Older Age, Early Symptoms and Physical Function are Associated with the Severity of Late Symptom Clusters for Men Undergoing Radiotherapy for Prostate Cancer

Abstract

AimsTo identify symptom clusters and predisposing factors associated with long-term symptoms and health-related quality of life after radiotherapy in men with prostate cancer.Materials and methodsPatient-reported outcomes (PROs) data from the Medical Research Council RT01 radiotherapy with neoadjuvant androgen deprivation therapy trial of 843 patients were used. PROs were collected over 5 years with the University of California, Los Angeles Prostate Cancer Index (UCLA-PCI) and the 36 item Short-Form Health Survey (SF-36). Symptom clusters were explored using hierarchical cluster analysis. The association of treatment dose, baseline patient characteristics and early symptom clusters with the change in severity of PROs over 3 years was investigated with multivariate linear mixed effects models.ResultsSeven symptom clusters of three or more symptoms were identified. The clusters were stable over time. The longitudinal profiles of symptom clusters showed the onset of acute symptoms during treatment for all symptom clusters and significant recovery by 6 months. Some clusters, such as physical health and sexual function, were adversely affected more than others by androgen deprivation therapy, and were less likely to return to pretreatment levels over time. Older age was significantly associated with decreased long-term physical function, physical health and sexual function (P < 0.001). Both baseline and acute symptom clusters were significant antecedents for impaired function and health-related quality of life at 3 years.ConclusionsMen with poorer physical function and health before or during treatment were more likely to report poorer PROs at year 3. Early assessment using PROs and lifestyle interventions should be used to identify those with higher needs and provide targeted rehabilitation and symptom management.

The Aptamer Functionalized Nanocomposite Used for Prostate Cancer Diagnosis and Therapy

“…Typically, PCa is especially common among elder men in Europe and the United States. Because of the lack of early specific symptoms of PCa and the low sensitivity and specificity of existing detection methods, many patients are in the advanced stage at the time of initial treatment and are thus deprived of the optimal treatment time [2]. Therefore, early diagnosis and timely and effective treatment are of great significance to reduce the mortality and improve the life quality of PCa patients.…”

Randomised controlled trial to investigate the effectiveness of the symptom management after radiotherapy (SMaRT) group intervention to ameliorate lower urinary tract symptoms in men treated for prostate cancer

“…Acute urinary symptoms are often transient, longterm symptoms can continue for 3-6 months, and late side effects can be newly occurring up to 2 years after external beam radiotherapy [11]. Adverse effects are more severe in those who are older and have poorer physical function and greater urinary symptoms at baseline [12][13][14]. External beam radiation (EBRT) utilises high-energy photon beams and is shaped and conformed to the profile of the prostate gland such as conformal radiotherapy (CFRT) or delivered through intensity-modulated radiotherapy (IMRT) minimising surrounding normal tissue damage [15]; however, lower doses of radiation can cover a wider field across the pelvis impacting on additional pelvic structures.…”

Randomised Controlled Trial To Investigate The Effectiveness of The Self-Management After Radiotherapy (SMaRT) Intervention To Ameliorate Lower Urinary Tract Symptoms in Men Treated for Prostate Cancer

“…Acute urinary symptoms are often transient, long term symptoms can continue for 3-6 months, and late side-effects can be newly occurring up to 2 years after external beam radiotherapy (11). Adverse effects are more severe in those who are older, have poorer physical function and greater urinary symptoms at baseline (12)(13)(14). External beam radiation (EBRT) utilises high-energy photon beams and is shaped and conformed to the pro le of the prostate gland such as conformal radiotherapy (CFRT) or delivered through intensity-modulated radiotherapy (IMRT) minimising surrounding normal tissue damage (15), however lower doses of radiation can cover a wider eld across the pelvis impacting on additional pelvic structures.…”