Cohort Of Prostate Cancer Survivors Research Articles

The association between age and long-term quality of life after curative treatment for prostate cancer: a cross-sectional study.

We aimed to investigate the associations between age at radical prostate cancer treatment and long-term global quality of life (QoL), physical function (PF), and treatment-related side effects. This single-center, cross-sectional study included men treated for localized prostate cancer with robotic-assisted radical prostatectomy (RARP) or external beam radiotherapy (EBRT) in 2014-2018. Global QoL and PF were assessed by the European Organisation of Research and Treatment in Cancer Quality of life Questionnaire-C30 (QLQ-C30), side effects by the Expanded Prostate Cancer Index Composite (EPIC-26). Adjusted linear regression models were estimated to assess associations between age (continuous variable) at treatment and outcomes. QLQ-C30 scores were compared to normative data after dividing the cohort in two groups, <70 years and ≥70 years at treatment. Of 654 men included, 516 (79%) had undergone RARP, and 138 (21%) had undergone EBRT combined with androgen deprivation therapy for 93%. Mean time since treatment was 57 months. Median age at treatment was 68 (min-max 44-84) years. We found no statistically significant independent association between age at treatment and global QoL, PF or side effects, except for sexual function (regression coefficient [RC] -0.77; p < 0.001) and hormonal/vitality (RC 0.30; p = 0.006) function. Mean QLQ-C30 scores were slightly poorer than age-adjusted normative scores, for men <70 years (n = 411) as well as for men ≥70 years (n = 243) at treatment, but the differences were not beyond clinical significance. In this cohort of prostate cancer survivors, age at treatment had little impact on long-term QoL and function. Due to the cross-sectional design, short term impact or variation over time cannot be ruled out.

Racial Distribution of Neighborhood-Level Social Deprivation in a Retrospective Cohort of Prostate Cancer Survivors.

Background: A better understanding of neighborhood-level factors’ contribution is needed in order to increase the precision of cancer control interventions that target geographic determinants of cancer health disparities. This study characterized the distribution of neighborhood deprivation in a racially diverse cohort of prostate cancer survivors. Methods: A retrospective cohort of 253 prostate cancer patients who were treated with radical prostatectomy from 2011 to 2019 was established at the Medical University of South Carolina. Individual-level data on clinical variables (e.g., stage, grade) and race were abstracted. Social Deprivation Index (SDI) and Healthcare Professional Shortage (HPS) status was obtained from the Robert Graham Center and assigned to participants based on their residential census tract. Data were analyzed with descriptive statistics and multivariable logistic regression. Results: The cohort of 253 men consisted of 168 white, 81 African American, 1 Hispanic and 3 multiracial men. Approximately 49% of 249 men lived in areas with high SDI (e.g., SDI score of 48 to 98). The mean for SDI was 44.5 (+27.4), and the range was 97 (1–98) for all study participants. African American men had a significantly greater likelihood of living in a socially deprived neighborhood compared to white men (OR = 3.7, 95% C.I. 2.1–6.7, p < 0.01), while men who lived in areas with higher HPS shortage status were significantly more likely to live in a neighborhood that had high SDI compared to men who lived in areas with lower HPS shortages (OR = 4.7, 95% C.I. = 2.1–10.7, p < 0.01). African Americans had a higher likelihood of developing biochemical reoccurrence (OR = 3.7, 95% C.I. = 1.7–8.0) compared with white men. There were no significant association between SDI and clinical characteristics of prostate cancer. Conclusions: This study demonstrates that SDI varies considerably by race among men with prostate cancer treated with radical prostatectomy. Using SDI to understand the social environment could be -particularly useful as part of precision medicine and precision public health approaches and could be used by cancer centers, public health providers, and other health care specialists to inform operational decisions about how to target health promotion and disease prevention efforts in catchment areas and patient populations.

Cardiovascular disease prevention and management of pre-existent cardiovascular disease in a cohort of prostate cancer survivors.

Cardiovascular disease (CVD) is a common cause of mortality among men with prostate cancer. However, receipt of preventive care and management of pre-existent CVD has not been well studied in prostate cancer survivors. This study examined a prospective cohort of men newly diagnosed with localized prostate cancer between 2011 and 2013 throughout North Carolina linked to Medicare and private insurance claims and clinical data from the Veterans Affairs (VA). In patients without pre-existent CVD, the primary outcome was a composite measure of annual preventive care (blood glucose screening, cholesterol level testing, and ≥ 1 primary care provider visit). In patients with pre-existent CVD, the primary outcome was annual cardiologist visit; blood glucose, cholesterol level testing, and primary care visits were also assessed. Our sample comprised 492 patients successfully linked to insurance claims and/or VA data, among whom 103 (20.9%) had pre-existent CVD. Receipt of preventive care declined from 52.7% (95% confidence interval [CI], 47.7 to 57.6%) during the first year after prostate cancer diagnosis to 40.8% (95% CI: 33.7 to 48.4%) during the third year. Among patients with pre-existent CVD, only 23.4% (95% CI: 13.6 to 37.2%) visited a cardiologist in all 3years. Black men were more likely than White men to visit a cardiologist the first year (risk ratio [RR] = 1.72, 95% CI: 1.10 to 2.71). In a population-based cohort of prostate cancer survivors, receipt of CVD preventive care declined over time, and frequency of cardiologist-led management of pre-existent CVD was low. There is a need to improve clinical strategies for reducing cardiovascular risk and managing pre-existent CVD in prostate cancer survivors.

Abstract PO-169: Racial distribution of neighborhood social deprivation in a retrospective cohort of prostate cancer survivors

Abstract Background: Cancer incidence and mortality rates vary across geographic areas; however, a better understanding of neighborhood level variables is needed to increase the precision of cancer control interventions that target geographic determinants of cancer health disparities. The purpose of this study is to characterize the distribution of neighborhood deprivation features in a cohort of racially diverse prostate cancer survivors based on social determinants (e.g., race) and clinical characteristics (e.g., Gleason score, tumor stage). Methods: A retrospective cohort of prostate cancer patients who were treated with radical prostatectomy from 2011 to 2019 was established using the tumor registry at the Hollings Cancer Center at the Medical University of South Carolina. Data on clinical variables (e.g., stage, grade) and social determinants (e.g., race) were abstracted from electronic medical records. Residential addresses were geocoded and neighborhood-level social deprivation measures (income, education, employment, housing, household characteristics, transportation and demographics) from the 2011-2015 American Community Survey five-year estimates were used to generate a composite Social Deprivation Index (SDI) using factor analysis. Next, descriptive, bivariate and correlation analyses were conducted to characterize SDI and examine the association between social determinants, clinical characteristics, and SDI. Results: The study sample included 249 men (168 white men and 81 African American men) who had an average age of 66 years (+6.6). The mean for SDI was 44.5 (+27.4) and the range was 97 (1-98). White men that were married were 88.7% while African American men that were married were 77.8% (p: 0.02). Men who lived in neighborhoods that had a high level of social deprivation (i.e., SDI score of 48 to 98) were 121 (48.6%). There were significant racial differences in SDI between African American and white men. The mean SDI score was 58.5 (+26.9) among African American men compared to 37.8 (+25.0) among white men (p&amp;lt;0.01). In the logistic regression model, African American men had a significantly greater likelihood of living in a socially deprived neighborhood compared to white men (OR=4.2, 95% C.I. 2.4-7.5, p&amp;lt;0.01). In addition, men between the ages of 47-67 years were significantly more likely than men ages 68-80 to in a deprived neighborhood (OR=1.8, 95% C.I.=1.1-3.0, p- value=0.02). None of the clinical characteristics were associated significantly with SDI. Conclusion: This study demonstrates that SDI varies considerably among men. Greater efforts may be needed to address neighborhood level factors among African American men who have a personal history of prostate cancer. Citation Format: Oluwole Adeyemi Babatunde, John Pearce, Melanie Jefferson, Lewis Frey, Peggi Angel, Rick Drake, Caitlin Allen, Chanita Hughes- Halbert. Racial distribution of neighborhood social deprivation in a retrospective cohort of prostate cancer survivors [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-169.

Determinants of changes in physical activity from pre-diagnosis to post-diagnosis in a cohort of prostate cancer survivors.

Physical activity (PA) has been shown to improve quality of life and survival in cancer survivors; however, a cancer diagnosis may change PA patterns. We examine determinants of changes in meeting the PA guidelines (150min/week of moderate aerobic PA) before and after a prostate cancer diagnosis. Eight hundred and thirty prostate cancer survivors who participated in a population-based case-control study between 1997 and 2000 in Alberta, Canada, enrolled in a prospective cohort study. Past year activity levels were self-reported at diagnosis (pre-diagnosis measure) and again 2years post-diagnosis. Determinants were collected by questionnaires and medical chart abstractions. Four PA patterns were created: non-exercisers (fail to meet guidelines pre-diagnosis and post-diagnosis), adopters (fail to meet guidelines pre-diagnosis, meet guidelines post-diagnosis), maintainers (meet guidelines pre-diagnosis and post-diagnosis) and relapsers (meet guidelines pre-diagnosis, fail to meet guidelines post-diagnosis). Multinomial logistic regression analyses identified that being a non-exerciser compared to maintainer was associated with being employed, rural location, high PSA, smoking status, not attending support groups and less than average physical quality of life (QoL). Being a relapser compared to maintainer was associated with rural location and lack of friend support. Finally, being a non-exerciser compared to adopter was associated with urinary incontinence, smoking status and less than average physical and mental QoL. Demographic, health and lifestyle variables are associated with changes in meeting PA guidelines from pre-diagnosis to post-diagnosis in prostate cancer survivors. Programming should be aimed at offering interventions to help inactive survivors adopt PA and active survivors to maintain PA.

Risk-assessed exercise and diet in prostate cancer survivors: Consequences of cancer treatment on cardiopulmonary fitness and cardiovascular risk.

142 Background: Evidence from large observational studies suggests that men with prostate cancer have a higher risk of cardiovascular events due to accelerated atherosclerosis linked to androgen deprivation therapy (ADT). Adults &gt; 70 years of age have poorer outcomes from cancer treatment in the UK. However, it is not yet clear what might be contributing to poorer outcomes among older men with prostate cancer. Thus the purpose of this study was to assess the health and fitness of a cohort of prostate cancer survivors, from 2 regions in the UK, and identify factors that may influence cardiovascular health. Methods: Baseline assessments from 83 men with prostate cancer with no evidence of distant disease particpated. Men undertook a Cardiopulmonary Exercise Test (CPET), sit to stand, step test, grip strength, hip to waist ratio, self-reported exercise questionnaire (Godin), and co-morbidity index. Men were 1-3 years post diagnosis. Age-group comparisons were made using analysis of covariance against cardiac risk profile (QRisk2). Results: Men who were older ( &gt; 75) were more likely to have poorer cardiopulmonary fitness, as measured by VO2 Peak , and worse grip strength than age standardised values. Increased obesity across all groups (raised BMI) and higher B/P all contributed to a raised QRisk2 (mean: 36.9±6.1), which is higher than men of a similar age. Older men perceived themselves to be less physically active and were more likely to be on ADT. Conclusions: In our sample, men older than 75 had greater CVD risk, poorer physical function and lower strength. Improvements in diet and physical activity could improve physical function and reduce cardiovascular risk factors. Older men were more likely to be on ADT so to reduce long term co-morbidities other risk factors need to be addressed. More comprehensive functional health assessment at point of treatment could help clinicians optimise therapy to reduce long term comorbidities. [Table: see text]

Identifying suicidal symptoms in prostate cancer survivors using brief self-report.

Prostate cancer (PC) survivors are at elevated risk for completed suicide even many years post-treatment. Despite this risk, practical and efficient methods for assessing these symptoms have not been established. We sought to determine if suicidal symptoms could be effectively and efficiently identified in a cohort of PC survivors, and whether these men were receptive to emotional health interventions. Six hundred fifty-six PC survivors, an average of 5 years post-diagnosis, completed eight self-report items about suicidal symptoms and behavior in the past 7 days, and 12 months, as well as medical utilization and interest in emotional health support. Between 3.6 and 17.9% of PC survivors endorsed a single suicidal ideation item, and denied all other ideation. All survivors who endorsed serious suicidal ideation/behavior also endorsed either passive or active ideation. 58.3% of survivors denied any suicidal symptoms within the past week, but endorsed it within the past year. Most survivors had medical provider contact within the past year and were open to receiving information about emotional health interventions. Suicidal ideation in PC survivors cannot be accurately evaluated using only a one-item screen, or by inquiring within a single time frame. In both research and clinical settings, the evaluation for suicidal ideation in PC survivors should utilize multiple questions, across several time periods. It is possible to skip queries about serious ideation/behavior if passive or active ideation is denied. Once identified, medical providers should refer these men to psychosocial providers who can offer emotional support.

Bone complications among prostate cancer survivors: long-term follow-up from the prostate cancer outcomes study.

BACKGROUNDTo assess the relationship between ADT exposure and self-reported bone complications among men in a population-based cohort of prostate cancer survivors followed for 15 years after diagnosis.METHODSThe Prostate Cancer Outcomes Study (PCOS) enrolled 3,533 patients diagnosed with prostate cancer between 1994 and 1995. This analysis included participants with non-metastatic disease at the time of diagnosis who completed 15-year follow-up surveys to report development of fracture, and use of bone-related medications. The relationship between ADT duration and bone complications was assessed using multivariable logistic regression models.RESULTSAmong 961 surviving men, 157 (16.3%) received prolonged ADT (>1 year), 120 (12.5%) received short-term ADT (≤ 1 year), and 684 (71.2%) did not receive ADT. Men receiving prolonged ADT had higher odds of fracture (OR 2.5, 95% CI 1.1–5.7), bone mineral density testing (OR 5.9, 95% CI 3.0–12), and bone medication use (OR 4.3, 95% CI 2.3–8.0) than untreated men. Men receiving short-term ADT reported rates of fracture similar to untreated men. Half of men treated with prolonged ADT reported bone medication use.CONCLUSIONSIn this population-based cohort study with long-term follow-up, prolonged ADT use was associated with substantial risks of fracture whereas short term use was not. This information should be considered when weighing the advantages and disadvantages of ADT in men with prostate cancer.

Influence of age on incident diabetes (DM) and cardiovascular disease (CVD) among prostate cancer survivors receiving androgen deprivation therapy (ADT).

31 Background: Androgen deprivation therapy (ADT) has been associated with an increased risk of developing diabetes (DM) and cardiovascular disease (CVD), though this is controversial, particularly for CVD. We prospectively assessed the relationship between ADT and incident DM and CVD in the Prostate Cancer Outcomes Study (PCOS), a population-based cohort of prostate cancer survivors followed longitudinally for 15 years from diagnosis. Methods: We identified men in the PCOS with non-metastatic prostate cancer diagnosed from 1994 to 1995 and followed through 2009 to 2010. We used multivariable logistic regression models to compare groups receiving short-term ADT (less than 2 years), prolonged ADT (2 years or more) and no ADT to assess the relationship between ADT exposure and subsequent diagnoses of DM and CVD (determined by patient report and cause of death data). We evaluated the effects of age at diagnosis, race, stage, and comorbidity on the development of DM and CVD. Results: Among 3,526 men with comorbidity and treatment data, 2,985 men without baseline DM and 3,112 men without baseline CVD constituted the DM and CVD cohorts, respectively. Regardless of duration of ADT exposure, there was not an increased risk of DM or CVD in men younger than 70 at diagnosis. Compared to no ADT exposure, prolonged ADT was associated with an increased risk of DM and CVD that increased steadily over age 76 at diagnosis for DM (OR 2.11 at age 74, 95% CI 1.02 – 4.36; OR 2.65 at age 80, 95% CI 1.09 – 6.47) and age 74 at diagnosis for CVD (OR 1.89 at age 74, 95% CI 1.02 - 3.49; OR 3.19 at age 80, 95% 1.25 – 8.17). Increasing comorbidity burden modified risk of DM and CVD (for 3 or more comorbidities vs. no comorbidities; for DM, OR 4.25, 95% CI 2.3 - 7.9; and for CVD, OR 8.1, 95% CI 4.3 -15.5 P&lt;0.001). Conclusions: The relationship between ADT and development of CVD and DM may be dependent upon age at diagnosis in addition to length of ADT administration, with longer ADT exposure predominantly increasing risk among older men only. Men with greater comorbid burden had increased risk of developing DM and CVD. Closer monitoring for development of DM and CVD may be most important among older men receiving prolonged ADT, especially those with other comorbidities.

Bone health among prostate cancer survivors: Long-term follow-up from the Prostate Cancer Outcomes Study (PCOS).

106 Background: Bone complications of androgen deprivation therapy (ADT) have been described using administrative databases and smaller prospective studies with relatively short follow-up. Prospectively acquired data with long term follow-up are lacking. We assessed the relationship of patient-reported bone health and ADT exposure in a population-based prospective cohort of prostate cancer survivors followed longitudinally for 15 years from diagnosis. Methods: Using PCOS 15 year patient-reported survey data, we identified men with non-metastatic prostate cancer diagnosed from 1994-1995 and followed through 2009-2010. We evaluated subgroups receiving &gt;1 yr, ≤1 yr, and no ADT. We then queried participants regarding the development of osteoporosis, fracture, and use of osteoporosis medications. We assessed the relationship between duration of ADT and bone health outcomes using univariable logistic regression models, and evaluated the association between ADT and osteoporosis medications using multivariable logistic regression adjusted for PSA and geographic location. Results: Among 961 men who completed 15 year surveys, 157 received &gt;1 yr ADT, 120 received ≤1 yr ADT, and 684 did not receive ADT. During the study period, 12 men developed bone metastases and were excluded from the fracture analysis (7 received &gt;1 yr ADT, 2 received ≤1 yr ADT, and 3 did not receive ADT). Men receiving &gt;1 yr ADT were more likely to report osteoporosis (OR 4.29, 95% CI 2.38-7.71) or fracture (OR 1.73, 95% CI 1.04-2.89) than men not receiving ADT. When compared with men not receiving ADT, men receiving &gt;1 yr ADT were more likely to report bone mineral density testing (OR 4.59, 95% CI 3.09-6.83), and bone medication use (OR 3.22, 95% CI 2.19-4.72). Half (50.3%) of men treated for &gt;1 yr ADT reported bone medication use. Among men who reported use of bone medications, 94% reported calcium or vitamin D use and 6% reported bisphosphonate use. Conclusions: Men treated with prolonged ADT (&gt;1 yr) reported higher rates of osteoporosis and fracture at 15 year follow up. Accordingly, they reported more frequent screening and treatment for osteoporosis, with 50% of men receiving prolonged ADT reporting use of bone medications.

Lifestyle Factors Correlate with the Risk of Late Pelvic Symptoms after Prostatic Radiotherapy

AimsAlthough technological improvements are reducing the risks of late side-effects of radiotherapy for prostate cancer, the influence of lifestyle has been less well examined. The aim of this study was to correlate the effects of exercise, body mass index and smoking on the incidence and severity of late pelvic symptoms after radical radiotherapy for prostate cancer. Materials and methodsIn total, 440 men completed a questionnaire consisting of the Vaizey rectal symptoms score, the National Cancer Institute common symptoms scores for rectal bleeding, erectile function and urinary incontinence, the General Practice Physical Activity Questionnaire and questions regarding smoking, height and weight. The effect of each lifestyle factor on pelvic symptoms was investigated using a non-parametric multivariate ANOVA (Kruskal-Wallis) test and the chi-squared test. ResultsAt the time of the survey, 63.3% of men were overweight or obese (body mass index > 25 kg/m2) and 71% were inactive or moderately inactive. Active men had significantly lower rectal symptoms scores (P < 0.001) and better erectile (P < 0.001) and urinary function (P < 0.01). Men smoking more than five a day had higher rectal symptoms scores (P < 0.001), as did overweight men (P < 0.05). ConclusionThe data show lower late pelvic symptoms after radiotherapy among non-smokers and physically active individuals with a body mass index <25. Although these results would ideally require confirmation in a prospective study, we now include advice on lifestyle in our pre-radiotherapy information pack. The high percentage of obesity and inactivity among this cohort of prostate cancer survivors revealed in this study has prompted the development of an exercise/weight reduction programme in our unit.

Aspirin Use after a Prostate Cancer Diagnosis and Cancer Survival in a Prospective Cohort

Experimental and clinical data suggest that aspirin and other nonsteroidal inflammatory drugs may delay the progression of prostate cancer through inhibition of the COX pathway and its effects on cellular proliferation, apoptosis, and angiogenesis. Epidemiologic data support a reduced risk of prostate cancer incidence with aspirin use, yet no evidence exists about whether aspirin after diagnosis influences progression or survival. We conducted a prospective study of 3,986 participants of the Health Professionals Follow-up Study, with a prostate cancer diagnosis between January 1, 1990, and December 31, 2005. We used Cox proportional hazards regression to evaluate the association between aspirin use after diagnosis and the development of metastases or fatal prostate cancer through January 31, 2008, adjusting for risk factors associated with incidence and mortality in this cohort, prediagnostic aspirin use, Gleason score, tumor-node-metastasis (TNM) stage, and primary treatment. In total, 265 men developed bony or other organ metastases or fatal prostate cancer during the 18 years of follow-up. We observed no association between updated aspirin use after diagnosis and lethal prostate cancer [tablets/week: <2: HR, 1.12; 95% confidence interval (CI), 0.72-1.72; 2-5: HR, 1.05; 95% CI, 0.62-1.80; ≥ 6: HR, 1.08; 95% CI, 0.76-1.54; P(trend) = 0.99]. The results remained unchanged when we examined aspirin use at baseline only (P(trend) = 0.70) or frequency of use (d/wk; P(trend) = 0.35) or limited the outcome to fatal prostate cancer (P(trend) = 0.63). There was no association between aspirin use after a prostate cancer diagnosis and lethal disease in this cohort of prostate cancer survivors.

Abstract 1819: Quality of life among prostate cancer survivors in the Physicians’ Health Study

Abstract Background: Quality of life (QOL) outcomes are an important issue among men with prostate cancer (PCa), and are a function of their advancing age, disease, and treatment status. We sought to characterize the frequency of moderate-to-severe impairment across a broad range of QOL domains in a large cohort of PCa survivors, and to assess effects of pre- and post-treatment patient and clinical factors on QOL outcomes. Methods: The study included 1,482 men enrolled in the Physicians’ Health Study who were diagnosed with PCa from 1982-2005 and responded to a follow-up questionnaire in 2005-2006. Median time from diagnosis to questionnaire response was 5.7 years. QOL in the previous year was assessed by self-reported occurrence of 13 conditions or symptoms related to urinary, bowel, and sexual function. We compared the frequency of moderate/severe symptoms (vs. never/mild) by age at questionnaire (&amp;lt;70, 70-79, ≥80 years), tumor stage (T3+, T1/T2), and first treatment (prostatectomy, radiation) using chi-square tests. We used logistic regression to evaluate the association of age, stage, and treatment with moderate/severe symptoms, mutually adjusting for these factors and time since diagnosis. Results: Among all PCa patients, the most commonly reported QOL symptoms were impotence (77.1%), reduced sexual desire (49.4%), and nocturia (22.6%). Urinary symptoms (nocturia, decreased force of stream), sexual symptoms (impotence, reduced desire), hot flashes, and fatigue were more common with increasing age, regardless of treatment, stage, or time since diagnosis. Compared to stage T1/T2, men with stage T3+ PCa were more likely (p&amp;lt;0.05) to report nocturia (32% vs. 22%), urinary frequency (26% vs. 15%), abdominal pain (4% vs. 1%), hot flashes (14% vs. 7%), impotence (92% vs. 77%), reduced sexual desire (69% vs. 48%), and fatigue (20% vs. 9%) even after a median of 6 years since diagnosis. Differences by stage remained statistically significant, except for nocturia and hot flashes, after adjusting for age, treatment, and time since diagnosis. Men who had a prostatectomy (n = 764) were more likely to report moderate/severe incontinence (14% vs. 5%, p&amp;lt;0.0001) and impotence (80% vs. 74%, p=0.02) than those who had radiation (n = 511). However, men who had a prostatectomy vs. radiation were less likely (p&amp;lt;0.01) to report nocturia (14% vs. 33%), urinary frequency (10% vs. 21%), decreased force of urinary stream (7% vs. 23%), hematuria (1% vs. 3%), rectal urgency (5% vs. 13%), diarrhea (2% vs. 5%), hot flashes (5% vs. 11%), reduced sexual desire (42% vs. 54%), and fatigue (7% vs. 13%); these associations were independent of age, stage, and time since diagnosis. Conclusions: PCa survivors in this US-based cohort experienced a variety of post-diagnostic symptoms, even after an average of 6 years, relating to urinary, bowel, and sexual function. These symptoms increased with age, varied by treatment type, and were more severe among men with advanced PCa. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1819.

5-Year Urinary and Sexual Outcomes After Radical Prostatectomy: Results From the Prostate Cancer Outcomes Study

Purpose Prior studies of postoperative outcomes following radical prostatectomy have been limited by selection bias and short-term followup. In this study we assessed temporal changes in urinary and sexual function up to 5 years following radical prostatectomy in a population based cohort. Materials and Methods A sample of 1,288 men with localized prostate cancer who underwent radical prostatectomy and completed a baseline survey within 6 to 12 months of diagnosis were included in the analysis. Two and 5-year functional and quality of life data were collected, as was information on the use of erectile aids. Temporal functional changes and potentially confounding or modifying factors were assessed using longitudinal regression models. Results Of these men 14% reported frequent urinary leakage or no urinary control 60 months after diagnosis, which was slightly higher than the 10% reporting incontinence at 24 months (p b = 0.007). At 60 months 28% of the men had erections firm enough for intercourse compared with 22% at 24 months (p b = 0.003). Sildenafil was the most commonly used erectile aid (43% ever used) and 45% of users reported that it helped “somewhat” or “a lot.” Conclusions Urinary and sexual dysfunction were common 5 years following radical prostatectomy in this large, community based cohort of prostate cancer survivors. While a small minority of subjects experienced changes in urinary or sexual function between years 2 and 5 after prostatectomy, functional outcomes remained relatively stable in the majority of participants.

5-YEAR URINARY AND SEXUAL OUTCOMES AFTER RADICAL PROSTATECTOMY: RESULTS FROM THE PROSTATE CANCER OUTCOMES STUDY

Prior studies of postoperative outcomes following radical prostatectomy have been limited by selection bias and short-term followup. In this study we assessed temporal changes in urinary and sexual function up to 5 years following radical prostatectomy in a population based cohort. A sample of 1,288 men with localized prostate cancer who underwent radical prostatectomy and completed a baseline survey within 6 to 12 months of diagnosis were included in the analysis. Two and 5-year functional and quality of life data were collected, as was information on the use of erectile aids. Temporal functional changes and potentially confounding or modifying factors were assessed using longitudinal regression models. Of these men 14% reported frequent urinary leakage or no urinary control 60 months after diagnosis, which was slightly higher than the 10% reporting incontinence at 24 months (p = 0.007). At 60 months 28% of the men had erections firm enough for intercourse compared with 22% at 24 months (p = 0.003). Sildenafil was the most commonly used erectile aid (43% ever used) and 45% of users reported that it helped "somewhat" or "a lot." Urinary and sexual dysfunction were common 5 years following radical prostatectomy in this large, community based cohort of prostate cancer survivors. While a small minority of subjects experienced changes in urinary or sexual function between years 2 and 5 after prostatectomy, functional outcomes remained relatively stable in the majority of participants.