision making) or a higher score in emotional instability predicted increased anxiety and distress at 9 mo, whilst better physical health was associated with lower scores.…”

Is There a Role for Active Surveillance in Low-Risk Prostate Cancer?

“…However, the invitation to complete the questionnaires was mailed to patients with PCa diagnosed within the last 6 months [47] . Another evaluation from the PRIAS cohort with 103 patients only and without a control group revealed that lack of a partner and impaired mental health were associated with low health-related quality of life (QoL) [48] . Based on the SPCG-4 trial data, Johansson et al [49] compared QoL outcomes between men undergoing RP and WW.…”