Quality of Life and Satisfaction with Outcome among Prostate-Cancer Survivors

Sanda, Martin G.; Dunn, Rodney L.; Michalski, Jeff M.; Sandler, Howard M.; Northouse, Laurel; Hembroff, Larry; Lin, Xihong; Greenfield, Thomas K.; Litwin, Mark S.; Saigal, Christopher S.; Mahadevan, A.; Klein, Eric A.; Kibel, Adam S.; Pisters, Louis L.; Kuban, Deborah A.; Kaplan, Irving; Wood, David P.; Ciezki, Jay P.; Shah, Nikhil; Wei, John T.

doi:10.1056/nejmoa074311

Cited by 2,058 publications

(1,613 citation statements)

References 41 publications

Supporting

Mentioning

1,465

Contrasting

Unclassified

Order By: Relevance

“…This may reflect a more contemporary surgical cohort in CaPSURE. Furthermore, nerve sparing during surgery is known to be associated with better sexual function [2], and the use of NSRP as our reference group could explain smaller differences between surgery and other treatments. We saw very little difference in the unadjusted proportion of NSRP and non-NSRP patients who experienced a decline in sexual function at 2 yr. Men undergoing NSRP had higher baseline Table 4 -Adjusted likelihood of a clinically significant decline in health-related quality of life of at least half standard deviation from baseline to 2, 5, and 10 yr by primary treatment modality among 3297 men in the study cohort sexual function scores, which may have resulted in them being more likely to cross our threshold for a clinically significant decline of one-half SD from baseline.…”

Section: Hrqol Domain Treatment Modalitymentioning

confidence: 99%

“…However, both studies measured urinary function using the UCLA PCI, which focuses primarily on urinary incontinence rather than irritating or obstructive symptoms, and, therefore, reflects the impact of surgery on urinary function to a greater extent than that of radiation or local tumor progression. Studies using other measures, such as the Expanded Prostate Cancer Index Composite (EPIC) [16], have reported consistently that surgery resulted in more incontinence but less irritating and obstructive symptoms [2,5]. As of 2012, CaPSURE has switched to using EPIC to provide a more comprehensive assessment of urinary HRQOL.…”

Section: Hrqol Domain Treatment Modalitymentioning

confidence: 99%

“…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%

“…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%

See 3 more Smart Citations

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

et al. 2015

View full text Add to dashboard Cite

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

show abstract

Section: Hrqol Domain Treatment Modalitymentioning

confidence: 99%

Section: Hrqol Domain Treatment Modalitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Early detection overdiagnoses many prostate cancersperhaps the majority of those found-which are biologically indolent. Men with such low-risk tumors often do not benefit from treatment [2], yet traditionally the vast majority undergo surgery, radiation, hormonal therapy, and other interventions [3,4] that expose them to risks [5] and incur high costs [6].…”

mentioning

confidence: 99%

Progress in Management of Low-risk Prostate Cancer: How Registries May Change the World

Cooperberg

2015

European Urology

View full text Add to dashboard Cite

show abstract

Risk Profiles and Treatment Patterns Among Men Diagnosed as Having Prostate Cancer and a Prostate-Specific Antigen Level Below 4.0 ng/mL

Shao¹,

Albertsen²,

Roberts³

et al. 2010

Arch Intern Med

View full text Add to dashboard Cite

Background Despite controversy over the benefit of prostate specific antigen (PSA) screening, little is known about risk profiles and treatment patterns in men diagnosed with prostate cancer who have a PSA value less than or equal to 4 ng/mL. Methods We utilized data from the Surveillance, Epidemiology, End Results system to describe patient characteristics and treatment patterns of 123,934 men with newly diagnosed prostate cancer in 2004–2006. Age-standardized treatment rates were calculated in five-year age strata. Logistic regression was used to quantify the odds ratios (OR) of men with low– and high–risk disease and the use of radical prostatectomy (RP) or radiation therapy (RT). Results Men with a PSA of 4.0 ng/ml or less represent 14% of incident prostate cancer cases. Fifty-four percent of men diagnosed with prostate cancer and PSA ≤ 4.0 ng/mL harbor low-risk disease (stage ≤ T2a, PSA level ≤ 10 ng/mL, and Gleason score ≤ 6), but over 75% of them received RP or RT. Men with screen-detected prostate cancer and PSA values ≤ 4 ng/mL were 1.49 (CI 1.38–1.62) and 1.39 (CI 1.30–1.49) times more likely to receive RP and RT, respectively, and were less likely to have high-grade disease than men who had non-screen detected prostate cancer (OR=0.67; 95% CI:0.60–0.76). Conclusions Most men diagnosed with prostate cancer with a PSA threshold ≤ 4.0 ng/mL had low-risk disease but underwent aggressive local therapy. Lowering biopsy threshold, while lacking the ability to distinguish indolent cancers from aggressive cancers, may increase overdiagnosis and overtreatment.

show abstract

Quality of Life and Satisfaction with Outcome among Prostate-Cancer Survivors

Abstract: Each prostate-cancer treatment was associated with a distinct pattern of change in quality-of-life domains related to urinary, sexual, bowel, and hormonal function. These changes influenced satisfaction with treatment outcomes among patients and their spouses or partners.

Cited by 2,058 publications

References 41 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

Progress in Management of Low-risk Prostate Cancer: How Registries May Change the World

Risk Profiles and Treatment Patterns Among Men Diagnosed as Having Prostate Cancer and a Prostate-Specific Antigen Level Below 4.0 ng/mL

Contact Info

Product

Resources

About