MP14-07 WHAT ARE WE MISSING? THE PERSISTENCE OF VITALITY SYMPTOM BURDEN IN LONG-TERM PROSTATE CANCER SURVIVORS WITHOUT RECURRENT DISEASE

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History III1 Apr 2015MP14-07 WHAT ARE WE MISSING? THE PERSISTENCE OF VITALITY SYMPTOM BURDEN IN LONG-TERM PROSTATE CANCER SURVIVORS WITHOUT RECURRENT DISEASE Alexander M. Helfand, Naveen Krishnan, Daniela A. Wittmann, Sarah T. Hawley, Chang He, May Darwish-Yassine, and Ted A. Skolarus Alexander M. HelfandAlexander M. Helfand More articles by this author , Naveen KrishnanNaveen Krishnan More articles by this author , Daniela A. WittmannDaniela A. Wittmann More articles by this author , Sarah T. HawleySarah T. Hawley More articles by this author , Chang HeChang He More articles by this author , May Darwish-YassineMay Darwish-Yassine More articles by this author , and Ted A. SkolarusTed A. Skolarus More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.869AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer survivors experience significant physical and psychological long-term effects of treatment. While sexual and urinary symptoms are well recognized, the burden of vitality symptoms, typically associated with recurrent disease treatment, may be underappreciated among men not treated with androgen deprivation therapy. For these reasons, we examined the variation in vitality symptom burden among long-term prostate cancer survivors and predictors that might explain it. METHODS We used the Michigan Cancer Registry to identify prostate cancer survivors diagnosed from 1985–2004. We used a stratified random cross-sectional sampling approach to identify potential survey respondents. Our survey included the EPIC Short Form vitality domain items (hot flashes, breast tenderness, depression, low energy, weight changes) and 'bother' (the degree to which these symptoms were problematic). We defined 'moderate/big problem' bother as major vitality symptom burden. We then used chi-square and logistic regression to evaluate predictors of major vitality symptom burden. RESULTS Among 2,499 respondents (38% response), the median time since diagnosis was 9 years. Nearly half (45%) reported ≥1 vitality symptom and 22% reported ≥2 symptoms. An increasing number of vitality symptoms was associated with major symptom burden (p<0.01) and most (58%) indicated they were not being treated for their vitality symptoms. Major vitality symptom burden (24%) exceeded urinary (20%) and bowel (14%) burdens. While prostate cancer recurrence was associated with major vitality symptom burden, even those without recurrence noted a major burden many years after diagnosis (Figure). Androgen deprivation therapy (OR 1.65, 95%CI 1.21-2.25) and black race (OR 1.77, 95%CI 1.27-2.46) predicted vitality burden but age and marriage status did not. CONCLUSIONS Vitality symptom burden is common and burdensome many years after prostate cancer diagnosis in those with and without recurrent disease. Vitality symptoms in long-term prostate cancer survivors appear to be undertreated, warranting systematic clinical approaches to identify and treat these often overlooked burdens. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e153 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexander M. Helfand More articles by this author Naveen Krishnan More articles by this author Daniela A. Wittmann More articles by this author Sarah T. Hawley More articles by this author Chang He More articles by this author May Darwish-Yassine More articles by this author Ted A. Skolarus More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...