Predictors of prostate cancer-specific anxiety following stereotactic body radiation therapy (SBRT) for clinically localized prostate cancer.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 64-64
Author(s):  
Kamran Salari ◽  
Nima Aghdam ◽  
Luara Gersony ◽  
Malika Danner ◽  
Marilyn Ayoob ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Stereotactic Body Radiation Therapy ◽  
Median Score ◽  
Single Institution ◽  
Risk Patients ◽  
Caucasian Patients ◽  
Risk Grouping ◽  
Disease Specific

64 Background: Prostate Cancer (PCa) related anxiety varies widely based on management option. SBRT offers a safe and effective treatment for localized PCa. However, there is a paucity of data regarding PCa specific anxiety following SBRT and its relationship with PSA kinetics. In this report we present the results of a mail-in survey conducted amongst the participants of our prospective institutional quality of life (QOL) trial and identify sociodemographic and disease specific predictors of anxiety. Methods: Patients with localized PCa treated with SBRT at a single institution from 2007-2018 were eligible for inclusion in this study. The Memorial Anxiety Scale for PCa (MAX-PC) survey, was mailed to 450 patients on July of 2018. Patient’s total MAX-PC score (scale 0-54) was recorded. A score of ≥ 27 was defined as significant anxiety. Disease specific as well as demographic features were analyzed for possible correlation with self-reported anxiety. Results: By August 31, 2018, 227 patients had responded to the survey . The median score at all time points was 5 (1-41). Stratified by risk grouping; Low, Intermediate, and High Risk patients’ median scores were 7, 4.5 and 6. Six patients had a MAX-PC score≥27. Patients who were at least 2 years out from SBRT treatment had lower mean MAX-PC scores than those who were still within 2 years (6.3 versus 8.1, p = 0.045). Stratified by age, patients > 80 years old had a median score of 2 versus those < 70 with a median score of 6. Caucasian patients had lower mean MAX-PC scores than non-Caucasian patients (6.6 versus 9.1, p = 0.021). Patients who had at least a 0.5 ng/mL increase in PSA in their last 3 measurements had higher mean MAX-PC scores than those who did not (13.0 versus 7.0, p = 0.040). Conclusions: Patients with clinically localized PCa treated with SBRT experience minimal PCa specific anxiety. Anxiety surrounding PCa decreases with time. Non-Caucasian patients tended to have more anxiety than Caucasian patients. Patients who had recent PSA bounces tend to have higher levels of anxiety about their disease. Further follow-up of these patients over time would aid in assessing the progression of PCa specific anxiety as their lives progress.

Associations between uncertainty, anxiety, and quality of life in men with favorable-risk prostate cancer on active surveillance: Two-and-a-half years' follow-up.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 135-135
Author(s):  
Patricia A. Parker ◽  
John W. Davis ◽  
David Latini ◽  
George Baum ◽  
Xuemei Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Active Surveillance ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Study Entry ◽  
Illness Uncertainty ◽  
Disease Specific

135 Background: Active surveillance (AS) has emerged as a viable option for many men with early stage prostate cancer (PC). This approach of careful monitoring with prostate-specific antigen (PSA) level, digital rectal examination, and prostate biopsy may allow men to avoid or delay the potentially debilitating side effects of such aggressive treatments as surgery or radiation; however, AS may create uncertainty and anxiety for men with PC. We examined the associations between illness uncertainty and anxiety and general and PC-specific quality of life (QOL) of 191 men with favorable-risk PC participating in the AS program at MD Anderson Cancer Center. Methods: Men completed measures of uncertainty (Mishel Uncertainty in Illness Scale), anxiety (State-Trait Anxiety Inventory), and general (SF-12, Physical Health [PCS] and Mental Health Component Score [MCS]) and disease-specific (Expanded Prostate Index Composite [EPIC]) QOL questionnaires upon study entry and every 6 months. These results are through a 2.5 year follow-up. Results: Men were primarily (86%) white and an average age of 67.2 (SD=8.9). Average baseline PSA was 3.3 ng/mL (SD=1.6), 98% had a Gleason score of 6, and 85% had cT1c disease. Both general and PC-specific QOL were relatively unchanged across the 2.5 year study period, except for statistically significant declines in the EPIC Sexual score (p<0.05). Controlling for demographic (age, ethnicity) and clinical characteristics (study entry PSA, PSA density, testosterone, BMI, baseline number of biopsies, family history of cancer, whether patients were taking a 5-alpha-reductase inhibitor, and whether the tumor was reclassified during the study), illness uncertainty was a significant predictor of all EPIC summary scores, PCS, and MCS (all, p<0.05). Anxiety was also a significant predictor of all EPIC summary scores and MCS (all, p<0.05), but not PCS (p=0.08). Conclusions: Both increased anxiety and increased illness uncertainty were associated with poorer general and disease specific QOL. Interventions that focus on reducing uncertainty and anxiety may enhance the QOL of men on AS for PC.

scholarly journals Focal therapy of prostate cancer: patient selection, current limitations, and perspective of introduction into clinical practice

2018 ◽  
Vol 13 (4) ◽  
pp. 55-63
Author(s):  
A. V. Vasilyev ◽  
A. V. Govorov ◽  
A. A. Shiryaev ◽  
S. O. Sukhikh ◽  
A. A. Zherdev ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Practice ◽  
Patient Selection ◽  
Focal Therapy ◽  
Minimal Impact ◽  
Minimal Invasiveness ◽  
Risk Patients ◽  
Methods Of Treatment

Focal therapy is a promising option for localized prostate cancer treatment in low and intermediate risk patients. The combination of minimal invasiveness, disease control and the possibility of re-treatment in case of recurrence have significantly increased interest in focal therapy. However, before the final introduction of focal therapy into clinical practice, a number of significant limitations have yet to be overcome, such as patient selection, visualization of target, the choice of the treatment modality and the surgery planning, as well as the development  of a follow-up protocol. Studies have shown that focal therapy has minimal impact on the quality of life, but its oncological effectiveness has yet to be evaluated in comparison with radical methods of treatment.

scholarly journals Quality of life and results of total androgen blockade alone and with radiotherapy in the treatment of nonmetastatic prostate cancer

2012 ◽  
Vol 140 (7-8) ◽  
pp. 462-468
Author(s):  
Lela Milovanovic ◽  
Blagoje Milovanovic
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Metabolic Syndrome ◽  
High Risk ◽  
Fatal Outcome ◽  
High Risk Patients ◽  
Risk Patients ◽  
Androgen Blockade

Introduction. Hormonal treatment of prostate cancer (CaP) in the form of total androgen blockade (TAB) with or without radiotherapy is applied in metastatic disease and in patients with nonmetastatic and localized disease as well. Objective. The aim of the study was to compare oncological results, residual and newly developed symptoms during treatment and the quality of life in patients with nonmetastatic CaP treated by using Tand in a group treated both with Tand radiotherapy (RT+TAB). Methods. Retrospective analysis of 126 patients with nonmetastatic CaP was performed. Follow-up was 36 months. Seventynine out of 126 patients were treated with Talone and 47 with Tand radiotherapy (TAB+RT). Overall survival, metabolic syndrome appearance and the frequency of nonmalignant complications during treatment were analyzed. Urinary, digestive and sexual symptoms were analyzed, as well as the overall health condition of the patients. Results. Fatal outcome and/or disease progression occurred in 29 out of 126 patients (23%). High risk patients were significantly more frequent in the TAB+RT group (p=0.04). Mortality rate was not different in both groups indicating that better results of treatment were achieved in patients treated with TAB+RT. Metabolic syndrome appeared in 51.6% of Tpatients and in 51.1 of TAB+RT patients, and was significantly more frequent at the end of the follow-up than at the beginning of the treatment (p=0.003 in Tand p=0.01 in TAB+RT group). Urinary symptoms were more frequent than digestive symptoms in both groups. The quality of life was slightly improved after the beginning of therapy to be followed by the tendency of gradual decrease. Conclusion. Both modalities of treatment were efficient. Therapy TAB+RT was more efficient in high risk patients. Metabolic syndrome was more frequent after a long-term administration of therapy than at the beginning. The quality of life was the most affected in sexually active patients.

scholarly journals Randomized controlled study of the impact of a participatory patient care plan among primary care patients with common chronic diseases: a one-year follow-up study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina Tusa ◽  
Hannu Kautiainen ◽  
Pia Elfving ◽  
Sanna Sinikallio ◽  
Pekka Mäntyselkä
Keyword(s):  
Quality Of Life ◽  
Patient Care ◽  
Usual Care ◽  
Care Plan ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Disease Specific

Abstract Backround Chronic diseases and multimorbidity are common in the ageing population and affect the health related quality of life. Health care resources are limited and the continuity of care has to be assured. Therefore it is essential to find demonstrable tools for best treatment practices for patients with chronic diseases. Our aim was to study the influence of a participatory patient care plan on the health-related quality of life and disease specific outcomes related to diabetes, ischemic heart disease and hypertension. Methods The data of the present study were based on the Participatory Patient Care Planning in Primary Care. A total of 605 patients were recruited in the Siilinjärvi Health Center in the years 2017–2018 from those patients who were followed up due to the treatment of hypertension, ischemic heart disease or diabetes. Patients were randomized into usual care and intervention groups. The intervention consisted of a participatory patient care plan, which was formulated in collaboration with the patient and the nurse and the physician during the first health care visit. Health-related quality of life with the 15D instrument and the disease-specific outcomes of body mass index (BMI), low density lipoprotein cholesterol (LDL-C), hemoglobin A1c (HbA1C) and blood pressure were assessed at the baseline and after a one-year follow-up. Results A total of 587 patients with a mean age of 69 years were followed for 12 months. In the intervention group there were 289 patients (54% women) and in the usual care group there were 298 patients (50% women). During the follow-up there were no significant changes between the groups in health-related quality and disease-specific outcomes. Conclusions During the 12-month follow-up, no significant differences between the intervention and the usual care groups were detected, as the intervention and the usual care groups were already in good therapeutic equilibrium at the baseline. Trial registration ClinicalTrials.gov Identifier: NCT02992431. Registered 14/12/2016

Ultrasound Biomicroscopy Documented Anterior Uveal Melanoma Regression after Ruthenium-106 Plaque Therapy

2021 ◽  
pp. 1-9
Author(s):  
Biljana Kuzmanović Elabjer ◽  
Mladen Bušić ◽  
Andrej Pleše ◽  
Mirjana Bjeloš ◽  
Daliborka Miletić ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Tumor Regression ◽  
Corneal Thickness ◽  
Case Series ◽  
Ultrasound Biomicroscopy ◽  
Close Monitoring ◽  
Single Institution ◽  
Retrospective Case ◽  
Caucasian Patients

<b><i>Introduction:</i></b> Ultrasound biomicroscopy (UBM) is the only widely used method for the evaluation of anterior uveal melanoma (AUM). <b><i>Objective:</i></b> Documentation of regression of AUM treated with ruthenium-106 (Ru-106) plaque types CCB and CCC using UBM. <b><i>Methods:</i></b> This single institution-based retrospective case series involved 10 Caucasian patients with AUM followed after brachytherapy with UBM from January 2014 until February 2019. The largest prominence of the tumor perpendicular to the sclera or the cornea (including scleral/corneal thickness) (<i>D</i>) and the largest basal dimension (<i>B</i>) were measured in millimeters with UBM for all patients prior to the brachytherapy and at 4-month interval follow-up. Tumor regression was calculated as a percentage of decrease in the initial <i>D</i> and <i>B</i> values. <b><i>Results:</i></b> The study involved 10 patients with a mean age of 64.4 years (yr) (range 46–80 yr). <i>D</i> ranged from 1.82 to 5.5 mm (median 2.99 mm) and <i>B</i> from 2.32 to 12.38 mm (median 4.18 mm). The apical radiation dose in all patients was 100 Gy. The median follow-up was 42.02 months. Regression for <i>D</i> was 21.11 ± 13.66%, 31.09 ± 14.66%, and 34.92 ± 19.86% at 1st, 2nd, and 3rd year of the follow-up, respectively, while for <i>B</i> it was 21.58 ± 16.05%, 28.98 ± 17.71%, and 32.06 ± 18.96%, respectively. Tumor recurrence was documented in 2/10 patients. <b><i>Conclusion:</i></b> The major regression of AUM, treated with Ru-106 plaque types CCB and CCC, was documented in the first 2 years after brachytherapy in our study group. In the following years, only minimal regression was documented that warns of the need for close monitoring and active search for local recurrences.

Functional outcomes and quality of life during long-term follow-up after acute pulmonary embolism: analysis of the prospective multicentre FOCUS study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Barco ◽  
L Valerio ◽  
M Jankowski ◽  
M.M Hoeper ◽  
F.A Klok ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Medical Center ◽  
Combination Group ◽  
Funding Source ◽  
Median Score ◽  
Persistent Symptoms

Abstract Background It is unclear to which extent persistence of symptoms and/or residual haemodynamic impairment clinical course of pulmonary embolism are associated with worse quality of life (QoL). Aims To study the correlation between symptoms and haemodynamic impairment with QoL during the first year after acute pulmonary embolism (PE). Methods The Follow-Up after acute pulmonary embolism (FOCUS) study prospectively enrolled and followed consecutive adult patients diagnosed with acute symptomatic objectively diagnosed PE. In the present analysis, we considered patients who completed the Pulmonary Embolism QoL (PEmb-QoL) Questionnaire at predefined visits 3 and 12 months after acute PE. The PEmb-QoL score ranges from 0% (best QoL) to 100% (worst QoL). We evaluated at these two time points the correlation between persisting symptoms (group: symptoms), elevation of natriuretic peptides or residual right ventricular dysfunction (group: RVD), or their combination (group: symptoms + RVD) and QoL. Results A total of 617 patients were included; their median age was 62 years, 44% were women; 8% had active cancer, and 21% previous venous thromboembolism. At 3 months, patients with neither symptoms nor RVD (n=302) had the highest quality of life (median score 18%, 25th–75th percentile: 8%–34%), followed by those without symptoms but with RVD (n=255; median score 19%, 25th–75th percentile: 7%–34%), and by those with symptoms only (n=131; median PEmb-QoL 31%, 25th–75th percentile: 18%–49%). Patients with both symptoms and RVD (n=170) had the worst quality of life (median score 38%, 25th–75th percentile: 19%–53%); Figure 1A. At 12 months, we found an overall improvement of PEmb-QoL score. The degree of this QoL improvement varied across groups, being largest for patients who recovered from having symptoms + RVD at 3 months to normalization of at least one at 12 months. The change in QoL from 3 to 12 months was smaller both in patients who had neither symptoms nor RVD and in patients who had no recovery in either symptoms or RVD; Figure 1B. Conclusions Persistent symptoms after PE, especially in patients with elevated biomarkers or residual echocardiographic dysfunction, were the main drivers of QoL at 3 months as well as of the course of QoL over time. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): University Medical Center of the Johannes Gutenberg University, Mainz, Germany; German Federal Ministry of Education and Research

scholarly journals Predictors of multidomain decline in health-related quality of life after stereotactic body radiation therapy (SBRT) for prostate cancer

Cancer ◽  
2016 ◽  
Vol 123 (9) ◽  
pp. 1635-1642 ◽  
Author(s):  
Robert T. Dess ◽  
William C. Jackson ◽  
Simeng Suy ◽  
Payal D. Soni ◽  
Jae Y. Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Health Related Quality ◽  
Stereotactic Body Radiation ◽  
Related Quality ◽  
Health Related
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