Life after prostate cancer diagnosis: One step beyond.

40 Background: Prostate cancer (PCa) outcome studies are frequently restricted to specific disease stage or treatments. Interpretation may be restricted through lack of population control data & selection bias. We report a whole population evaluation of health-related quality of life (HRQL) following diagnosis of PCa compared to a general population (GenPop) cohort. Methods: Cross-sectional postal survey of all men diagnosed with PCa in the UK 18-42 months earlier. Measures of generic HRQL (EQ-5D) and PCa specific outcomes (EPIC-26 & interventions for erectile dysfunction), as defined in ICHOM minimum dataset, were utilized. Comparable GenPop data was collected from men never diagnosed with PCa in Northern Ireland. Results: 35,823 PCa survivors responded (60.8% response rate), median age 71, and 2,995 from the GenPop (30%). Overall HRQL was slightly lower in the PCa men than the GenPop, this difference was significant only in stage 4 disease. Men with PCa were less likely to report problems in individual EQ5D domains than men in the GenPop (62.0% vs. 68.8%). Both populations were most likely to report pain/discomfort, this was lower in PCa men than the GenPop (42.1% vs. 60.8%). Problems increased with age in all domains, with the exception of anxiety/depression. Men generally reported good function on EPIC-26; however PCa survivors reported poorer sexual function (78.9% vs 48%) except in the oldest. Medications/devices/services to aid or improve erections were offered to 45.4%, 26.0% & 16.9% respectively (and considered helpful by 14.7%, 7.5% & 3.2%). Men with PCa reported more problems with urinary leakage (13.1% vs. 7.1%), particularly after surgery. Hormonal symptoms were linked with receiving Androgen Deprivation Therapy and, to a lesser extent, external beam radiation. Conclusions: 18-42 months following diagnosis of PCa significant sexual and urinary morbidity is experienced relative to the GenPop. Specialist support for sexual dysfunction is not always offered. With the exception of men with stage 4 disease, overall HRQL is only mildly reduced. Funding The Life After Prostate Cancer Diagnosis study was funded by the Movember Foundation, in partnership with Prostate Cancer UK, as part of the Prostate Cancer Outcomes programme, grant number BO26/MO.

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External beam radiation treatment for rectal cancer is associated with a decrease in subsequent prostate cancer diagnosis

Cancer ◽

10.1002/cncr.23241 ◽

2008 ◽

Vol 112 (4) ◽

pp. 943-949 ◽

Cited By ~ 6

Author(s):

Karen E. Hoffman ◽

Theodore S. Hong ◽

Anthony L. Zietman ◽

Anthony H. Russell

Keyword(s):

Prostate Cancer ◽

Rectal Cancer ◽

Cancer Diagnosis ◽

Radiation Treatment ◽

External Beam Radiation ◽

External Beam ◽

Beam Radiation ◽

Prostate Cancer Diagnosis

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Cigarette smoking is not associated with prostate cancer diagnosis and aggressiveness: a cross sectional Italian study

Minerva Urologica e Nefrologica ◽

10.23736/s0393-2249.18.03182-x ◽

2018 ◽

Vol 70 (6) ◽

Cited By ~ 7

Author(s):

Cosimo De Nunzio ◽

Giorgia Tema ◽

Riccardo Lombardo ◽

Alberto Trucchi ◽

Mariangela Bellangino ◽

...

Keyword(s):

Prostate Cancer ◽

Cigarette Smoking ◽

Cancer Diagnosis ◽

Cross Sectional ◽

Italian Study ◽

Prostate Cancer Diagnosis

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Awareness of prostate cancer diagnosis and management among Turkish males: a cross sectional study from Çorum

The Aging Male ◽

10.1080/13685538.2019.1577377 ◽

2019 ◽

Vol 23 (3) ◽

pp. 202-205 ◽

Cited By ~ 2

Author(s):

Mustafa Sungur ◽

Selahattin Caliskan

Keyword(s):

Prostate Cancer ◽

Cancer Diagnosis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Prostate Cancer Diagnosis ◽

Diagnosis And Management

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Rates of Adverse IBD-Related Outcomes for Patients With IBD and Concomitant Prostate Cancer Treated With Radiation Therapy

Inflammatory Bowel Diseases ◽

10.1093/ibd/izz175 ◽

2019 ◽

Vol 26 (5) ◽

pp. 728-733 ◽

Cited By ~ 4

Author(s):

Linda A Feagins ◽

Jaehyun Kim ◽

Anchalia Chandrakumaran ◽

Cassandra Gandle ◽

Katrina H Naik ◽

...

Keyword(s):

Prostate Cancer ◽

Inflammatory Bowel Disease ◽

Radiation Therapy ◽

Cancer Diagnosis ◽

Bowel Disease ◽

Radiation Treatment ◽

Multiple Logistic Regression Analysis ◽

External Beam Radiation ◽

Beam Radiation ◽

Inflammatory Bowel

Abstract Background Patients with inflammatory bowel disease (IBD) may be at higher risk for complications from radiation treatment for prostate cancer. However, available data are limited, and controversy remains regarding the best treatment approach for IBD patients who develop prostate cancer. Methods A retrospective cohort study across 4 Department of Veterans Affairs hospital systems. Patients with established IBD who were diagnosed and treated for prostate cancer between 1996–2015 were included. We assessed for flares of IBD, IBD-related hospitalizations, and IBD-related surgeries within 6, 12, and 24 months of cancer diagnosis and survival at 1, 2, and 5 years. Flares of IBD were those documented as such by the treating physician, and treatment changed accordingly. Results One hundred patients with IBD and prostate cancer were identified. Forty-seven were treated with either treatment with external beam radiation or brachytherapy, and 53 were treated with nonradiation modalities. Comparing cohorts with or without radiation treatment, there were no differences in baseline IBD characteristics, Charlson comorbidity index, or prostate cancer stage. Inflammatory bowel disease flares were 2-fold higher for radiation-treated patients within 6 months (10.6% vs 5.7%) and 6–12 months (4.3% vs 1.9%) after cancer diagnosis. On multiple logistic regression analysis, radiation treatment (adjusted odds ratio, 4.82; 95% confidence interval, 1.15–20.26) was a significant predictor of flares. However, rates of IBD-related hospitalizations or surgeries were not significantly different. Conclusions In this retrospective, multicenter study, 2-fold higher rates of flare were found within the first year after prostate cancer diagnosis for patients treated with radiation, but there were no differences in IBD-related hospitalizations or surgeries. Although patients should be counseled of these risks, avoidance of radiation therapy in IBD patients with prostate cancer is likely not necessary.

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A Comparative Investigation of Therapeutic Approaches for Primary Prostate Cancer and Risk of Acute Myeloid Leukemia.

Blood ◽

10.1182/blood.v110.11.1816.1816 ◽

2007 ◽

Vol 110 (11) ◽

pp. 1816-1816

Author(s):

Rohit P. Ojha ◽

Raymond Thertulien ◽

Deepak Prabhakar ◽

Yi Zhou ◽

Lori A. Fischbach

Keyword(s):

Prostate Cancer ◽

Acute Myeloid Leukemia ◽

Cancer Patients ◽

Cancer Diagnosis ◽

Myeloid Leukemia ◽

External Beam Radiation ◽

Therapeutic Approaches ◽

Prostate Cancer Diagnosis ◽

Primary Prostate Cancer ◽

Acute Myeloid

Abstract Radiation is a common therapeutic approach for prostate cancer. However, previous studies have reported that exposure to ionizing radiation may initiate leukemogenesis. We utilized a case-cohort design to investigate whether prostate cancer patients treated with external beam radiation therapy (EBRT) demonstrated greater risk of developing acute myeloid leukemia (AML) than prostate cancer patients that underwent surgery. Cases (n=224) were identified using Surveillance, Epidemiology, and End Results (SEER), a population-based cancer registry representative of the United States. Cases were restricted to men with primary prostate cancer diagnosed from January 1986-December 1994 and subsequent diagnosis of AML within 15 years of follow-up. Controls (n=256) were randomly sampled from all available primary prostate cancer diagnoses in SEER that corresponded to the study period selected for cases. We excluded patients that developed secondary cancers other than AML when selecting cases and controls because of competing risks. The outcome (AML) was dichotomized and mutually exclusive exposure categories (no treatment [reference], EBRT, surgery, or combination EBRT and surgery) were included as dummy variables in the model. Logistic regression was used to directly estimate 5-, 10-, and 15-year risk ratios (RRs) for AML. Prostate cancer patients treated with EBRT, surgery, or a combination of EBRT and surgery demonstrated a greater risk of developing AML than untreated prostate cancer patients after controlling for age, race, grade, and stage of prostate cancer. However, patients who received EBRT had consistently greater risk of developing AML across the time intervals than patients that underwent surgery (EBRT: 5-yr RR=1.77, 95% CI=0.75, 4.20; 10-yr RR=2.70, 95% CI=1.29, 5.65; 15-yr RR=2.76, 95% CI=1.34, 5.69. Surgery: 5-yr RR=1.42, 95% CI=0.63, 3.20; 10-yr RR=1.51, 95% CI=0.76, 3.00; 15-yr RR=1.56, 95% CI=0.80, 3.04). Patients who received a combination of EBRT and surgery exhibited risk estimates similar to EBRT alone (5-yr RR=1.79, 95% CI=0.65, 4.94; 10-yr RR=2.34, 95% CI=0.97, 5.66; 15-yr RR=2.61, 95% CI=1.09, 6.23). Our data indicate that prostate cancer patients who received EBRT had almost a 2-fold greater risk of developing AML 10-years after prostate cancer diagnosis than patients who underwent surgery. The finding may be of interest when considering treatment options, but requires further elucidation of specific predictors that may contribute to increased AML risk among prostate cancer patients. Furthermore, our data indicate that AML risk begins to plateau 10-years after prostate cancer diagnosis for patients that received EBRT and may assist with defining induction and latency. Data limitations prevented addressing potential confounding by independent or concomitant chemotherapy and socioeconomic status. The magnitude of bias introduced by the inability to incorporate such variables is difficult to speculate without further data. Future investigations with access to robust data may be able to address the limitations herein. Our investigation thus far provides the largest comparison of therapeutic approaches and AML risk among prostate cancer patients.

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