Material, psychological, and behavioral financial hardship and prostate cancer treatment type.

e19013 Background: A prostate cancer diagnosis can have a significant financial impact on the family; and, the various treatment options present a variety of economic consequences. Treatments can present short- and long-term sequelae leading to additional therapies, and the costs for the household can vary depending on the type of treatment received. Cancer survivorship research has shown that many survivors experience financial hardship following diagnosis. Financial hardship has recently been conceptualized in cancer survivorship research across three domains: material, psychological, and behavioral. The material domain refers to the lack of financial resources (e.g. material hardship), the psychological domain refers to how one feels about the lack of financial resources (e.g. financial worry), and the behavioral domain captures the financial adjustments made in response to a lack of financial resources. The purpose of this study was to investigate the association between the material, psychological, and behavioral domains of financial hardship and the type of prostate cancer treatment received. Methods: The prostate cancer non-profit organization, ZERO - The End of Prostate Cancer, conducted an online “Prostate Cancer Education Survey” to determine information needs among individuals diagnosed with prostate cancer (N = 1,000). We used bivariate tests and simple and adjusted multivariable logistic regression models to test the association between financial hardship and the type of treatment received. Results: The results revealed no statistically significant differences across the treatment types for material hardship. Patients who received chemotherapy and primary hormone therapy had higher odds (OR = 1.84; CI: 1.01-3.33) of reporting psychological hardship compared to those reporting active surveillance/watchful waiting; and those reporting active surveillance/watchful waiting had higher odds (OR = 1.50; CI: 1.07-2.11) of reporting psychological hardship compared to those reporting surgery. Patients who received chemotherapy also had higher odds (OR = 2.52; CI: 1.30-4.88) of reporting behavioral hardship compared to those reporting active surveillance/watchful waiting treatment. Conclusions: Explicating the material, psychological, and behavioral correlates of prostate cancer treatment types provides greater specificity for potential intervention targets where programs can be designed for reducing specific types of financial hardship following prostate cancer diagnosis and during survivorship.

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Sexual function of men undergoing invasive prostate cancer treatment versus active surveillance – Results of the EUPROMS study

European Urology ◽

10.1016/s0302-2838(21)01422-6 ◽

2021 ◽

Vol 79 ◽

pp. S1483-S1484

Author(s):

L.D.F. Venderbos ◽

A. Deschamps ◽

E-G. Carl ◽

J. Dowling ◽

S. Remmers ◽

...

Keyword(s):

Prostate Cancer ◽

Sexual Function ◽

Cancer Treatment ◽

Active Surveillance ◽

Prostate Cancer Treatment

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Regenerative technology to restore and preserve erectile function in men following prostate cancer treatment: evidence for penile rehabilitation in the context of prostate cancer survivorship

Therapeutic Advances in Urology ◽

10.1177/17562872211026421 ◽

2021 ◽

Vol 13 ◽

pp. 175628722110264

Author(s):

Eric Chung

Keyword(s):

Prostate Cancer ◽

Gene Therapy ◽

Growth Factors ◽

Cancer Treatment ◽

Cancer Survivorship ◽

Erectile Function ◽

Neural Regeneration ◽

Prostate Cancer Treatment ◽

Penile Rehabilitation

Introduction: Erectile dysfunction (ED) following prostate cancer treatment is not uncommon and penile rehabilitation is considered the standard of care in prostate cancer survivorship (PCS), where both patient and his partner desire to maintain and/or recover pre-treatment erectile function (EF). There is a clinical interest in the role of regenerative therapy to restore EF, since existing ED treatments do not always achieve adequate results. Aim: To review regenerative therapies for the treatment of ED in the context of PCS. Materials and Methods: A review of the existing PubMed literature on low-intensity extracorporeal shockwave therapy (LIESWT), stem cell therapy (SCT), platelet-rich plasma (PRP), gene therapy, and nerve graft/neurorrhaphy in the treatment of ED and penile rehabilitation, was undertaken. Results: IESWT promotes neovascularization and neuroprotection in men with ED. While several systematic reviews and meta-analyses showed positive benefits, there is limited published clinical data in men following radical prostatectomy. Cellular-based technology such as SCT and PRP promotes cellular proliferation and the secretion of various growth factors to repair damaged tissues, especially in preclinical studies. However, longer-term clinical outcomes and concerns regarding bioethical and regulatory frameworks need to be addressed. Data on gene therapy in post-prostatectomy ED men are lacking; further clinical studies are required to investigate the optimal use of growth factors and the safest vector delivery system. Conceptually interpositional cavernous nerve grafting and penile re-innervation technique using a somatic-to-autonomic neurorrhaphy are attractive, but issues relating to surgical technique and potential for neural ‘regeneration’ are questionable. Conclusion: In contrast to the existing treatment regime, regenerative ED technology aspires to promote endothelial revascularization and neuro-regeneration. Nevertheless, there remain considerable issues related to these regenerative technologies and techniques, with limited data on longer-term efficacy and safety records. Further research is necessary to define the role of these alternative therapies in the treatment of ED in the context of penile rehabilitation and PCS.

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Interactions in the aetiology, presentation and management of synchronous and metachronous adenocarcinoma of the prostate and rectum

Annals of The Royal College of Surgeons of England ◽

10.1308/003588412x13373405384611 ◽

2012 ◽

Vol 94 (7) ◽

pp. 456-462 ◽

Cited By ~ 10

Author(s):

GF Nash ◽

KJ Turner ◽

T Hickish ◽

J Smith ◽

M Chand ◽

...

Keyword(s):

Prostate Cancer ◽

Rectal Cancer ◽

Cancer Treatment ◽

Cancer Diagnosis ◽

Prostate Cancer Treatment ◽

Diagnosis And Management ◽

Adenocarcinoma Of The Prostate

Adenocarcinoma of the prostate and rectum are common male pelvic cancers and may present synchronously or metachronously and, due to their anatomic proximity. The treatment of rectal or prostate cancer (in particular surgery and/or radiotherapy) may alter the presentation, incidence and management should a metachronous tumour develop. This review focuses on the interaction between prostatic and rectal cancer diagnosis and management. We have restricted the scope of this large topic to general considerations, management of rectal cancer after prostate cancer treatment and vice versa, management of synchronous disease and cancer follow-up issues.

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Active Surveillance for Localized Prostate Cancer – Current Practices and Recommendations

The Scientific World JOURNAL ◽

10.1100/tsw.2010.227 ◽

2010 ◽

Vol 10 ◽

pp. 2352-2361 ◽

Cited By ~ 3

Author(s):

Jennifer N. Wu ◽

Marc A. Dall'Era

Keyword(s):

Prostate Cancer ◽

Active Surveillance ◽

Watchful Waiting ◽

Low Grade ◽

Prostate Cancer Treatment ◽

Diagnostic Practices ◽

High Prevalence ◽

Localized Disease ◽

Selective Therapy

Prostate cancer is now the most commonly diagnosed solid tumor in American men, due in part to widespread screening and aggressive diagnostic practices. Prostate cancer autopsy studies show the uniquely high prevalence rates of small, indolent tumors in men dying of other causes. These findings have led to increased concern for the overdetection and overtreatment of prostate cancer. Active surveillance for prostate cancer allows one to limit prostate cancer treatment with concomitant risks of treatment-related morbidity to the men who will benefit the most from aggressive therapies. Several tools have been developed in treated and surveyed men to assist physicians in selecting men with potentially indolent tumors amenable to active surveillance. Recent published results describe institutional experiences with active surveillance and delayed selective therapy for men with low-grade, early prostate cancer. Although median follow-up from these studies is relatively short, the outcomes appear favorable. Data from these reports provide information for selecting men for this approach, as well as for following them over time and determining triggers for further intervention. Ongoing clinical trials with watchful waiting and active surveillance for prostate cancer will ultimately provide improved evidence for managing early, localized disease.

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Shared-decision making in prostate cancer with clinical decision-support.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e16576 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e16576-e16576 ◽

Cited By ~ 1

Author(s):

Hermano Alexandre Lima Rocha ◽

Irene Dankwa-Mullan ◽

Sergio Ferreira Juacaba ◽

Van Willis ◽

Yull Edwin Arriaga ◽

...

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Cancer Treatment ◽

Shared Decision Making ◽

Active Surveillance ◽

Treatment Options ◽

Clinical Decision ◽

Treatment Decisions ◽

Shared Decision ◽

Prostate Cancer Treatment

e16576 Background: Shared decision-making is the process of deliberately interacting with patients who wish to make informed value-based choices, when there are no indicated best treatment options. Given the wide variation in prostate cancer treatment options, clinical decision-support systems (CDSS) may effectively support treatment decisions for patients with challenging risk-benefit profiles. However, limited data are available regarding CDSS in shared decision making. This study aimed to assess the alignment of CDSS therapeutic options with treatment received through a shared decision process. Methods: We identified patients with prostate cancer (Gleason Groups 1-5) who were engaged in shared treatment decision making, (from August–September 2018) at the Instituto do Câncer do Ceará, Brazil. IBM Watson for Oncology (WfO), a CDSS was used for the study. Treatment decisions were compared with WfO options (active surveillance, clinical trial, chemotherapy [CT], hormone therapy [HT], radiation [RT], brachytherapy [brachy], surgery and systemic therapy with GnRH suppression) and categorized as concordant (equivalent), partially concordant (a partial match), or discordant. Results: Concordance between WfO and shared treatment decisions was observed in 54% (26/48) of patients, partial concordance in 15% (7/48) and discordance in 31% (15/48). Most frequent treatments were RT+HT combination therapy (25%) and prostatectomy (21%). 8/15 (53%) discordant cases were due to patient preference for treatment over active surveillance. Patient preference for treatment over active surveillance was the most common reason (53%) for discordance. Conclusions: Variation in prostate cancer treatment exists. CDSS therapy options may be useful in quantifying and modifying unwarranted variations in prostate cancer treatment. Future studies are important for understanding reasons for variations. [Table: see text]

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