Psychological impact of different primary treatments for prostate cancer: A critical analysis

Maggi, Martina; Gentilucci, Alessandro; Salciccia, Stefano; Gatto, Antonio; Gentile, Vincenzo; Colarieti, Anna; Heland, Magnus Von; Busetto, Gian Maria; Giudice, Francesco Del; Sciarra, Alessandro

doi:10.1111/and.13157

Cited by 46 publications

(39 citation statements)

References 38 publications

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“…Urinary incontinence is widely recognised as one of the most debilitating complications following prostatectomy, with significant impact of cancer survivors’ quality of life. Recent research on the psychological burden of PPI has demonstrated the extent of its detrimental effects, including increased cognitive dysfunction, anxiety and depression [ 19 , 20 ]. As a consequence, the selection of surgical treatment for PPI, and predicting the outcomes of surgery are critical metrics for prostate cancer survivors.…”

Section: Discussionmentioning

confidence: 99%

Is pre-operative urodynamic bladder function the true predictor of outcome of male sling for post prostatectomy incontinence?

et al. 2020

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Purpose To investigate pre-operative urodynamic parameters in male sling patients to ascertain whether this might better predict surgical outcomes and facilitate patient selection. Methods We performed a retrospective, case notes and video-urodynamics, review of men who underwent AdVanceXP male sling in three London hospitals between 2012 and 2019. Urodynamics were performed in all centres, while retrograde leak point pressure (RLPP) was performed in one centre. Results Successful outcome was seen in 99/130 (76%) of men who required one pad or less per day. The dry rate was 51%. Pad usage was linked to worse surgical outcomes, mean 2.6 (range 1-6.5) for success vs 3.6 (range 1-10) although the ranges were wide (p = 0.002). 24 h pad weight also reached statistical significance (p = 0.05), with a mean of 181 g for success group versus 475 g for the non-successful group. The incidence of DO in the non-successful group was significantly higher than in successful group (55% versus 29%, p = 0.0009). Bladder capacity less than 250 ml was also associated with worse outcomes (p = 0.003). Reduced compliance was not correlated with outcomes (31% for success groups vs 45% for non-successful group, p = 0.15). Preoperative RLPP was performed in 60/130 patients but did not independently reach statistical significance (p = 0.25). Conclusion Urodynamic parameters related to bladder function-detrusor overactivity and reduced maximum cystometric capacity predict male sling outcomes and may help in patient selection for male sling (or sphincter) surgery; whereas urodynamic parameters of sphincter incompetency (RLPP) were not predictive. Further larger scale studies are required to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

Is pre-operative urodynamic bladder function the true predictor of outcome of male sling for post prostatectomy incontinence?

et al. 2020

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“…5,12 Also, differences in mental distress and psychiatric disorders were not found between patients undergoing prostatectomy, AS and radiotherapy. 15,16 In terms of need for psychosocial support, various studies in Germany found that approximately 20% of patients with prostate cancer wish to have psychosocial support. 8,17,18 This number is low compared to cancer patients in general, of which every third patient expresses a wish for psychosocial support.…”

Section: Introductionmentioning

confidence: 99%

“…5,12 Also, differences in mental distress and psychiatric disorders were not found between patients undergoing prostatectomy, AS and radiotherapy. 15,16…”

Section: Introductionmentioning

confidence: 99%

Mental distress and need for psychosocial support in prostate cancer patients: An observational cross-sectional study

Baba

Schrage

Hartmann

et al. 2020

Int J Psychiatry Med

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Objective Prostate cancer is the most common cancer in German men and associated with various physical and psychosocial problems. This study investigated the association between mental distress and the subjective need for psychosocial support comparing subgroups of patients with different treatments and disease stages. Method We performed an observational, cross-sectional study including patients with four medical conditions: Active Surveillance, radical prostatectomy, biochemical relapse, metastasized disease. Mental distress (NCCN Distress-Thermometer), symptoms of depression and anxiety (PHQ-9, GAD-7), psychosocial needs and coping resources (self-designed questionnaire) were assessed. Results N = 130 patients were included. 33.3% showed distress, 16.5% symptoms of moderate depression and 13% symptoms of moderate anxiety. We found no significant differences between the four groups. An association was present between distress and wish for psychosocial support ( χ2 = 4.3; p < 0.05; ϕ = 0.19). Almost 90% lived with a partner, which represents a resource. Conclusions Prostate cancer patients showed low levels of mental distress, depression and anxiety with no difference in terms of disease stage and treatment modality. Therefore, careful psychosocial screening of all patients is essential to identify those in need for support. Distressed patients express a need for psychosocial support more often. Interpersonal relationships, most often wives and children, represent important coping resources.

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“…Although AS is intended to avoid or delay unnecessary radical treatment, it is not without costs and concerns to patients and their physicians [6,7]. A patient's anxiety about a cancer diagnosis or preference for an aggressive approach in the absence of clinical progression could be a trigger for choosing alternative treatments [8,9]. Some patients may not be compliant with follow-up, thus exposing them to the risk of disease progression [10].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Cancer Progression on Serial Biopsy in Men on Active Surveillance for Early-stage Prostate Cancer: Implications for Focal Therapy

Fasulo

Cowan

Maggi

et al. 2022

European Urology Oncology

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Background: Active surveillance (AS) is a safe and accepted option for managing men with low-risk prostate cancer. Nevertheless, some patients lack confidence in or access to AS. Focal therapy (FT) is a possible alternative to radical treatment for such patients. Objective: We evaluated dominant tumor (DT) progression across serial biopsies to determine whether men on AS could be reasonable candidates for FT. Design, setting, and participants: Men enrolled in AS at University of California, San Francisco between 1996 and 2017 with low/intermediate risk were included. Outcome measurements and statistical analysis: Changes in biopsy grade, volume, and focality of the DT over time were assessed. Focality (good or poor for FT) was defined by the number of cores, laterality, and contiguity of prostate sites containing tumor (based on pathology reports). Candidates (either for targeted/quadrant ablation or for hemigland ablation) were defined based on good focality, grade group (GG) 2, and low-volume disease. Patients were classified as favorable (GG 2 with good focality and concordant multiparametric magnetic resonance imaging [mpMRI]) or unfavorable (poor focality or high-volume disease or discordant mpMRI) for FT at surveillance biopsies. Results and limitations: A total of 1057 men met the inclusion criteria. The median number of biopsies per patient was three (interquartile range 2-4), and 196 patients (18.5%) underwent five or more biopsies. At confirmatory biopsy, 43% remained candidates for FT (67% for targeted/quadrant ablation and 33% for hemigland ablation) and 20% had a negative biopsy. Of the candidates for FT at initial biopsy, 11% had less favorable characteristics at confirmatory biopsy. Among candidates for FT based on both initial and confirmatory biopsies, 70% remained favorable for hemigland ablation at subsequent biopsies. Limitations include retrospective design and mpMRI information only at surveillance biopsy.

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Psychological impact of different primary treatments for prostate cancer: A critical analysis

Cited by 46 publications

References 38 publications

Is pre-operative urodynamic bladder function the true predictor of outcome of male sling for post prostatectomy incontinence?

Is pre-operative urodynamic bladder function the true predictor of outcome of male sling for post prostatectomy incontinence?

Mental distress and need for psychosocial support in prostate cancer patients: An observational cross-sectional study

Characteristics of Cancer Progression on Serial Biopsy in Men on Active Surveillance for Early-stage Prostate Cancer: Implications for Focal Therapy

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