Life In Prostate Cancer Patients Research Articles

P075 Assessment of the quality of life of prostate cancer patients treated with WMAT

P075 Assessment of the quality of life of prostate cancer patients treated with WMAT

Assessing the Impact of the Prostate Cancer Patient Empowerment Program (PC-PEP) on Relationship Satisfaction, Quality of Life, and Support Group Participation: A Randomized Clinical Trial.

Background/Objectives: The Prostate Cancer Patient Empowerment Program (PC-PEP) is a 6-month, home-based intervention aimed at enhancing mental health in men undergoing curative prostate cancer treatment. This exploratory secondary analysis evaluates PC-PEP's impact on relationship satisfaction, quality of life, and support group attendance among partnered participants. Methods: In a crossover randomized clinical trial ClinicalTrials.gov identifier: NCT03660085) of 128 men aged 50-82 scheduled for curative prostate cancer surgery or radiotherapy, 119 participants in relationships were included. Of these, 59 received the 6-month PC-PEP intervention, while 60 were randomized to a waitlist-control arm, receiving standard care for 6 months before starting PC-PEP. The intervention included daily emails with video instructions on mental and physical health, diet, social support, fitness, stress reduction, and intimacy. Outcomes were assessed using the Dyadic Adjustment Scale (DAS) and the Functional Assessment of Cancer Therapy-Prostate (FACT-P). Results: While relationship satisfaction remained stable, a significant improvement in emotional well-being was observed at 12 months in participants undergoing radiation therapy (p = 0.045). The PC-PEP intervention also led to significantly higher support group attendance at both 6 months (p = 0.001) and 12 months (p = 0.003), emphasizing its role in fostering social support and community engagement. Conclusions: The PC-PEP program effectively maintains relationship satisfaction and enhances emotional well-being, particularly in patients with fewer physical side effects. Its design promotes comprehensive care by integrating physical, psychological, and social support, making it a valuable resource for improving the quality of life in prostate cancer patients and potentially applicable to other cancer types.

Decision regret after curative treatment and its association with the decision-making process and quality of life for prostate cancer patients.

To determine how the treatment decision-making process and posttreatment health-related quality of life (HRQOL) are related to regret about treatment choice for prostate cancer patients in Japan. We invited a total of 614 patients who were treated with radiation therapy (RT), radical prostatectomy (RP), or active surveillance/watchful waiting (AS/WW) from April 2007 to March 2021. Posttreatment regret was evaluated by the Decision Regret Scale. HRQOL was evaluated by the Expanded Prostate Cancer Index Composite and the 12-item Short Form Survey. The decision-making process was assessed by patient evaluation of the decision-making process. We compared the decision regret scale scores across treatment types, HRQOL, and decision-making processes. Data from 371 patients were analyzed (RT: 202, RP: 149, AS/WW: 20). The median length of time since treatment was 64 (IQR: 43-93) months. The decision regret scale scores were not significantly different among the treatment groups but were significantly greater (strong regret) in patients with poor urinary summary scores, bowel summary scores, and hormonal summary scores. The decision regret scale scores were significantly lower (less regret) for patients who reported being adequately informed at the time of the treatment decision and who had adequately communicated their questions and concerns to physicians than for patients who reported less adequate communication. This result was also observed among patients who reported low HRQOL scores. These findings underline the important influence of posttreatment HRQOL and decision-making as an interactive process between physicians and their patients on posttreatment regret in prostate cancer patients.

Effect of Prior Transurethral Prostate Resection (TURP) or Laser Enucleation (ThuLEP) on Radiotherapy-Induced Toxicity and Quality of Life in Prostate Cancer Patients Undergoing Definitive Radiotherapy.

In our study, the post-radiotherapy quality of life of prostate cancer patients who previously underwent transurethral resection of the prostate (TURP) is compared to those who had thulium laser enucleation of the prostate (ThuLEP) and those who had no prior surgery. It also aims to identify and assess risk factors affecting therapy tolerance in this patient group. We analyzed 132 patients with localized prostate cancer treated with definitive radiotherapy (RT), including 23 who had prior TURP and 19 who previously underwent ThuLEP. A total of 62% of patients underwent irradiation within 12 months after surgery. We included only patients treated with radiotherapy using the IMRT technique. Changes in patient-reported urinary toxicity were evaluated using the International Prostate Syndrome Score (IPSS) and the quality of life index of the World Health Organization (QoL/WHO-PSS) over a three-year post-radiotherapy period. Patients with prior TURP experienced significant deterioration in QoL and IPSS immediately after irradiation (p < 0.001), whereas those without previous surgery showed both less significant differences in IPSS and QoL scores. In conclusion, patients with previous TURP/ThuLEP differ from those without previous surgery in urinary quality of life and acute and chronic urinary symptom profiles after RT. The surgical technique (ThuLEP vs. TURP) and the time interval to irradiation are crucial factors affecting RT tolerance in acute and late settings. The previously operated patient group reported a significantly longer period of increased symptom burden.

Physician reported toxicities and patient reported quality of life of transperineal ultrasound-guided radiotherapy of prostate cancer

PurposeThis study aims to address therapy-related toxicities and quality of life in prostate cancer patients undergoing transperineal ultrasound (TPUS) guided radiotherapy (RT). MethodsAcute and late gastrointestinal (GI) and genitourinary (GU) toxicities were assessed by physicians using CTCAE v5.0. Patient-reported quality of life outcomes were evaluated using EORTC QLQ-C30, -PR25 and IPSS. We utilized Volumetric Modulated Arc Therapy (VMAT) or intensity modulated radiation therapy (IMRT) as the RT technique for this study. The assessments were carried out before RT, at RT end, 3 months after RT and subsequently at 1-year intervals. Prostate-specific antigen (PSA) was also evaluated at each follow-up. ResultsIn this study, a total of 164 patients were enrolled, while among them, 112 patients delivered quality-of-life data in a prospective evaluation. The median pre-treatment PSA was 7.9 ng/mL (range: 1.8–169 ng/ml). At the median follow-up of 19 months (3–82 months), the median PSA decreased to 0.22 ng/ml. Acute grade II GI and GU toxicities occurred in 8.6 % and 21.5 % patients at RT end. Regarding late toxicities, 2.2 % patients experienced grade II GI toxicities at 27 months and only one patient at 51 months, whereas no grade II GU late toxicities were reported at these time points. Quality of life scores also indicated a well-tolerated treatment. Patients mainly experienced acute clinically relevant symptoms of fatigue, pain, as well as deterioration in bowel and urinary symptoms. However, most symptoms normalized at 3 months and remained stable thereafter. Overall functioning showed a similar decline at RT end but improved over time. ConclusionThe outcomes of TPUS-guided RT demonstrated promising results in terms of minimal physician-reported toxicities and satisfactory patient-reported QoL.

Perceptions of prostate cancer patients undergoing definitive radiotherapy on the impact of prostate cancer and radiation therapy on male sexuality.

Male sexual function is an important aspect of the life of prostate cancer patients and plays a significant role in the long-term quality of life of prostate cancer survivors. However, there is a paucity of published literature on the perceived impact of prostate cancer and its treatment on the sexual function of patients in Ghana and West Africa in general. The purpose of this study was to explore the perceptions of prostate cancer patients on the effects of the disease and radiation therapy on male sexual function. The study also examined the changes in sexuality experienced by men with prostate cancer. This research was a descriptive longitudinal study conducted at the third largest hospital in Africa. The study included Ghanaian prostate cancer patients of all ages who were treated with definitive radiotherapy at the study site between October 2021 and May 2022. Quantitative data were collected and analysed using the Statistical Package for Social Sciences version 26.0 and Microsoft Excel 2019. Descriptive statistics were used to determine frequencies and percentages of the demographic characteristics. The mean age of the participants was 65.7 years (SD 6.7) ranging from 50 to 81 years. Patients had different ideas about the potential adverse effects of prostate cancer (86%) and radiotherapy (70%) on male sexual function. A decrease in sexual desire (54%) was the commonest perceived effect of prostate cancer on male sexual function followed by premature ejaculation (49%) and a decrease in sexual activity (48%). On the other hand, erectile dysfunction (49%) was the commonest perceived effect of radiotherapy for prostate cancer on male sexual function followed by a decrease in sexual desire (38%) and premature ejaculation (37%). Health professionals were the major source of information regarding the perceptions of the patients on the effects of both prostate cancer (46%) and radiation therapy (43%) on male sexual function. There should be enhancement of awareness measures to educate Ghanaian cancer patients on the side effects and implications of treatment on their sexuality. Comprehensive sexual health assessment should be incorporated in the routine care of patients with cancers that have the potential to impact the sexual function of patients.

Health Related Quality of Life of Prostate Cancer Patients: Assessment Using the Short Form 12 Health Survey and Patient Oriented Prostate Utility Scale

Health Related Quality of Life of Prostate Cancer Patients: Assessment Using the Short Form 12 Health Survey and Patient Oriented Prostate Utility Scale

Bayesian Spatio-Temporal Multilevel Modelling of Patient-Reported Quality of Life following Prostate Cancer Surgery.

Globally, prostate cancer is the second leading cause of cancer deaths among males. It is the most commonly diagnosed cancer in Australia. The quality of life of prostate cancer patients is poorer when compared to the general population due to the disease itself and its related complications. However, there is limited research on the geographic pattern of quality of life and its risk factors in Victoria. Therefore, an examination of the spatio-temporal pattern and risk factors of poor quality of life, along with the impact of spatial weight matrices on estimates and model performance, was conducted. A retrospective study was undertaken based on the Prostate Cancer Outcome Registry-Victoria data. Patient data (n = 5238) were extracted from the Prostate Cancer Outcome Registry, a population-based clinical quality outcome assessment from 2015 to 2021. A Bayesian spatio-temporal multilevel model was fitted to identify risk factors for poor quality of life. This study also evaluated the impact of distance- and adjacency-based spatial weight matrices. Model convergence was assessed using Gelman-Rubin statistical plots, and model comparison was based on the Watanabe-Akaike Information Criterion. A total of 1906 (36.38%) prostate cancer patients who had undergone surgery experienced poor quality of life in our study. Belonging to the age group between 76 and 85 years (adjusted odds ratio (AOR) = 2.90, 95% credible interval (CrI): 1.39, 2.08), having a prostate-specific antigen level between 10.1 and 20.0 (AOR = 1.33, 95% CrI: 1.12, 1.58), and being treated in a public hospital (AOR = 1.35, 95% CrI: 1.17, 1.53) were significantly associated with higher odds of poor quality of life. Conversely, residing in highly accessible areas (AOR = 0.60, 95% CrI: 0.38, 0.94) was significantly associated with lower odds of poor prostate-specific antigen levels. Variations in estimates and model performance were observed depending on the choice of spatial weight matrices. Belonging to an older age group, having a high prostate-specific antigen level, receiving treatment in public hospitals, and remoteness were statistically significant factors linked to poor quality of life. Substantial spatio-temporal variations in poor quality of life were observed in Victoria across local government areas. The distance-based weight matrix performed better than the adjacency-based matrix. This research finding highlights the need to reduce geographical disparities in quality of life. The statistical methods developed in this study may also be useful to apply to other population-based clinical registry settings.

A mitochondrion-targeted cyanine agent for NIR-II fluorescence-guided surgery combined with intraoperative photothermal therapy to reduce prostate cancer recurrence

Poorly identified tumor boundaries and nontargeted therapies lead to the high recurrence rates and poor quality of life of prostate cancer patients. Near-infrared-II (NIR-II) fluorescence imaging provides certain advantages, including high resolution and the sensitive detection of tumor boundaries. Herein, a cyanine agent (CY7-4) with significantly greater tumor affinity and blood circulation time than indocyanine green was screened. By binding albumin, the absorbance of CY7-4 in an aqueous solution showed no effects from aggregation, with a peak absorbance at 830 nm and a strong fluorescence emission tail beyond 1000 nm. Due to its extended circulation time (half-life of 2.5 h) and high affinity for tumor cells, this fluorophore was used for primary and metastatic tumor diagnosis and continuous monitoring. Moreover, a high tumor signal-to-noise ratio (up to ~ 10) and excellent preferential mitochondrial accumulation ensured the efficacy of this molecule for photothermal therapy. Therefore, we integrated NIR-II fluorescence-guided surgery and intraoperative photothermal therapy to overcome the shortcomings of a single treatment modality. A significant reduction in recurrence and an improved survival rate were observed, indicating that the concept of intraoperative combination therapy has potential for the precise clinical treatment of prostate cancer.Graphical

Coping Mechanisms and Illness Perception Associated with Health-Related Quality of Life of Prostate Cancer Patients in Ogun State

Background: The second most common malignancy in men globally is prostate cancer. Moreover, one of the regions with the highest estimated death rates from prostate cancer is sub-Saharan Africa. Similarly, the leading cause of cancer-related mortality among Nigerian men is prostate cancer. However, negative illness perceptions, including worry about the disease and the severity of symptoms, have been linked to poorer prognosis among cancer patients. Generally, cancer patients adopt various coping mechanisms to deal with these stressors. Meanwhile, little is known about the health-related quality of life of prostate cancer patients in this region, regarding their coping mechanisms and illness perception. Therefore, this study examined, coping mechanisms and illness perceptions associated with health-related quality of life among prostate cancer patients in Ogun State, Nigeria. Methods: This cross-sectional study employed the Purposive sampling technique. Correlation analysis was used to determine the association between coping mechanisms, illness perception, and the health-related quality of life of participants. Results: The association between illness perception and health-related quality of life was positively correlated and statistically significant (r=.547, p=.000). However, in the association between coping mechanism and health-related quality of life; problem-focused coping and health-related quality of life were found to be positively correlated and statistically significant (r=.228, p=.000); emotion-focused coping and health-related quality of life were found to be positively correlated and statistically significant (r=.388, p=.000); while avoidant coping and health-related quality of life were found to be negatively correlated (r= -0.192, p=.000). Conclusion: This study found that a higher illness perception score correlated with a higher health-related quality of life score. Also, a higher problem-focused and emotion-focused coping mechanism score correlated with a higher health-related quality of life score. While a higher avoidant coping score inversely correlated to a lower health-related quality of life score.

Health-Related Quality of Life of Prostate Cancer Patients Receiving Care in Tertiary Hospitals in Ogun State

Prostate cancer is the commonest malignancy among males in Nigeria. Most prostate cancer cases in sub-Saharan Africa get diagnosed in its late stages – which is associated with poorer health-related quality of life (HRQoL). Meanwhile, HRQoL has been shown to be a strong predictor of survivorship; therefore, this study was conducted to examine the HRQoL among prostate cancer patients receiving care in tertiary hospitals in Ogun state. With the cross-sectional research design and sample size of 387 prostate cancer patients selected using purposive sampling technique, the FACT-P instrument was used in data collection. Descriptive statistics analysis was used to assess participants' HRQoL levels. Findings showed that prostate cancer patients in this region have an average health-related quality of life level; the physical wellbeing domain of participants health-related quality of life was most affected by prostate cancer, with physical wellbeing having the lowest mean score (M=14.66), followed by emotional wellbeing (M=15.57), functional wellbeing (M=17.7), and social wellbeing being the least affected (M=18.33). Tertiary hospitals should ensure the inclusion of psycho-oncology counselling and psychotherapy, into the treatment plan of all patients after a prostate cancer diagnosis to improve the emotional and psychological wellbeing of prostate cancer patients. Similarly, access to physical rehabilitation and physiotherapy should be made easily accessible to improve physical wellbeing among prostate cancer patients.

Investigation of the effects of recreational rowing exercises on physical fitness and quality of life in prostate cancer patients

The aim of the study is to investigate the effects of recreational rowing exercises on cancer patients, who have undergone prostate treatment, on their physical fitness and quality of life. A total of 37 participants (mean age of 59.10± 9.67 years) who completed their prostate cancer (PC) treatments and had no disability to exercise and participated in the recreational sea rowing program were included in the study. The study is consisting of two groups. The participants who refused to participate exercise (n=17 mean age 57.17±13.33 years) are Control Group (CG) and who accepted to join sea rowing program are Exercise Group (EG) (n=19 mean age 59.10 ±9.67 years). The program was carried out 3 days a week for 12 weeks, with an average of 60 minutes per day. Anthropometric measurements (height, weight, circumference measurements, BMI), VO2max and strength measurements were taken at the beginning and end of the program. Quality of life was assessed (EORTC-QLQ-C30 scale) and prostate cancer-specific module (EORTC QLQ-PR25) test. Since the data did not show normal distribution in the statistical analysis, centrality and prevalence criteria were determined for the continuous variables in the analysis, the Wilcoxon test was used for the differences between the pre-test and post-test measurements of the participants, and the Mann Whitney U test was used to determine the differences between the two groups. Statistically significant differences were found in physical fitness; arm thickness, one mile walking, peak force, 1000 m walking, strength and VO2max values (p&lt;0.05). In the comparison of the two groups; Forearm thickness, upper leg circumference, lower leg circumference, average strength (kg), peak force (kg), average power (watt), Vo2max values were found significantly different (p&lt;0.05).According to the result of EORTC-QLQ-C30; When the EG was compared with the pre-test, post-test and CG, a significant difference was found in the parameters of physical function, grip function, fatigue and constipation (p&lt;0.05). According to EORTC QLQ-PR25 results, there was a significant difference in the urinary symptoms and sexual functioning sub-dimensions between the exercise and control groups (p&lt;0.05).As a result of recreational sea rowing exercise, it was observed that the quality of life of the patients increased, the side effects of the disease decreased, aerobic capacity and strength characteristics improved.

Prophylaxis for Treatment-Induced Gynecomastia in Prostate Cancer Patients: A Network Meta-Analysis.

Treatment-induced gynecomastia is a side-effect that can severely limit quality of life in prostate cancer patients. We performed a network meta-analysis (NMA) to comparing the effectiveness of multiple non-surgical prophylactic treatment for gynecomastia. A systematic review was performed through MEDLINE, Cochrane Central Register of Controlled Trials and meeting abstracts to identify randomized controlled trials comparing treatments for treatment-induced gynecomastia. Treatments included radiotherapy (RT), Anastrozole (ANZ), daily Tamoxifen (TMQD), and weekly Tamoxifen (TMQW), compared to no treatment/placebo (NoTx). The primary endpoint was events of gynecomastia development. Odds Ratio (OR) was the effect size of choice. An NMA was used to compare treatments with random-effects model was used. All tests were 2-sided with an alpha of 0.05. A total of 9 studies involving 1319 patients were identified with 5 distinct arms: RT (n = 358), ANZ (n = 90), TMQD (n = 321), TMQW (n = 39) and NoTx (n = 511). Gynecomastia occurred in 79.2% (405/511) of patients with NoTx, 65.5% (59/90) with ANZ, 37.7% (135/358) with RT, 19.6% (63/321) with TMQD and 74.4% (29/39) with TMQW. TMQD was significantly better than RT (OR 4.73 [1.53, 14.61]), ANZ (OR 7.21 [2.25,23.06]), TMQW (OR 6.25 [1.07, 36.43]) and NoTx (OR 26.30 [10.42,66.40]). RT were significantly better than NoTx (OR 5.56 [2.58,11.95]), but did not reach significance compared to ANZ (OR 1.52 [0.36, 6.43]) or TMQW (OR 1.32 [0.16, 10.70]). ANZ was significantly better than NoTx (OR 3.65 [1.03,12.93]). TMQW was not significantly better than NoTx. RT, TMQW and ANZ were significantly worse compared to TMQD in terms of preventing gynecomastia development. Daily Tamoxifen was the best prophylactic treatment choice, significantly better than RT, weekly Tamoxifen and Anastrozole. RT, weekly Tamoxifen and Anastrozole were significantly better than No Treatment/Placebo, but not daily Tamoxifen, in terms of prevention of treatment-induced gynecomastia in patients with prostate cancer.

Quality of Life after Radical Prostatectomy: A Longitudinal Study.

Men with prostate cancer who undergo radical prostatectomy experience a decrease in quality of life, often related to sexual disfunction and urinary incontinence. Knowing and measuring the impact of radical prostatectomy on the individual's social, emotional, and family quality of life could help to plan and develop an appropriate, patient-centred therapeutic approach. In this study, we aimed to evaluate changes in quality of life of patients with prostate cancer before and after radical prostatectomy. A longitudinal, observational study of 114 participants was conducted using the method of test-retest. Quality of life before and after radical prostatectomy was measured through the following self-administered questionnaires: (1) The EORTC QLQ-C30 in its Spanish version was used to assess the generic quality of life the participants; (2) the EORTC QLQ-PR25 in its Spanish version was used to assess the specific, health-related quality of life of prostate cancer patients. A total of 114 men took part in this study. The results from the QLQ-C30 questionnaire indicated an improvement in the dimensions of emotional role and cognitive function, as well as in the symptoms of fatigue, pain, nausea and vomiting, insomnia, and loss of appetite, after surgery. Patients scored lower in the dimensions of role functioning, social function, and economic impact after radical prostatectomy. According to the results from the QLQ-PR25 questionnaire, 61.40% of the participants experienced sexual impotence and 26.31% suffered urinary incontinence after surgery. There were significant differences in some postsurgical outcomes between patients who had neurovascular bundles preserved and those who had not. In-depth knowledge of, and measurement of changes in, quality of life after radical prostatectomy should allow for comprehensive, multidisciplinary, patient-centred care planning. Psychosocial assessment, both before and after surgery, is crucial in patients with prostate cancer. This study was prospectively registered with the CEIC-A on 2012-06-27, with registration number C.P.-C.I. PI12/0088.

Effect of exercise mode specificity on quality of life in prostate cancer patients undergoing androgen suppression.

72 Background: Androgen deprivation therapy (ADT) is accompanied by a range of adverse effects including those of the musculoskeletal, metabolic, and cardiovascular systems, as well as compromised functioning and quality of life (QoL). Exercise has been shown to be an effective countermeasure to a number of these toxicities, although the effects of different modes or prescriptions on self-report QoL is unclear. Here we report the effects from a yearlong trial of 3 different exercise prescriptions involving aerobic, resistance, and impact loading modes on QoL in men with prostate cancer undergoing ADT. Methods: One hundred and fifty-four prostate cancer patients (43-90 yrs, BMI 28.7 ± 4.1) on ADT (Mdn 3 mths, IQR 2.0-4.0 mths) were randomized to exercise targeting the musculoskeletal system (impact loading + resistance training; ILRT, n=57) supervised for 12 months, cardiovascular and muscular systems (aerobic + resistance training; ART, n=50) supervised for 6 months followed by a 6-month home program, or delayed aerobic exercise (DelAer, n=47) receiving exercise information for 6 months followed by 6 months supervised stationary cycling exercise. Supervised exercise was undertaken twice weekly at a moderate intensity. QoL domains were assessed at baseline, 6, and 12 months using the Short Form-36 questionnaire. Results: There were no significant differences among groups in QoL domains at baseline. Following exercise there was a significant group x time interaction (p &lt; 0.05) for the domain role physical and the physical health composite score with increases at 12 months for ILRT and DelAer. There was also a significant time effect (p &lt; 0.001) for improvements in physical functioning, general health, vitality, and mental health, and also bodily pain (p = 0.037), with no between-group differences. Patients in the lowest tertile for QoL at baseline improved the most with exercise (Ptrend &lt; 0.001). Conclusions: Different exercise modes had similar effects on improving QoL in patients with prostate cancer undergoing ADT. Importantly, those with the lowest QoL derived the greatest benefits from exercise. Recommending patients on ADT to undertake exercise, regardless of mode, will help to preserve or improve quality of life. Clinical trial information: ACTRN12609000200280 .

Acute toxicity and quality of life in prostate cancer patients treated with definitive hypofractionated pelvic radiation therapy: a single-center report.

The objective was to report acute toxicity and quality of life in prostate cancer patients treated with definitive hypofractionated pelvic radiation therapy. Patients were designated candidates for hypofractionated pelvic radiation therapy if biopsy or imaging studies evidenced unfavorable intermediate-risk, high-risk or node-positive disease. Patients were treated using a regimen of 44 Gy to the nodal areas and simultaneous integrated boost of 60 Gy to the prostate in 20 fractions with CBCT-based imaging and volumetric arc therapy (VMAT). Patient data was obtained retrospectively; acute gastrointestinal (GI) and genitourinary (GU) toxicity was classified per Common Terminology Criteria for Adverse Events (CTCAE) v5.0 and obtained from clinical records. Quality of life was surveyed via phone call using the European Organization for Research and Treatment of Cancer (EORTC) questionnaire QLQ-PR25. 78 patients were treated between May and December 2021. 83.33% of patients had high-risk disease, 16.67% had intermediate-risk disease, and 34.62% patients had node-positive disease. Median follow-up was 10.6 months. No patients presented acute grade >3 GI toxicity, and one patient presented grade 3 GU toxicity. 25.64% patients presented acute G2 GI toxicity and 17.95% patients presented acute G2 GU toxicity. 60.26% of patients responded to the EORTC-PR25 questionnaire. Mean scores for symptom scales were 11.26, 4.96 and 9.57 for Urinary Symptoms, Bowel Symptoms and Hormonal Treatment-Related Symptoms; mean scores for Sexual Activity and Functioning were 19.86 and 31.08, respectively. Definitive hypofractionated pelvic radiation therapy has an acceptable acute toxicity and QoL profile in this series of patients, although longer follow-up is needed to properly evaluate short and long-term toxicity. Further follow-up and patient recruitment is ongoing.

Quality of life of prostate cancer patients: A nursing care model

Quality of life of prostate cancer patients: A nursing care model

Resource use in the last year of life of prostate cancer patients-A register-based analysis.

Given the paucity of data on the end of life (EOL) of prostate-cancer (PC) patients, we investigated medication prescription patterns and hospitalizations during their final year of life. The data base of the Österreichische Gesundheitskasse Vienna (ÖGK-W) was used to identify all men who died with the diagnosis PC between 1.1.2015 and 31.12.2021 and who were under androgen deprivation and/or new hormonal therapies. Patient age, prescription patterns and hospitalizations during the last year of life were recorded, odds ratios for age groups were analyzed. A total of 1.109 patients were included. ADT was given in 86.7% (n = 962) and NHT in 62.8% (n = 696). Overall, prescription of analgesics increased from 41% (n = 455) during the first to 65.1% (n = 722) in the last quarter of the final year of life. Prescription of NSAIDs was almost consistent (18-20%) whereas the number of patients receiving other non-opioids (paracetamol, metamizole) more than doubled (18 to 39%). Older men had lower prescription rates for NSAID (OR: 0.47, 95% CI: 0.35-0.64), non-opioids (OR: 0.43, 95% CI: 0.32-0.57), opioids (OR: 0.45, 95% CI: 0.34-0.6) and adjuvant analgesics (OR: 0.42, 95% CI: 0.28-0.65). Approximately 2/3 of patients (n = 733) died in the hospital with a median of four hospitalizations in the final year of life. The overall cumulative length of admission was less than 50d in 61.9%, 51-100d in 30.6% and >100d in 7.6%. Younger patients (<70 yrs) were more likely to die in the hospital (OR: 1.66, 95% CI: 1.15-2.39), had a higher median rate of hospitalizations (n = 6) and longer cumulative duration of admissions. Resource use increased during the last year life of PC patients with highest rates in younger men. Hospitalization rates were high and 2/3 died in the hospital, both showed clear age dependency with higher rates, duration and death in the hospital for younger men.

Impact of modified bladder neck suspension on early recovery of continence after robot-assisted radical prostatectomy (RARP).

The incontinence after RARP significantly decreases the quality of life in prostate cancer patients. A number of techniques have been introduced for the recovery of continence after RARP. Although, the mechanism of the continence recovery is still unclear. We aimed to evaluate the early recovery of continence after RARP by inducing early anterior adhesion and reducing the hypermobility of the urethra through the modified bladder neck suspension (BNS) procedure. From March 2018 to February 2020, a total of 227 consecutive patients who underwent RARP (by single surgeon) were included. Patients were divided into two groups based on operation procedure (Standard procedure vs BNS procedure). Demographics, perioperative variables, and pathologic outcome were analyzed. We assessed recovery of continence at 1, 3, 6 and 9months after surgery. Postoperative recovery of continence defined as the use of no pad during 24h. Multivariable logistic regression analyses were performed to evaluate independent predictors of the early recovery of continence at 1month. We performed RARP with standard procedure (n = 106) or BNS procedure (n = 121). There was no statistical difference in perioperative variables between the two groups except anastomosis time (21.6 ± 12.9 vs 17.0 ± 7.6, p = 0.003). The pad free continence rate were 80.2% (standard group) and 91.3% (BNS group) at 9month after RARP (p = 0.037). However, early continence rate (1mo) were significantly higher in the BNS group (12.3% vs 29.1%, p = 0.004). On multivariate logistic analyses, BNS procedure (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.03-7.45, p = 0.0426), age (OR 0.92, CI 0.86-0.98, p = 0.0154) were independent factor for early recovery of continence after RARP. The modified bladder neck suspension procedure showed significantly better outcomes than the standard procedure in terms of the early recovery of urinary continence.

PO-1539 Quality of life in prostate cancer patients treated with definitive hypofractionated radiotherapy

PO-1539 Quality of life in prostate cancer patients treated with definitive hypofractionated radiotherapy