Survey suggests high level of long-term side effects after treatment for prostate cancer


According to new data presented at the Frontiers in Cancer Prevention Research meeting ongoing this week in Boston, MA, some 70 percent of prostate cancer patients participating in a survey in Michigan reported long-term, treatment-related, adverse effects after first-line treatment with surgery or radiation therapy.

The Michigan Prostate Cancer Survivors Study was initiated to describe and quantify long-term symptoms reported by male patients after first-line treatment for prostate cancer. Data were collected from 2,500 men who received an initial diagnosis and first-line treatment for prostate cancer between 1985 to 2004 and who were still alive at the end of 2005.

Data were reported at the conference by May Darwish-Yassine, PhD, and can be summarized as follows:

  • The patient mix (at the time of the survey)
    • 53.0 percent of participants were 75 years of age or older.
    • 33.3 percent of participants were between 65 and 74 years of age.
    • 13.8 percent of participants were < 64 years of age.
    • 75 percent of participants were Caucasian.
    • 11.1 percent of participants were < 5 years post-diagnosis.
    • 40.9 percent of participants were 5 to 9 years post-diagnosis.
    • 28.8 percent of participants were 10 to 14 years post-diagnosis.
    • 19.3 percent of participants were ≥ 15 years post-diagnosis.
  • The treatment mix
    • About 70 percent of participants had received only one form of therapy.
    • 55.1 percent of participants had received surgery alone.
    • 67.5 percent of participants had received surgery and some other form of treatment.
    • About a third of participants had received external beam radiation therapy.
    • 10.0 percent of participants had received some form of brachytherapy.
    • 20.0 percent of participants had received some form of androgen deprivation therapy.
  • Post-treatment symptoms reported  within 4 weeks prior to the survey
    • 89.6 percent of participants reported symptoms of sexual dysfunction, including
      • Poor or no erection (55 to 85 percent)
      • Erection not reliable (54 to 87 percent)
      • Erection not firm (61 to 89 percent)
    • 69.9 percent of participants reported symptoms of urinary tract dysfunction, inluding
      • Urinary leakage (52 to 60 percent)
      • Urinary frequency (37 to 50 percent)
    • 44.8 percent of participants reported symptoms of bowel dysfunction, including
      • Bowel frequency (25 to 37 percent)
    • 45.0 percent of participants reported effects on vitality, including
      • Lack of energy (26 to 33 percent)
  • Severity of post-treatment symptoms
    • 46 percent of  participants reported sexual dysfunction as a moderate or big problem.
    • 20 percent of participants reported urinary tract dysfunction as a moderate or big problem.
    • 10 percent of participants reported bowel dysfunction as a moderate or big problem.
    • 24 percent of participants reported vitality as a moderate or big problem.

Now we do have to be careful about how we interpret these data. There are a number of issues that could have profoundly affected the resulsts of this study, for example:

  • Could the way patients were recruited have made it likely that men with few post-treatment problems did not participate?
  • To what extent did increasing age alone affect study results (particularly with respect to sexual function)?

On the other hand, this is the only study we are aware of that has attempted to collect meaningful data on the adverse affects of treatment for prostate cancer for up to 15+ years post-treatment.

The data above have been extracted from a report on this presentation on MedPage Today.

6 Responses

  1. Is there is difference bewteen “therapy” and “treatment”? I am trying to understand how 70 percent received only one form of therapy and 67.5 percent received surgery and some other form of treatment. If the first statistic is correct and therapy is the same as treatment, then theoretically, at most only 30 percent could have received more than one form of therapy/treatment? Thanks.

    Richard

  2. Richard:

    These data could have been mis-reported by MedPage Today or improperly presented by the original author. We have simply re-presented what was reported. This is not a peer-reviewed and published paper. Don’t over-analyze the data.

  3. This is my first comment to anything that I have read in the 19 months since my prostate cancer diagnosis.

    Regardless of the accuracy or interpretation of this information by MedPage, it’s about time someone made an organized attempt to do an evaluation and comparison of the side effects of what the medical community is doing to all of those who have prostate cancer as they try “cure us,” “treat us,” or “help us”. I have never been exposed to so much biased and confusing information in my life while trying to figure out how to treat my disease. Until doctors put their egos and financial interests aside, I for one do not believe that they will ever find a cure for prostate cancer or any other cancer for that matter.

    I have spoken to a lot of doctors — from the most respected teaching hospitals/university’s to the small local urology practices, including famous surgeons, radiation oncologists, and even radiologists offering laser ablation — and one thing that they all agree on is that none of them agree on much of anything.

    Now don’t misunderstand me, there are a lot of doctors out there doing a lot of good things (including some of the doctors that I spoke to); however, it’s just not working. Something is broken!

    Unfortunately, it appears that the treatment recommended by a physician is determined by the specialty that that physician is earning his or her living from and/or fueling his or her ego with.

    I am fortunate in that I have a low-grade and non-aggressive form of the disease (Gleason 3 + 3 = 6 and a PSA that ranges and will vary from 2.0 to 3.19) and I have been able to research and learn an incredible amount about prostate cancer, the treatments available, and the side effects of those treatments before I am finally forced to take the plunge in order to try to save my life.

    In my opinion the doctors treating prostate cancer (and other cancers for that matter) need to thoroughly inform their patients (which they are not doing) and should be working together as a team to make a collective, unbiased decision that is in the patient’s best interest and not their own regarding treatment.

    We must begin to ask ourselves what is happening to all of the research dollars that are spent on research for cancer cures and treatments?

    John

  4. Dear John:

    I am in complete agreement with you. Some of us are trying to do something about this, but it is an uphill battle because of all the vested interests.

  5. John, I believe that most of the research dollars are going into studies that show as much useless information as the old studies do. The studies are done because researchers have to “publish or die”.

    When I look back at the 15 years since my diagnosis and think of the billions that have been spent since the “War on Cancer” was started, and see that the same percentage of male deaths in the US are related to prostate cancer as was the case in 1976, I have to say that any claims of winning the war are misplaced.

  6. John:

    It appears that you and I started with the same numbers; I am about 2.5 years ahead of you, however.

    After my Gleason ticked up to 4 + 3 and 3 + 4, I decided to move from active surveillance to treatment. My urologist, a da Vinci pioneer, provided me with all of the appropriate information on surgery, without a recommendation or opinions on alternative approaches. He and I (and my wife) agreed that the decision was, appropriately, mine to make.

    I then carefully and exhaustively researched the mainstream options and interviewed practitioners.

    I decided that PBRT was the best choice for me and finished the course a month ago.

    I have no regrets, feel terrific, and am optimisticly awaiting my first post-treatment PSA.

    My point is that only the patient can and should decide on whether, when, and how to deal with what can be a lethal disease. Of course, with that decision goes responsibility — as it should.

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