Quality of life three years after diagnosis of localised prostate cancer: population based cohort study

Smith, David P.; King, Madeleine; Egger, Sam; Berry, Martin; Stricker, Phillip D.; Cozzi, Paul; Ward, Jeanette; O’Connell, Dianne; Armstrong, Bruce K.

doi:10.1136/bmj.b4817

Cited by 247 publications

(298 citation statements)

References 31 publications

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“…Finally, adherence to treatment and acceptance of surgical risks may differ by SES. 21 Timely access to and provision of high quality cancer care is a key determinant for cancer outcomes. In our study, men with high SES, and in particular men with high income, had significantly shorter waiting times, more frequently received treatment with curative intent, and had better short-term surgical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. A nationwide population-based study

Tomic¹,

Ventimiglia²,

David³

et al. 2018

European Urology Supplements

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Patients with high socioeconomic status (SES) have better cancer outcomes than patients with low SES. This has also been shown in Sweden, a country with tax-financed health care aiming to provide care on equal terms to all residents. The association between income and educational level and diagnostics and treatment as outlined in national guidelines and prostate cancer (Pca) and all-cause mortality was assessed in 74,643 men by use of data in the National Prostate Cancer Register of Sweden and a number of other health care registers and demographic databases. In multivariable logistic regression analysis, men with high income had higher probability of Pca detected in a health-check-up, top versus bottom income quartile, odds ratio (OR) 1.60 (95% CI 1.45-1.77) and lower probability of waiting more than 3 months for prostatectomy, OR 0.77 (0.69-0.86). Men with the highest incomes also had higher probability of curative treatment for intermediate and high-risk cancer, OR 1.77 (1.61-1.95) and lower risk of positive margins, (incomplete resection) at prostatectomy, OR 0.80 (0.71-0.90). Similar, but weaker associations were observed for educational level. At 6 years of follow-up, Pca mortality was modestly lower for men with high income, which was statistically significant for localized high-risk and metastatic Pca in men with no comorbidities. All-cause mortality was less than half in top versus bottom quartile of income (12% vs. 30%, p < 0.001) among men above age 65. Our findings underscore the importance of adherence to guidelines to ensure optimal and equal care for all patients diagnosed with cancer.

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Section: Discussionmentioning

confidence: 99%

Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. A nationwide population-based study

Tomic¹,

Ventimiglia²,

David³

et al. 2018

European Urology Supplements

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“…4 However, there is a paucity of high quality evidence comparing these treatments to guide patients and clinicians in their treatment choices 5 and adverse effects including impotence are common, persistent and associated with reduced quality of life. 6,7 Men with prostate cancer may choose to supplement their conventional treatment with one or more forms of complementary or alternative medicine (CAM).…”

Section: Introductionmentioning

confidence: 99%

Complementary medicine use by men with prostate cancer: a systematic review of prevalence studies

Bishop

Rea

Lewith

et al. 2010

Prostate Cancer Prostatic Dis

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Men with prostate cancer are reported as commonly using complementary and alternative medicine (CAM) but surveys have not recently been subjected to a rigorous systematic review incorporating quality assessment. Six electronic databases were searched using pre-defined terms. Detailed information was extracted systematically from each relevant article. Study reporting quality was assessed using a quality assessment tool, which demonstrated acceptable inter-rater reliability and produces a percentage score. In all, 42 studies are reviewed. All were published in English between 1999 and 2009; 60% were conducted in the United States. The reporting quality was mixed (median score ¼ 66%, range 23-94%). Significant heterogeneity precluded formal meta-analysis. In all, 39 studies covering 11 736 men reported overall prevalence of CAM use; this ranged from 8 to 90% (median ¼ 30%). In all, 10 studies reported prevalence of CAM use specifically for cancer care; this ranged from 8 to 50% (median ¼ 30%). Some evidence suggested CAM use is more common in men with higher education/incomes and more severe disease. The prevalence of CAM use among men with prostate cancer varies greatly across studies. Future studies should use standardised and validated data collection techniques to reduce bias and enhance comparability.

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“…28 Cohort studies consistently reported an increased risk of erectile dysfunction associated with radical prostatectomy (RR 1.6, 95% CI 1.3-1.8, affecting 23.4% or 234 per 1000 of men) compared with no treatment. [39][40][41][42][43] Both RCTs 28,38 and cohort studies [39][40][41][42] found that radical prostatectomy increased the risk of urinary incontinence compared with watchful waiting (metaanalysis of trial data: RR 3.2, 95% CI 2.3-4.6; 17.8% of men or 178 per 1000 affected 13 ). In addition, between 11% and 21% of men will experience short-term (< 30 d) postoperative complications, such as infection, additional surgery and blood transfusions.…”

Section: Benefits and Harms Of Treatmentmentioning

confidence: 99%

“…28,[44][45][46] Trial data indicate that radiation therapy increases the risk of urinary incontinence 47 (not supported by observational studies 13 ) and erectile dysfunction. [39][40][41][42] Combined radiation and hormonal therapy also increases the risk of bowel and erectile dysfunction. 13 Hormonal therapy (androgen deprivation therapy) has been shown to increase the risk of erectile dysfunction (76% v. 33% in control group), but not urinary incontinence (9% v. 6% in control group).…”

Section: Benefits and Harms Of Treatmentmentioning

confidence: 99%

Recommendations on screening for prostate cancer with the prostate-specific antigen test

Bell

Gorber

Shane

et al. 2014

CMAJ

166

136

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• The prevalence of undiagnosed prostate cancer at autopsy is high and increases with age (> 40% among men aged 40-49 yr to > 70% among men aged 70-79 yr).• Only a small proportion of men with prostate cancer have symptoms or die from the disease; most prostate cancers are slowly progressive and not life threatening.• Screening with the PSA test may lead to a small reduction in prostate cancer mortality but not a reduction in all-cause mortality.• Thresholds for PSA of 2.5 to 4.0 ng/mL are commonly used for screening; lower thresholds increase the probability of false-positive results, and no threshold completely excludes prostate cancer.• Harms associated with PSA screening (e.g., bleeding, infection, urinary incontinence, a false-positive result and overdiagnosis) are common.• The PSA test should not be used for screening without a detailed discussion with the patient, ideally with the use of decision aids to facilitate comprehension.

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Quality of life three years after diagnosis of localised prostate cancer: population based cohort study

Abstract: Objective To quantify the risk and severity of negative effects of treatment for localised prostate cancer on long term quality of life.

Cited by 247 publications

References 31 publications

Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. A nationwide population-based study

Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. A nationwide population-based study

Complementary medicine use by men with prostate cancer: a systematic review of prevalence studies

Recommendations on screening for prostate cancer with the prostate-specific antigen test

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