Prostate Cancer Survivors Experience Long-Term Sexual, Urinary Adverse Effects
“To our knowledge, this was the first comparison of prostate-related dysfunction among screened survivors versus screened noncancer controls and indicated that these long-term problems were attributable to prostate cancer treatment and not to aging or comorbidities,” Kathryn L. Taylor, PhD, of the Georgetown University, Lombardi Comprehensive Cancer Center, Washington, DC, and colleague wrote.
Using data from the 5-site Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, the investigators assessed long-term disease-specific function among survivors of prostate cancer vs noncancer controls; the effect of the trial arm (eg, screening or usual care) on functioning; and the effect of treatment modality on functioning.
A total of 529 survivors of prostate cancer who were 5 to 10 years postdiagnosis were frequency-matched to 514 noncancer controls for race, screening center, year of enrollment, and trial arm. Each participant completed a telephone interview that detailed prostate cancer-specific symptomatology.
Poorer sexual and urinary function was found among survivors of prostate cancer vs noncancer controls (P<0.001). Compared with patients who underwent radical prostatectomy (n=201), those who received radiation therapy (n=110) reported better sexual (P<0.05) and urinary (P<0.001) functioning but poorer bowel outcomes (P<0.05).
Survivors who received treatment combinations that included androgen deprivation (n=207) reported significantly poorer hormone-related symptoms vs those who underwent radical prostatectomy (P<0.05). The investigators did not find trial arm to be significantly related to any outcome (P>0.31).
These differences in long-term adverse effects between treatment modalities, which demonstrate the enduring nature of commonly experienced adverse effects and the need for providers to manage them on a long-term basis, are particularly relevant for patients and clinicians when making treatment decisions, they concluded.