Quality of Life and Sexual Health in the Aging of PCa Survivors

Abstract

Prostate cancer (PCa) is the most common malignancy in elderly men. The progressive ageing of the world male population will further increase the need for tailored assessment and treatment of PCa patients. The determinant role of androgens and sexual hormones for PCa growth and progression has been established. However, several trials on androgens and PCa are recently focused on urinary continence, quality of life, and sexual function, suggesting a new point of view on the whole endocrinological aspect of PCa. During aging, metabolic syndrome, including diabetes, hypertension, dyslipidemia, and central obesity, can be associated with a chronic, low-grade inflammation of the prostate and with changes in the sex steroid pathways. These factors may affect both the carcinogenesis processes and treatment outcomes of PCa. Any treatment for PCa can have a long-lasting negative impact on quality of life and sexual health, which should be assessed by validated self-reported questionnaires. In particular, sexual health, urinary continence, and bowel function can be worsened after prostatectomy, radiotherapy, or hormone treatment, mostly in the elderly population. In the present review we summarized the current knowledge on the role of hormones, metabolic features, and primary treatments for PCa on the quality of life and sexual health of elderly Pca survivors.

Racial disparities in prostate cancer a molecular perspective

“…AA men have low serum level of vitamin D than EA that might make them more susceptible to prostate cancer (11). In addition, family history and quality of life are other factors responsible not only for prostate cancer risk in specific race, but also for overall clinical outcomes (12). …”

Are biomarkers evaluated in biopsy specimens predictive of prostate cancer aggressiveness?

“…The reasons of such different behavior of prostate malignancies are presently unclear. PCa screening methods cannot identify aggressive cancers as no well-defined markers of aggressiveness are currently available (Romero Otero et al 2014), implying, in most western countries, the same invasive treatment (chirurgic or radiotherapic) which may lead to severe side effects for the patients (Corona et al 2011;Gacci et al 2014). At present, the strategy employed for PCa diagnosis consists of measurement of serum prostate-specific antigen (PSA), which is considered pathological if ≥4 ng/ml, followed by ultrasound-guided prostate needle biopsy to confirm the occurrence of the cancer (Roobol et al 2007).…”

Kanserli erkek hastalarda cinsel sorunlar

“…[17] Relaps veya hormon duyarlı metastatik prostat kanserli hastalarda uygulanan androjen yoksunluğu tedavisinde serum testosteron seviyelerinin azalması sıcak basmasına, yorgunluğa, emosyonel dalgalanmaya, uyku kalitesinde azalmaya, jinekomastiye, libidoda azalmaya, erektil fonksiyon bozukluğuna ve cinsel ilişki sıklığında azalmaya neden olabilmektedir. [6,16,18,20,23] Ayrıca, başarısızlık korkusu ve psikolojik sorunlar da prostat kanserli hastalarda cinsel fonksiyon bozukluğuna neden olabilmektedir.…”

“…Testis kanseri genç erişkinlerde sık görüldüğünden hastalar cinsel kaygılar yaşayabilmektedir. [23] Testis kanseri tedavisinde kitlenin büyüklüğüne ve yayılımına göre orşiektomi, retroperitoneal lenf nodu diseksiyonu, pelvik kitlenin çıkartılması şeklinde cerrahi girişimler uygulanmakta; cerrahi girişim sonrası kemoterapi veya radyoterapiyle tedaviye devam edilmektedir. Tek taraflı orşiektomi genellikle infertilite veya cinsel fonksiyon bozukluğuna neden olmazken, bilateral orşiektomi testosteron kaybına bağlı sterilite ve libido azalmasına neden olabilmektedir.…”