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Prostate cancer survivors experienced treatment-related side effects for up to 10 years
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Long-term prostate cancer treatment-related adverse effects, including poorer sexual function and bladder control problems, can persist for as long as 10 years, according to results of an observational study.
The findings are relevant to clinicians and patients as they make treatment decisions, the researchers wrote.
They also contribute to the debate over the value of PSA tests, which can identify slow-growing cancers that would never threaten a patient’s life. Multiple studies have failed to prove PSA tests save lives, and the US Preventive Services Task Force recently recommended against routine PSA screening for healthy men, regardless of age.
“When the survival benefit is uncertain, patient-reported outcomes such as disease-specific function are critical for making informed decisions and for understanding whether the quality of the years living with prostate cancer justifies screening,” Kathryn Taylor, PhD, associate professor of oncology for the Lombardi Comprehensive Cancer Center at Georgetown University, and colleagues wrote in the study.
Taylor and colleagues conducted telephone interviews with 1,043 patients who participated in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trials to determine whether adverse effects related to sexual, urinary or bowel function were due to prostate cancer treatment or other comorbidities such as age.
The study included 529 prostate cancer survivors and 514 control patients. The mean age of the patients was 74 years.
Prior studies designed to evaluate adverse effects experienced by prostate cancer survivors have followed men for as long as 5 years after treatment.
In this study, a decade after treatment, more than 95% of prostate cancer survivors reported suffering from sexual dysfunction, and about 50% reported having at least some urinary and bowel dysfunction.
A weighted linear regression analysis that accounted for patient age and overall health compared 269 prostate cancer survivors vs. 260 men who were screened but did not have cancer. The results showed that survivors had worse sexual and urinary function (P<.001) 10 years post-treatment than the noncancer controls.
Adverse effects varied by treatment type.
Patients who underwent radical prostatectomy (n=201) reported better sexual function (P<.05) and urinary function (P<.001) but poorer bowel function (P<.05) compared with patients who underwent radiation therapy (n=110).
Prostate cancer survivors who received androgen deprivation (n=207) reported significantly poorer hormone-related symptoms compared with radical prostatectomy patients.
“Providers need to be prepared to manage these chronic, long-term effects regardless of treatment modality,” the researchers concluded.
Reference:
- Taylor K. J Clin Oncol. 2012;doi:10.1200/JCO.2011.41.2767.