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Patient-reported 'ever had' and 'current' long-term physical symptoms after prostate cancer treatments

Lookup NU author(s): Professor Linda Sharp



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


ObjectiveTo investigate the prevalence of physical symptoms that were 'ever' and 'currently' experienced by survivors of prostate cancer at a population level, to assess burden and thus inform policy to support survivors.Patients and MethodsThe study included 3 348 men surviving prostate cancer for 2-18 years after diagnosis. A cross-sectional, postal survey of 6 559 survivors diagnosed 2-18 years ago with primary, invasive prostate cancer (ICD10-C61) identified via national, population-based cancer registries in Northern Ireland and Republic of Ireland. Questions included symptoms at diagnosis, primary treatments and physical symptoms (erectile dysfunction [ ED]/urinary incontinence [ UI]/bowel problems/breast changes/loss of libido/hot flashes/fatigue) experienced 'ever' and at questionnaire completion ('current'). Symptom proportions were weighted by age, country and time since diagnosis. Bonferroni corrections were applied for multiple comparisons.ResultsAdjusted response rate 54%; 75% reported at least one 'current' physical symptom ('ever' 90%), with 29% reporting at least three. Prevalence varied by treatment. Overall, 57% reported current ED and this was highest after radical prostatectomy (RP, 76%) followed by external beam radiotherapy with concurrent hormone therapy (HT, 64%). UI (overall 'current' 16%) was highest after RP ('current' 28%; 'ever' 70%). While 42% of brachytherapy patients reported no 'current' symptoms, 43% reported 'current' ED and 8% 'current' UI. 'Current' hot flashes (41%), breast changes (18%) and fatigue (28%) were reported more often by patients on HT.ConclusionSymptoms after prostate cancer treatment are common, often multiple, persist long-term and vary by treatment method. They represent a significant health burden. An estimated 1.6% of men aged >45 years are survivors of prostate cancer and currently experiencing an adverse physical symptom. Recognition and treatment of physical symptoms should be prioritised in patient follow-up. This information should facilitate men and clinicians when deciding about treatment as differences in survival between radical treatments is minimal.

Publication metadata

Author(s): Gavin AT, Drummond FJ, Donnelly C, O'Leary E, Sharp L, Kinnear HR

Publication type: Article

Publication status: Published

Journal: BJU International

Year: 2015

Volume: 116

Issue: 3

Pages: 397-406

Print publication date: 01/09/2015

Online publication date: 22/06/2015

Acceptance date: 18/01/2015

Date deposited: 20/04/2016

ISSN (print): 1464-4096

ISSN (electronic): 1464-410X

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1111/bju.13036


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