Time Course and Predictors of Symptoms After Primary Prostate Cancer Therapy

Abstract

Pretreatment function and the primary treatment modality for early stage PC strongly predict the affected organ systems and time course of dysfunction. With this information, patients and their physicians may refine their choice of treatment and better anticipate its consequences.

Measuring Health-Related Quality of Life Consequences From Primary Treatment for Early-Stage Prostate Cancer

“…[6][7][8]11] External beam radiotherapy has not been found to cause incontinence in these studies, whereas evidence suggests that brachytherapy may impact urinary incontinence at low levels, whose clinical significance is uncertain. Brachytherapy and external beam radiotherapy have both been found to impact overall urinary functioning, with the principal impacted subdomain being urinary irritative/ obstructive symptoms, that are common during early follow-up after brachytherapy, and less common, but also detected, after external radiotherapy.…”

“…Valid, conclusive data regarding impact of brachytherapy on these HRQOL domains is limited to early follow-up (1 year or less). [6,11] The hormonal and vitality HRQOL domain, that has emerged as a significant component of HRQOL status among prostate cancer patients (due to increasing utilization of neoadjuvant hormonal therapy) has not been characterized in multicenter studies as of yet, though ongoing cohorts aim to address this knowledge gap.…”

“…[11][12][13] Instead of developing an instrument de novo based on input from prostate cancer survivors, Talcott and Clark constructed a questionnaire combining items adopted from various prior non-validated prostate cancer surveys with items constructed based on practitioner input. Their consequent "Symptom Index" has 29 items and was validated for quantifiable measurement of urinary, bowel, and sexual domains, with the ability to distinguish function and distress (Table 1).…”

“…[11] The study consisted of patients from teaching hospitals associated with Harvard Medical School, and was well balanced with regard to participation by surgery and brachytherapy patients. Patients were questioned prospectively over three years post-treatment using both the general SF-36 and a prostate cancer treatment symptom index.…”

From bad to worse: comorbidity severity and quality of life after treatment for early-stage prostate cancer

“…Numerous studies have shown that baseline HRQOL is a predictor of HRQOL after treatment. 17,18 However, we also observed a strong interaction between comorbidity and baseline HRQOL. To avoid overcorrection for a relevant aspect of comorbidity that impacts both baseline and future HRQOL, we elected to report our data without correction for baseline HRQOL, though we conducted all of our analyses with Comorbidity severity predicts HRQOL TJ Daskivich et al and without inclusion of baseline HRQOL as a covariate.…”