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. 2015 Sep;116(3):397-406.
doi: 10.1111/bju.13036. Epub 2015 Jun 22.

Patient-reported 'ever had' and 'current' long-term physical symptoms after prostate cancer treatments

Anna T Gavin  1 , Frances J Drummond  2 , Conan Donnelly  1 , Eamonn O'Leary  2 , Linda Sharp  3 , Heather R Kinnear  1
Affiliations

Patient-reported 'ever had' and 'current' long-term physical symptoms after prostate cancer treatments

Anna T Gavin et al. BJU Int. 2015 Sep.

Abstract

Objective: To investigate the prevalence of physical symptoms that were 'ever' and 'currently' experienced by survivors of prostate cancer at a population level, to assess burden and thus inform policy to support survivors.

Patients and methods: The study included 3 348 men surviving prostate cancer for 2-18 years after diagnosis. A cross-sectional, postal survey of 6 559 survivors diagnosed 2-18 years ago with primary, invasive prostate cancer (ICD10-C61) identified via national, population-based cancer registries in Northern Ireland and Republic of Ireland. Questions included symptoms at diagnosis, primary treatments and physical symptoms (erectile dysfunction [ED]/urinary incontinence [UI]/bowel problems/breast changes/loss of libido/hot flashes/fatigue) experienced 'ever' and at questionnaire completion ('current'). Symptom proportions were weighted by age, country and time since diagnosis. Bonferroni corrections were applied for multiple comparisons.

Results: Adjusted response rate 54%; 75% reported at least one 'current' physical symptom ('ever' 90%), with 29% reporting at least three. Prevalence varied by treatment. Overall, 57% reported current ED and this was highest after radical prostatectomy (RP, 76%) followed by external beam radiotherapy with concurrent hormone therapy (HT, 64%). UI (overall 'current' 16%) was highest after RP ('current' 28%; 'ever' 70%). While 42% of brachytherapy patients reported no 'current' symptoms, 43% reported 'current' ED and 8% 'current' UI. 'Current' hot flashes (41%), breast changes (18%) and fatigue (28%) were reported more often by patients on HT.

Conclusion: Symptoms after prostate cancer treatment are common, often multiple, persist long-term and vary by treatment method. They represent a significant health burden. An estimated 1.6% of men aged >45 years are survivors of prostate cancer and currently experiencing an adverse physical symptom. Recognition and treatment of physical symptoms should be prioritised in patient follow-up. This information should facilitate men and clinicians when deciding about treatment as differences in survival between radical treatments is minimal.

Keywords: patient-reported outcomes; population; prostate cancer.

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Figures

Figure 1
Figure 1
Recruitment of prostate cancer survivors. RoI, Republic of Irleand; NI, Northern Ireland.
Figure 2
Figure 2
(a) ‘Current’ ED, UI and bowel problems. (b) ‘Current’ loss of libido, breast changes, fatigue and hot flushes.
Figure 3
Figure 3
(A) ED pretreatment and currently. (B) Loss of libido pretreatment and currently. Note, only ED and loss of libido are compared before and after treatment as definitions for other conditions differed before and after treatment.
Figure 4
Figure 4
Current symptoms reported by the survivors of prostate cancer using HT.
See this image and copyright information in PMC

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References

    1. Ferlay J, Soerjomataram I, Ervik M et al GLOBOCAN 2012 v 1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11 [Internet] Lyon, France: International Agency for Research on Cancer, 2013. Available at: http://globocan.iarc.fr. Accessed January 2014
    1. Maddams J, Utley M, Moller H. Projections of cancer prevalence in the United Kingdom, 2010–2040. Br J Cancer 2012; 107: 1195–202 - PMC - PubMed
    1. Bray F, Lortet Tieulent J, Ferlay J, Forman D, Auvinen A. Cancer incidence and mortality trends in 37 European countries: an overview. Eur J Cancer 2012; 46: 3040–52 - PubMed
    1. Donnelly D. Living with and Beyond Cancer. A Report on Cancer Prevalence in Northern Ireland 2010. Northern Ireland Cancer Registry, 2013. Available at: http://www.qub.ac.uk/research-centres/nicr/FileStore/PDF/Incidence/Filet.... Accessed February 2014
    1. Gomella LG, Johannes J, Trabulsi EJ. Current Prostate cancer treatments: effect on quality of life. Urology 2009; 73: 28–35 - PubMed

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