QOL Takes Huge Hit After Prostate Cancer Treatment: Patient Survey

By Megan Brooks

July 27, 2020

NEW YORK (Reuters Health) - Prostate cancer treatments take a huge toll on multiple quality of life domains and the impact may be greater than reported in clinical trials, according to results of the Europa Uomo Patient Reported Outcomes Study (EUPROMS).

The results show that quality of life is negatively impacted by any treatment for prostate cancer other than active surveillance, which "should be prompted as the first option for treatment for those men where it can be offered safely," Dr. André Deschamps, Europa Uomo Chairman, reported in a presentation at the European Association of Urology (EAU) Virtual Congress.

The findings are based on 2,943 men treated for prostate cancer from 24 European countries who completed a 20-minute online survey that used validated quality of life questionnaires.

Their mean age was 64 at diagnosis and 70 when they completed the survey, meaning they were reporting quality of life six years after treatment. Two-thirds of the men received one treatment for prostate cancer, 22% received two treatments, 10% received three, and 2% received four or more.

Overall, half of the men reported that loss of sexual function was a "big" (28%) or "moderate" (22%) problem in the years following treatment.

"We often hear that decline in sexual functioning is a relatively small problem for prostate cancer patients. This survey paints a different picture," Dr. Deschamps, of Erasmus University Medical Centre Department of Urology, said in a conference statement.

The men also reported that different treatments had different effects of quality of life.

Radiation therapy had the biggest reported impact on sexual function and radical prostatectomy had the biggest reported impact on urinary incontinence.

The impact of radiotherapy on sexual function was reported as worse than radical prostatectomy, but both had a severe impact, Dr. Deschamps reported.

Fatigue and insomnia scores were highest with radiotherapy and chemotherapy. Radiotherapy doubled the fatigue a patient experienced in comparison to surgery, whereas chemotherapy tripled the fatigue score, he noted.

"Fatigue and insomnia rates were higher than we were expecting. The results for incontinence and sexual function confirmed that data gathered in clinical environments are an understatement," Dr. Deschamps told Reuters Health by email. "I hope healthcare professionals will give a better indication to patients before treatment and make sure that after treatment all possible help is given to minimize effects."

The survey also found that the best quality of life scores are seen when prostate cancer is detected in an early, curable stage.

"This means efforts toward early detection and awareness are essential to avoid unnecessary deterioration in quality of life. Wherever it is possible and safe, active surveillance should be considered the first line treatment to ensure best quality of life," Dr. Deschamps said in the statement.

"Our findings provide patients and health care professionals with a snapshot of the impact of treatments. We hope they will be used to set realistic expectations of the effects of the different treatments for prostate cancer on quality of life," he added.

Dr. Deschamps told Reuters Health, "This is the first time ever that such a study has been done. EAU has recognized this by giving us the opportunity to speak in one of the four game changing sessions."

The study was sponsored by Bayer, Ipsen, and Janssen. The companies had no influence over any aspect of this study.

SOURCE: https://bit.ly/2D1cPaF European Association of Urology 2020 Virtual Congress, presented July 17, 2020.