K Clint Cary1, Nirmish Singla2, Janet E Cowan2, Peter R Carroll2, Matthew R Cooperberg2. 1. Department of Urology, University of California, San Francisco and UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California. Electronic address: clintcary20@gmail.com. 2. Department of Urology, University of California, San Francisco and UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
Abstract
PURPOSE: While androgen deprivation therapy can delay cancer progression and reduce tumor burden, its use can be limited by adverse side effects. We evaluated the effect of androgen deprivation therapy on mental and emotional well-being in men with nonmetastatic prostate cancer. MATERIALS AND METHODS: Participants were enrolled in the national CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor) registry, and treated with radical prostatectomy, external beam radiation therapy or brachytherapy with no androgen deprivation therapy (local); local with androgen deprivation therapy (combination); or primary androgen deprivation therapy. Emotional quality of life was evaluated by SF-36® social function, role emotional, vitality and mental health subscales before and up to 24 months after treatment. Subscales were assessed as continuous scores and as clinically meaningful declines of at least half a standard deviation since pretreatment. Associations between treatment and quality of life changes over time were evaluated with mixed modeling. Quality of life declines were evaluated with logistic regression. RESULTS: Among 3,068 men the combination and primary androgen deprivation therapy groups were older, single, with less education and higher clinical CAPRA (Cancer of the Prostate Risk Assessment) score risk than the local group (all values p <0.01). Androgen deprivation therapy exposure was associated with significant changes with time in adjusted role emotional (-8.4 points, p = 0.01) and vitality (-9.2 points, p = 0.02) scores. Treatment group was not associated with any clinically meaningful quality of life declines. A potential limitation is the observational nature of the study. CONCLUSIONS: Use of androgen deprivation therapy was associated with changes in mental and emotional well-being but did not result in clinically meaningful declines at 24 months. Patients must be counseled on possible quality of life changes related to androgen deprivation therapy as well as interventions to attenuate these effects before receiving treatment for prostate cancer.
PURPOSE: While androgen deprivation therapy can delay cancer progression and reduce tumor burden, its use can be limited by adverse side effects. We evaluated the effect of androgen deprivation therapy on mental and emotional well-being in men with nonmetastatic prostate cancer. MATERIALS AND METHODS:Participants were enrolled in the national CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor) registry, and treated with radical prostatectomy, external beam radiation therapy or brachytherapy with no androgen deprivation therapy (local); local with androgen deprivation therapy (combination); or primary androgen deprivation therapy. Emotional quality of life was evaluated by SF-36® social function, role emotional, vitality and mental health subscales before and up to 24 months after treatment. Subscales were assessed as continuous scores and as clinically meaningful declines of at least half a standard deviation since pretreatment. Associations between treatment and quality of life changes over time were evaluated with mixed modeling. Quality of life declines were evaluated with logistic regression. RESULTS: Among 3,068 men the combination and primary androgen deprivation therapy groups were older, single, with less education and higher clinical CAPRA (Cancer of the Prostate Risk Assessment) score risk than the local group (all values p <0.01). Androgen deprivation therapy exposure was associated with significant changes with time in adjusted role emotional (-8.4 points, p = 0.01) and vitality (-9.2 points, p = 0.02) scores. Treatment group was not associated with any clinically meaningful quality of life declines. A potential limitation is the observational nature of the study. CONCLUSIONS: Use of androgen deprivation therapy was associated with changes in mental and emotional well-being but did not result in clinically meaningful declines at 24 months. Patients must be counseled on possible quality of life changes related to androgen deprivation therapy as well as interventions to attenuate these effects before receiving treatment for prostate cancer.
Authors: Michael D Nyquist; Alexandra Corella; Osama Mohamad; Ilsa Coleman; Arja Kaipainen; Daniel A Kuppers; Jared M Lucas; Patrick J Paddison; Stephen R Plymate; Peter S Nelson; Elahe A Mostaghel Journal: JCI Insight Date: 2019-10-03
Authors: Michael D Nyquist; Alexandra Corella; John Burns; Ilsa Coleman; Shuai Gao; Robin Tharakan; Luke Riggan; Changmeng Cai; Eva Corey; Peter S Nelson; Elahe A Mostaghel Journal: Mol Cancer Res Date: 2017-05 Impact factor: 6.333
Authors: Sarah Wilding; Amy Downing; Penny Wright; Peter Selby; Eila Watson; Richard Wagland; David W Donnelly; Luke Hounsome; Hugh Butcher; Malcolm Mason; Ann Henry; Anna Gavin; Adam W Glaser Journal: Qual Life Res Date: 2019-05-21 Impact factor: 4.147
Authors: Kathryn T Dinh; Gally Reznor; Vinayak Muralidhar; Brandon A Mahal; Michelle D Nezolosky; Toni K Choueiri; Karen E Hoffman; Jim C Hu; Christopher J Sweeney; Quoc-Dien Trinh; Paul L Nguyen Journal: J Clin Oncol Date: 2016-04-11 Impact factor: 50.717