Editorial Comment

Abstract

In their original article, investigators from the Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment Consortium report short-term changes in health-related quality of life (HRQOL) in patients receiving neoadjuvant androgen deprivation therapy before initiating external beam radiation or brachytherapy for localized prostate cancer. Using the Expanded Prostate Cancer Index Composite-26 instrument, the study found statistically and clinically significant declines in the sexual and vitality/hormonal domain summary scores and in multiple individual items 2 months after initiating neoadjuvant androgen deprivation therapy. After 2 months of therapy, patients were more than twice as likely to report erectile dysfunction and orgasmic dysfunction. In addition, and perhaps not surprisingly, the risk of hot flashes increased with ADT administration, as did the likelihood of depressive symptoms and lack of energy. These data provide physicians and patients both with some sense of the short-term functional declines presumably attributable to ADT administration and should be used to guide expectations in the early treatment period. Neoadjuvant Androgen Deprivation Therapy Leads to Immediate Impairment of Vitality/Hormonal and Sexual Quality of Life: Results of a Multicenter Prospective StudyUrologyVol. 82Issue 6PreviewTo evaluate the immediate effects of neoadjuvant androgen deprivation therapy (NADT) on health-related quality of life (HRQOL) among patients undergoing radiation therapy (RT) for newly diagnosed prostate cancer. Full-Text PDF ReplyUrologyVol. 82Issue 6PreviewWe greatly appreciate the thoughtful commentary on our study. The effect of neoadjuvant androgen deprivation therapy (NADT) on health-related quality of life (HRQOL) deserves further study. It is our intention to publish the Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment Consortium long-term data in the future. In the context of NADT, the relationship between testosterone levels and HRQOL, testosterone recovery rates, and kinetics, and the effect of diminished muscle strength and cognitive functioning from NADT on HRQOL are some research areas that deserve further exploration so we can best advise our patients. Full-Text PDF