Abstract
PurposePatient-reported fatigue after robotic-assisted radical prostatectomy (RARP) has not been characterised to date. Fatigue after other prostate cancer (PCa) treatments is known to impact on patient-reported quality of life. The aim of this study was to characterise fatigue, physical activity levels and cardiovascular status post-RARP.MethodsBetween October 2016 and March 2017, men post-RARP or on androgen deprivation therapy (ADT) were invited into the study. Participants were asked to complete the Brief Fatigue Inventory (BFI) and Stage of Change and Scottish Physical Activity Questionnaires (SPAQ) over a 2-week period. Outcome measures were patient-reported fatigue, physical activity levels and the 10-year risk of cardiovascular disease (Q-Risk). Data were analysed in SPSS.Results96/117 (82%) men approached consented to participate; of these, 62/96 (65%) returned complete questionnaire data (RARP n = 42, ADT n = 20). All men reported fatigue with 9/42 (21%) post-RARP reporting clinically significant fatigue. Physical activity did not correlate with fatigue. On average, both groups were overweight (BMI 27.0 ± 3.9 kg/m2 and 27.8 ± 12.3 kg/m2 for RARP and ADT, respectively) and the post-RARP group had an 18.1% ± 7.4% Q-Risk2 score.ConclusionsA proportion of men is at increased risk of cardiovascular disease within 10 years post-RARP and have substantial levels of fatigue; therefore, clinicians should consider including these factors when counselling patients about RARP. Additionally, men post-RARP did not meet the recommended guidelines for resistance-based exercise. Future research is needed to establish whether interventions including resistance-based exercise can improve health and fatigue levels in this population.
Highlights
Radical prostatectomy is an accepted curative treatment option for men with clinically localised significant prostate cancer (PCa) with greater than 10 years of life expectancy and the ability to perform activities of daily living [1]
What data there is suggests that fatigue is present in PCa patients but is affected by treatment modality and the time period over which fatigue is assessed; it has been previously reported that approximately 14% of patients who have undergone radical prostatectomy experience fatigue [4, 5]
Men on continuous medical androgen deprivation therapy (ADT), a treatment strongly associated with a number of side effects that impact quality of life including significant fatigue [7], were purposely used as a comparative population with which to relate the morbidity of Roboticassisted radical prostatectomy (RARP)
Summary
Radical prostatectomy is an accepted curative treatment option for men with clinically localised significant prostate cancer (PCa) with greater than 10 years of life expectancy and the ability to perform activities of daily living [1]. Roboticassisted radical prostatectomy (RARP) is the most prevalent modality for surgical removal of the prostate for PCa in the UK [2]. The prevalence of fatigue and post-operative physical fitness in men who have undergone RARP is largely unknown with few studies performed to date have explored cancer-related fatigue post-RARP. What data there is suggests that fatigue is present in PCa patients but is affected by treatment modality and the time period over which fatigue is assessed; it has been previously reported that approximately 14% of patients who have undergone radical prostatectomy experience fatigue [4, 5]. Fatigue in cancer patients and survivors has been associated with reduced physical activity levels [6], potentially adversely
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