MP67-17 ASSOCIATION BETWEEN TREATMENT FOR LOCALIZED PROSTATE CANCER AND MENTAL HEALTH OUTCOMES

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy III (MP67)1 Apr 2020MP67-17 ASSOCIATION BETWEEN TREATMENT FOR LOCALIZED PROSTATE CANCER AND MENTAL HEALTH OUTCOMES Amy Luckenbaugh*, Daniela Wittmann, Ann Arbor, MI, Zighuo Zhao, Tatsuki Koyama, Li-Ching Huang, Aaron Laviana, Christopher Wallis, Karen Hoffman, David Penson, and Daniel Barocas Amy Luckenbaugh*Amy Luckenbaugh* More articles by this author , Daniela WittmannDaniela Wittmann More articles by this author , Ann Arbor, MIAnn Arbor, MI More articles by this author , Zighuo ZhaoZighuo Zhao More articles by this author , Tatsuki KoyamaTatsuki Koyama More articles by this author , Li-Ching HuangLi-Ching Huang More articles by this author , Aaron LavianaAaron Laviana More articles by this author , Christopher WallisChristopher Wallis More articles by this author , Karen HoffmanKaren Hoffman More articles by this author , David PensonDavid Penson More articles by this author , and Daniel BarocasDaniel Barocas More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000947.017AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Management options for localized prostate cancer are similar with respect to intermediate-term survival outcomes and differ with respect to disease-specific functional outcomes. However, little is known about the impact of prostate cancer treatment on mental health. In this context, we evaluated the association between prostate cancer treatment choice and patient-reported mental health outcomes over time. METHODS: We enrolled a population-based cohort of men who underwent active surveillance, surgery or radiation therapy as part of the Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study. Depression (using the CES-D score, range 0-27, higher score indicating worse depression) and emotional well-being, energy and vitality (using the SF-36, range 0-100, higher scores indicating better function) were evaluated longitudinally through five years. Patients who did not complete at least one CES-D or SF-36 follow-up survey were excluded from the analysis. Univariate and multivariate analysis were performed to assess factors associated with CES-D and SF-36 scores. RESULTS: Among 1509 (52.4%) patients undergoing radical prostatectomy, 961 (33.4%) undergoing radiation therapy and 409 (14.2%) undergoing active surveillance there were no significant differences in CES-D or SF-36 scores between treated patients and those undergoing active surveillance (Table 1). The most significant predictors of decline in CES-D score included: older age (p=0.0075), poor overall health (p<0.0001), being unmarried (p<0.0195) and lower baseline CES-D score (p<0.0001). Baseline sexual function and urinary control were not correlated with longitudinal CES-D scores. Similar factors were found to be correlated with SF-36 emotional well-being, energy and vitality scores. CONCLUSIONS: Treatment with surgery or radiation was not associated with depression symptoms, or emotional well-being, energy, and vitality scores when compared to active surveillance through five years. Factors associated with development of declining mental health included: older age, being unmarried, poor overall health and lower baseline scores. Further analysis is warranted to determine if post-treatment sexual, urinary and bowel function are associated with longitudinal changes in mental health. Source of Funding: Grants (1R01HS019356 and 1R01HS022640) from the Agency for Healthcare Research and Quality and an award (CE12-11- 4667) from the Patient-Centered Outcomes Research Institute. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1031-e1032 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Amy Luckenbaugh* More articles by this author Daniela Wittmann More articles by this author Ann Arbor, MI More articles by this author Zighuo Zhao More articles by this author Tatsuki Koyama More articles by this author Li-Ching Huang More articles by this author Aaron Laviana More articles by this author Christopher Wallis More articles by this author Karen Hoffman More articles by this author David Penson More articles by this author Daniel Barocas More articles by this author Expand All Advertisement PDF downloadLoading ...