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. 2017 Mar 28;116(7):864-873.
doi: 10.1038/bjc.2017.30. Epub 2017 Feb 21.

Patients' perceptions of the negative effects following different prostate cancer treatments and the impact on psychological well-being: a nationwide survey

Ulla-Sisko Lehto  1 , Heli Tenhola  1   2 , Kimmo Taari  3 , Arpo Aromaa  1
Affiliations

Patients' perceptions of the negative effects following different prostate cancer treatments and the impact on psychological well-being: a nationwide survey

Ulla-Sisko Lehto et al. Br J Cancer. .

Abstract

Background: Although the prognosis of localised prostate cancer is good, the negative effects of prostate cancer treatment often impair patient quality of life. A growing number of men experience these negative effects over a longer time because of the increased incidence of and prolonged survival in prostate cancer, and the ageing of the population. Only a few studies have investigated the adverse effects of different prostate cancer treatments using large population-based samples.

Methods: We conducted a nationwide survey (n=1239) to collect detailed information regarding the negative effects (i.e., the occurrence, perceived level and perceived bother since the beginning of the treatment) of prostate cancer treatments: radical prostatectomy, external beam radiotherapy, brachytherapy, hormone therapy and surveillance. Furthermore, we measured patient satisfaction with the outcome of the treatment and their psychological well-being (i.e., psychological symptoms and satisfaction with life) 5 years after diagnosis. The negative effects between the treatments were compared, and the determinants of satisfaction and psychological well-being were investigated.

Results: The negative effects of all types of active prostate cancer treatments were common and persistent (33-48% reported symptoms at 5 years) and showed the known differences between the treatments. Prostatectomy and the radiotherapies caused urinary leakage; radiotherapy also caused symptoms of urinary irritation; and external radiation also caused bowel dysfunction. Most symptoms were considered highly bothersome. Most respondents (81-93%) reported that their treatment negatively affected their sex lives; 70-92% reported sexual dysfunction; and 20-58% reported that their sex lives with their spouses had ended. Urinary symptoms were especially associated with poorer psychological outcomes. The perception of symptom level and bother had a greater effect on patient satisfaction and well-being than the symptoms per se.

Conclusion: Multiple and persistent negative effects follow active prostate cancer treatment, and these effects predict long-term patient satisfaction and psychological well-being. The harms and benefits associated with prostate cancer treatments should be considered when selecting whether and how to actively treat prostate cancer.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The study sample.
Figure 2
Figure 2
Negative effects in different treatments (Reproduced by kind permission Lehto et al, 2013).(A) Urinary leakage after different treatments (age-adjusted), %. (B) Perceived impact on sex life (age-adjusted), %. (C) Potency deficiency after different treatments, %. (D) Sex life with the spouse before and after the treatment, %. (E) Adverse effects of hormonal treatment, %.
See this image and copyright information in PMC

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