Treatment Of Men Research Articles

(121) Acceptant and Commitment Therapy to Increase Compliance to Sexual Dysfunction Treatments in Men with Prostate Cancer: 6- and 12-Month Data from a Randomized Controlled Trial

Abstract Introduction For many men with prostate cancer, difficulty with sexual dysfunction, in particular erectile dysfunction (ED), can trigger a psychological process which leads to avoidance of utilizing sexual dysfunction treatments. Objective This study tests a novel psychological intervention based on Acceptance and Commitment Therapy (ACT) concepts to help men utilize these treatments. Methods This ongoing study recruited men with prostate cancer starting intracavernosal injection therapy (ICIT) for the treatment of ED. The recruitment goal is N=220. Subjects are randomized to ICIT + ACT (ACT), which focuses on reducing avoidance, or ICIT + Enhanced Monitoring and Education (EME), which includes enhanced follow-up. Both groups receive ICIT plus 3 sessions (30–45 min) and 10 booster sessions (10 min). The interventions are delivered over the course of a year. Subjects are assessed at entry and every 6 months (m) for two years. The primary outcomes are the number of penile injections/week (verified by syringe count), and compliance (defined as ≥2 injections/week). Secondary outcomes assess psychosexual variables. Preliminary 6m and 12m data is presented. Since these are preliminary analyses, effect sizes (d) are reported for secondary variables (d=0.2, small effect; d=0.5, medium effect; d=0.8, large effect). Results To date, 191 subjects have been randomized; 112 have completed the 6m assessment (ACT n=57, EME n=55) and 97 completed the 12m assessment (ACT n=48, EME n=49). Mean age at baseline was 60±7 years. At 6m and 12m, the ACT group utilized more injections/week vs. the EME group (6m: median 1.8 vs. 1.2, p=0.01; 12m: median 2.0 vs. 1.4, p=0.01) and were more compliant with ICI vs. the EME group (6m: 65% vs. 35%, p=0.01, RR=1.86; 12m: 79% vs. 41%, p=0.01, RR=1.93). At 6m and 12m, the ACT group reported greater: satisfaction with ED treatment (d=0.6) and overall sexual relationship (d=0.2). The ACT group also reported lower: sexual bother (d=0.2), prostate cancer treatment regret (d=0.3), negative psychological impact of cancer (d=0.3), and depressive symptoms (d=0.4). Conclusions Preliminary analysis suggests ACT significantly increases ICI use. Data also indicate that ACT helps increase men’s satisfaction with injections and sexual relationship, while reducing sexual bother, prostate cancer treatment regret, the psychological impact of cancer, and depressive symptoms. Disclosure No.

PREVENTION OF VIOLENCE AGAINST WOMEN IN DISADVANTAGED FAMILIES

In the article, the authors determined the relevance of the problem of violence against women and its prevention in dysfunctional families; the ways of social assistance to them and prevention of complications of the consequences of violence in the family are revealed. The content of the definition of "disadvantage" of the family and its status, which is revealed due to the connection with the specific situation of the functioning of the family and its individual members, have been clarified. The authors also characterized the phenomenon of violence against women in terms of physical, psychological, sexual and economic content. The content of the root causes of violence is revealed and revealed from the point of view of a retrospective review of the problem and taking into account the opinions of supporters of psychological theories and theories of social causation. The causes of family dysfunction are listed, such as economic instability, unemployment, legal illiteracy, alcohol and drug addiction of family members, lack of understanding of life goals and means of achieving them, and their impact on the risk and perpetration of violence against women in dysfunctional families is substantiated. . Emphasis is placed on the multiplicity of root causes of violence and their conditioning by a set of interrelated factors and factors. The possibility of influence of some on the crucial importance of others in dysfunctional families has been proven. The need for specialists in the field of social work, social pedagogues, and psychologists to provide qualified assistance to women who have become victims of domestic violence is substantiated. Social protection of women, in particular in dysfunctional families, is presented in the article as a holistic system of social prevention, which is based on clearly formulated principles and legal acts. The possibilities and expediency of social prevention of violence against women in dysfunctional families are substantiated; revealed the content and purpose of its three levels: primary, secondary, tertiary. Resources for the development and improvement of preventive activities to prevent violence against women in dysfunctional families are outlined. It was concluded that the effectiveness of social work with women who have become or could potentially become victims of violence will be facilitated by a set of preventive measures to prevent men's cruel treatment of them, and directions of work to overcome the consequences of domestic violence against them in dysfunctional families.

Undermining the Moral Obligations of Manhood Acts

Hybrid masculinities—men's integration of previously marginalized characteristics into acceptable performances of manhood—are emergent in contemporary gender studies. While some scholars see egalitarian promise in these configurations of manhood, their utility in improving gender equality is contested. Drawing from an ethnography of a profeminist Batterer Intervention Program (BIP), I utilize prominent symbolic interactionist theories to explore how men in the program were resocialized to a hybrid hegemonic masculinity. I position defining the situation as fundamental to manhood acts and show how rules in the BIP alter establishment of the working consensus, prompting resocialization even when participants reject ideological or educational program content. The process of resocialization is bolstered by masculinity affirmations deployed when men exhibit desired traits, but undermined by false indicators of change and protective practices deployed by other men. At their most severe, these patterns resulted in symbolic egalitarians—men who promptly adopt the progressive sign‐equipment of the hybrid masculinity, but actively shore up their gendered power. I conclude that awareness of these processes can improve men's interventions, and demonstrate the effectiveness of symbolic interactionism for explaining how hybrid masculinities result in various fields of egalitarian outcomes informed by other theories of masculinity.

Effects of Transcranial Direct Current Stimulation and Behavior Therapy Using the Start-Stop Method on the Treatment of Men with Sexual Disorder Premature Ejaculation

Background: Men suffering from premature ejaculation often report emotional and relational problems, and some of them do not pursue sex due to embarrassment. This condition leads to mental disorders, e.g., anxiety and depression, and the couple's relationship may suffer. Objectives: The present study aimed to investigate the effectiveness of transcranial direct-current stimulation (tDCS) and behavior therapy using the start-stop method in improving premature ejaculation. Methods: This was a quasi-experimental study with two experimental groups and a control group. The statistical population comprised all men with premature ejaculation residing in Tehran (2021) who visited sexual health centers in this city. A sample of 45 men aged 25-65 was selected using convenience sampling and divided into three groups of 15. The research instrument included the International Index of Erectile Function (IIEF). The data were analyzed in SPSS-23 using the analysis of covariance. Results: The mean ± SD of the pretest of premature ejaculation in the tDCS, start-stop method, and control groups was 13.60 ± 5.45, 12.86 ± 3.24, and 15.68 ± 4.87, respectively; while in the posttest was 23.53 ± 9.65, 18.66 ± 5.25 and 17.53 ± 4.83, respectively. Based on the results, tDCS alleviated premature ejaculation (P < 0.001). The start-stop method also decreased the symptoms of premature ejaculation, but this reduction was not significant. There was a significant difference between the two treatment methods, and tDCS proved more effective. Conclusions: tDCS demonstrated acceptable effectiveness in the treatment of premature ejaculation. Given its effectiveness in increasing marital satisfaction, it should be considered in the treatment of premature ejaculation.

Proton Therapy in the Treatment of Men with Breast Cancer

PurposeMale breast cancer treatment involves multimodality therapy, including radiation therapy; nevertheless, few men have received proton therapy (PT) for it. Further, heart disease is an established leading cause of death in men, and radiation therapy heart dose correlates with cardiac toxicity, highlighting the need for cardiac-sparing radiation techniques. Thus, we provide a descriptive analysis of PT in a male breast cancer cohort. Patients and MethodsMen who received PT for localized breast cancer between 2012 and 2022 were identified from a prospective database. Toxicities were prospectively recorded by using the Common Terminology Criteria for Adverse Events (CTCAE), version 4.0. ResultsFive male patients were identified. All had estrogen receptor (ER)–positive, Her2neu-negative disease and received adjuvant endocrine therapy. One had genetic testing positive for BRCA2, one had a variant of unknown significance (VUS) in the APC gene, and one had a VUS in MSH2. Median age was 73 years (range, 41–80). Baseline comorbidities included obesity (n = 1), diabetes (n = 1), hypertension (n = 4), history of deep vein thrombosis (n = 1), personal history of myocardial infarction (n = 3; 1 with a pacemaker), and a history of lung cancer (n = 1). All received PT to the left chest wall and comprehensive regional lymphatics. One received passive-scattering PT, and 4 received pencil beam scanning. One patient received a boost to the mastectomy incision via electrons. Median heart dose was 1 GyRBE (range, 0–1.0), median 0.1-cm3 dose to the left anterior descending artery was 7.5 GyRBE (range, 0–14.2), and median follow-up was 2 years (range, 0.75–6.5); no patient experienced a new cardiac event, and all remain free from breast cancer recurrence and progression. ConclusionIn a small case series for a rare diagnosis, PT to the chest wall and regional lymphatics, including internal mammary nodes, resulted in low cardiac exposure, high local regional disease control rates, and minimal toxicity. Proton therapy should be considered for treating men with breast cancer to achieve cardiac sparing.

Oral 19 - Outcomes of Bladder Neck Onabotulinumtoxin A Injection In The Treatment Of Men and Women with Primary Bladder Neck Obstruction

Oral 19 - Outcomes of Bladder Neck Onabotulinumtoxin A Injection In The Treatment Of Men and Women with Primary Bladder Neck Obstruction

PO63: Optimizing Prostate Cancer Treatment in Men with Advanced Local Disease (OPTiMAL) Study: Initial Multi-Modal Imaging Results

PO63: Optimizing Prostate Cancer Treatment in Men with Advanced Local Disease (OPTiMAL) Study: Initial Multi-Modal Imaging Results

A community-based participatory protocol to improving communication with Black men about oral and pharyngeal cancers: Research protocol.

Black men are disproportionately impacted by oral and pharyngeal cancer (OPC) mortality. This is in part due to a lack of information received about OPCs and their associated risk factors during health encounters. Discussions between dentists and Black men may improve Black men's knowledge, screening, and treatment uptake. Yet, dentists do not commonly communicate with Black men about OPCs due to their own discomfort. This paper describes the protocol for our research project, which proposes an initiative, grounded in community-based participatory research, to adapt a culturally-specific OPC communication tool. This tool will be adapted using a mixed-methods approach to assess the knowledge, attitudes, and experiences of Black men discussing OPCs and associated risk factors with dental providers. The tool will then be assessed for feasibility and acceptability among Black men, as well as dental students and dental providers in community-based clinical settings.

Effectiveness of Mindfulness for Anger Expression on Men in Treatment for Substance Use Disorders: a Randomized Controlled Trial

Effectiveness of Mindfulness for Anger Expression on Men in Treatment for Substance Use Disorders: a Randomized Controlled Trial

A Qualitative Study of Men's Experiences Using Navigate: A Localized Prostate Cancer Treatment Decision Aid.

The Navigate decision aid Web site was created to help Australian men diagnosed with localized prostate cancer (LPC) make an informed decision about their treatment.Navigate was helpful in supporting men's ongoing treatment decision making for LPC.Men's treatment decision making for LPC was greatly influenced by perceived authority and trust in their clinician.Trustworthiness, timing of access, and the clinician's role in empowering men to use available decision aids are crucial.

Percutaneous Coronary Intervention in Men, Women, and Minorities With a Previous Coronary Artery Bypass Graft Surgery (from the Pooled PLATINUM Diversity and PROMUS Element Plus Registries)

There is limited data on new-generation stent outcomes in patients with previous coronary artery bypass graft (CABG) and the associated risk of gender and race/ethnicity is unclear. We investigated 1-year outcomes after platinum chromium everolimus-eluting stent implantation in a diverse population of men, women, and minorities with previous CABG pooled from the PLATINUM Diversity (NCT02240810) and PROMUS Element Plus (NCT01589978) registries. Our primary outcome was major adverse cardiac events (MACE), a composite of all-cause death, myocardial infarction (MI), and target vessel revascularization (TVR) at 1-year post percutaneous coronary intervention (PCI). Secondary end points included all-cause death, MI, TVR, target vessel failure, and stent thrombosis. A total of 4,175 patients were included in the analysis, including 1,858 women (44.5%), 1,057 minorities (25.3%), and 662 (15.9%) with previous CABG. Patients with previous CABG were older, included more men and White patients, and had more co-morbidities compared with patients without previous CABG. At 1 year, patients with previous CABG had a higher risk of MACE (12.6% vs 7.5%, hazard ratio 1.70, 95% confidence interval 1.32 to 2.19, p<0.001) and end points, including death/MI, TVR, and target vessel failure. After multivariate adjustment, no differences were observed in MACE (adjusted hazard ratio 1.11, 95% confidence interval 0.82 to 1.49, p=0.506) or any secondary end points. No interaction was observed between previous CABG and gender or minority status. In conclusion, in a contemporary PCI population, patients with previous CABG remain at high risk for PCI because of their elevated risk profile. Previous CABG status was however not independently associated with worse outcomes after adjustment, nor was any interaction observed with gender or race/ethnicity.

Association of Recent Fatherhood With Antidepressant Treatment Initiation Among Men in the United Kingdom

There is some evidence that men may be at higher risk of depression directly following the birth of their child and that approximately 1 in 10 men will experience depression in the year after birth, but less is known about men's antidepressant treatment during this time. Likewise, few direct comparisons have been made with antidepressant treatment in men who have not recently become fathers. To determine whether recently having a child was associated with increased odds of antidepressant treatment in men. This cohort study used UK primary care electronic health records from the IQVIA Medical Research Database. Participants included men aged 15 to 55 years who had had a child in the previous year, from January 2007 to December 2016, and compared with up to 5 men who did not have a child in the same calendar year. Data were analyzed from January 2022 to March 2023. A record of having a child in the previous year was identified through linked primary care records using a family identification number. The main outcome was antidepressant initiation in the year after childbirth or in the year after this index date for men who did not have a child. Random-effects Poisson regression was used to determine associations of cohort, age group, social deprivation, history of antidepressant treatment, and calendar year with having an antidepressant prescription in the year after index date using prevalence risk rates (PPRs). Analysis included 90 736 men who had had a child in the previous year and 453 632 men in the comparison cohort. Most men in the study (463 879 men [85.2%]) were aged between 25 and 44 years, and there were more men living in the least deprived areas (130 277 men [23.9%]) than the most deprived areas (72 268 men [13.3%]). Overall, 4439 men (4.9%) had at least 1 antidepressant prescription in the year after they had a child, compared with 26 646 men (5.9%) who did not have a child in the same year. However, after adjustment there was no difference in antidepressant treatment between groups (adjusted PRR [aPRR], 1.01; 95% CI, 0.98-1.04). In fathers, those who had recently received antidepressant treatment were much more likely to receive antidepressant treatment after childbirth compared with fathers with no history of antidepressant treatment (aPRR, 32.31; 95% CI, 30.37-34.38). Fathers living in the most deprived areas were 18% more likely to have an antidepressant prescription compared with fathers living in the least deprived areas (aPRR, 1.18; 95% CI, 1.07-1.30). These findings suggest that recently having a child was not associated with an increase in antidepressant treatment among men, but previous antidepressant treatment in fathers was strongly associated with treatment after childbirth. Further research is needed to determine whether antidepressant treatment or experiencing depression can be a barrier to fatherhood and whether fatherhood is a barrier to receiving antidepressant treatment.

The Role of Medicinal Plants in Drug Discovery across the World

Throughout the dawn of time, medicinal plants have been crucial in minimizing human suffering from ailments, afflictions, and diseases. This study examines the pharmacological role, contributions, and value of medicinal plants in treating significant illnesses for public health, emphasizing the current strategic approaches to disease prevention. Interest in complementary therapies and the therapeutic use of plants has increased as a result of the crucial role that medicinal plants have played in the sustainable management of human health. This is because it is cheaper than manufactured, synthetic kinds of Medicine. Yet, medicinal plants are in peril because of man's intervention and unregulated wild collection. It is thus advised that purposeful domestication and cultivation efforts are crucial for ensuring a steady supply of these plant species.

Correlation Analysis between Hypogonadal Symptoms and Changes in Body Composition and Physical Fitness after Testosterone Treatment in Men with Testosterone Deficiency.

This study analyzed changes in body composition and physical fitness in men with testosterone deficiency (TD) after testosterone treatment (TT) and examined the correlations of body composition and physical fitness with serum testosterone levels and hypogonadal symptoms. Seventy patients with TD were divided into control (group I, n=23) and experimental (group II, n=47) groups. Patients in the experimental group were administered intramuscular testosterone enanthate (250 mg) for six months. The aging males symptom scale (AMS) score, international prostate symptom score (IPSS), body mass index, waist circumference, and serum laboratory values were measured at baseline and at the end of the study. Bioelectrical impedance analysis was used to assess the patients' body composition. Seven types of basic exercise tests were used to evaluate the patients' physical fitness. After six months, there were no significant differences in group I, while group II had significantly improved IPSS and AMS scores; increased hemoglobin, hematocrit, prostate-specific antigen, and testosterone levels and skeletal muscle mass; and waist circumference, and body fat mass. All elements of the physical fitness test were significantly improved in group II, with the exceptions of flexibility and endurance. Decreased waist circumference was correlated with changes in testosterone levels in group II, and the IPSS, cardiorespiratory fitness, and agility were correlated with improved hypogonadal symptoms. TT improved the hypogonadal and lower urinary tract symptoms in patients with TD and improved body composition, physical fitness, and metabolic syndrome parameters. Increased testosterone and improved hypogonadal symptoms were correlated with a decrease in waist circumference and an improvement in cardiorespiratory fitness and agility. As such, when implementing TT, we should consider whether these areas may be improved, as this can help to predict the effect.

Treatment of Men with Erectile Dysfunction through Lifestyle Modification Using a Digital Application - A Pilot Study

Introduction: Erectile dysfunction affects up to 30% of men in industrialized nations. Although the disease is more common in older age, men in their 30s and 40s are also affected. Despite the quantity and the important socio-psycho-pathogenic significance of erectile dysfunction, it is still treated almost exclusively by the administration of phosphodiesterase 5 inhibitors. Objective: To evaluate the effectiveness and acceptability of a digital lifestyle change intervention for men with erectile dysfunction. Material and Methods: In this pilot study, 20 patients with erectile dysfunction were encouraged to make lifestyle changes using a digital application. Results: We were able to show that the use of a digital application is very effective in supporting the lifestyle change efforts of patients with erectile dysfunction. Conclusion: Digital applications could offer valuable assistance in extending the purely symptomatic therapeutic approach (PDE5I) of men suffering from erectile dysfunction, to include the important component of lifestyle change in order to address the long-term implications of this complex condition

Medical Treatment in Men with Infertility Can Be Misinterpreted as Doping Practice: A Case of Unintentional World Anti-doping Agency (WADA) Code Violation

Introduction: Clomiphene, a selective estrogen receptor modulator (SERM), is a drug which is primarily used for the treatment of anovulatory infertility in female patients. Although as an off-label use, some authorities and physicians use this drug for the treatment of idiopathic oligoasthenospermia in male patients. Clomiphene has two isomers and multiple metabolites, and its cis isomer (Zuclomiphene) can be detected in urine for as long as eight months in some cases. Case Presentation: A 30-year-old male futsal player used clomiphene for infertility for two months. After 17 weeks from the last dose, his urine sample result came out as an adverse analytical finding for clomiphene. Despite the initial ruling on a four-year ban by the national anti-doping agency, the appeals committee reduced the athlete's ban to two years after receiving explanations from the athlete, his appropriate doping record, and the fact that no trace of other substances, such as anabolic androgenic steroids (AAS) was found in the player's sample. Conclusions: In this article, the authors try to show the importance of athletes' familiarity with the anti-doping code and try to emphasize the importance of the fact that athletes should receive therapeutic use exemption (TUE) if they take any drugs with doping potential.

Strategies for effective implementation and scale-up of a multi-level co-designed men's health initiative "Sheds for Life" in Irish Men's Sheds.

Sheds for Life is a gender-specific tailored men's health initiative engaging "hard-to-reach" men in the Men's Shed setting in Ireland. It is implemented by multiple stakeholders at individual, provider, organization and systems level and thus multiple contextual factors influence its scalability. This research used established implementation science frameworks to guide participatory research approaches that captured the process and identified facilitators of and barriers to implementation and scale-up. Active recruitment, co-design processes, leadership and stakeholder engagement emerged as key facilitators of implementation. Prominent barriers were institutional capacity and funding. Acceptability, adoption and appropriateness of the initiative were high among stakeholders with sustainability largely contingent on funding and staff resources. Findings make a valuable contribution to knowledge by capturing the process involved in the implementation of a complex multi-level men's health intervention. It provides a "how to" guide of strategies to engage hard-to-reach men with health promotion, the operationalization and application of implementation frameworks in community-based health promotion, and the implementation of health promotion in Men's Sheds. Documented barriers and facilitators that impact implementation of a community-based men's health program are rare and provide a valuable blueprint for practitioners, researchers and policy makers in the field.

The Influence of Practice Structure on Urologists' Treatment of Men With Low-Risk Prostate Cancer.

Vertical and horizontal integration among health care providers has transformed the practice arrangements under which many physicians work. To examine the influence of type of practice structure, and by implication the financial incentives associated with each structure, on treatment received among men newly diagnosed with low-risk prostate cancer. We compiled a unique database from cancer registry records from 4 large states, Medicare enrollment and claims for the years 2005-2014 and SK & A physician surveys corroborated by extensive internet searches. We estimated a multinomial logit model to examine the influence of urologist practice structure on type of initial treatment received. The probability of being monitored with active surveillance was 7.4% and 4.2% points higher for men treated by health system and nonhealth system employed urologists ( P <0.01), respectively, in comparison to men treated by single specialty urology practices. Among multispecialty practices, the rate of active surveillance use was 3% points higher compared with single specialty urology practices( P <0.01). Use of intensity modulated radiation therapy among urologists with ownership in intensity modulated radiation therapy was 17.4% points higher compared with urologists working in small single specialty practices. Physician practice structure attributes are significantly associated with type of treatment received but few studies control for such factors. Our findings-coupled with the observation that urologist practice structure shifted substantially over this time period due to mergers of small urology groups-provide one explanation for the limited uptake of active surveillance among men with low-risk disease in the US.

HIV testing and linkage to ART following secondary distribution of HIV self-test kits to male partners of women living with HIV: a pilot randomized control trial in Mpumalanga, South Africa.

IntroductionSouth African men are underrepresented in HIV testing and treatment services. Secondary distribution of oral HIV self‐test (HIVST) kits by women living with HIV (WLHIV) to their male partners (i.e. index partner HIVST) may increase men's testing and treatment but has been understudied.MethodsBetween March and July 2021, we evaluated the effectiveness of index partner HIVST versus the standard of care (SOC) (invitations for men's facility‐based testing) on men's testing in a 1:1 randomized control trial. Eligibility criteria included: WLHIV; ≥18 years of age; attending one of four high‐density rural clinics; have a working cell phone; and self‐reported having a primary male partner of unknown serostatus. The primary outcome was the proportion of WLHIV reporting that her partner tested for HIV within 3 months after enrolment.ResultsWe enrolled 180 WLHIV and 176 completed an endline survey (mean age = 35 years, 15% pregnant, 47% unmarried or non‐cohabiting). In the HIVST arm, 78% of male partners were reported to have tested for HIV versus 55% in SOC (RR = 1.41; 95% CI = 1.14–1.76). In the HIVST arm, nine men were reactive with HIVST (14% positivity), six were confirmed HIV positive with standard testing (67%) and all of those started antiretroviral therapy (ART), and four HIV‐negative men started pre‐exposure prophylaxis (PrEP) (5%). In SOC, six men were diagnosed with HIV (12% positivity), 100% started ART and seven HIV‐negative men started PrEP (16%). One case of verbal intimate partner violence was reported in the HIVST arm.ConclusionsSecondary distribution of HIVST to partners of WLHIV was acceptable and effective for improving HIV testing among men in rural South Africa in our pilot study. Interventions are needed to link reactive HIVST users to confirmatory testing and ART.

Secondary Treatment for Men with Localized Prostate Cancer: A Pooled Analysis of PRIAS and ERSPC-Rotterdam Data within the PIONEER Data Platform.

Introduction: Treatment choice for localized prostate cancer is complicated, as each treatment option comes with various pros and cons. It is well established that active surveillance (AS), may be ended with a change to curative treatment at the time of disease progression, but it is less clear whether secondary treatment after initial curative treatment is required. As part of the PIONEER project, we quantified the probabilities of treatment change. Methods: A cohort study based on PRIAS and ERSPC-Rotterdam data was conducted. Patients were followed up for 10 years or until the 31st of December 2017. The primary outcome was the incidence of treatment change following initial treatment (i.e., a change to curative treatment following AS or secondary treatment after initial RP/RT). Results: Over a period of 1 to 5 years after initial treatment, the cumulative incidence of treatment change ranged from 3.8% to 42.8% for AS, from 7.6% to 12.1% for radical prostatectomy (RP) and from no change to 5.3% for radiation therapy (RT). While the possibility of treatment change in AS is known, the numbers within a five-year period were substantial. For RP and RT, the rate of change to secondary treatment was lower, but still non-neglectable, with 5 (10)-year incidences up to 12% (20%) and 5% (16%), respectively. Conclusion: This is one of the first studies comparing the incidence of guideline-recommended treatment changes in men receiving different primary treatments (i.e., AS, RT, or RP) for localized prostate cancer (PCa).