Prostate cancer survivors need lifelong psychological care

GU cancer

By Mardi Chapman

20 Nov 2019

Quality of life needs to improve in men who are long-term survivors of prostate cancer, according to Queensland-led research presented at the 2019 COSA AGM.

In a 10-year follow-up study of 598 men diagnosed with prostate cancer, 35% reported poor physical health-related quality of life and 40.3% reported adverse mental health-related quality of life.

The study, also published in Psycho-Oncology, found 41.7% of men reported low life satisfaction a decade after their diagnosis.

Lower household income and more comorbidities were significant predictors of poorer quality of life, in both physical and mental domains, and less satisfaction with life.

Receipt of external beam radiation therapy was an added risk factor for poor physical health-related quality of life while younger age and being single were risks for poor satisfaction with life.

Androgen deprivation therapy (ADT) was an additional risk factor for the lowest quality of life in the physical health domain.

The study also found time-varying effects of the Expanded Prostate Cancer Index Composite (EPIC) subscales but overall bowel function typically had more of an impact than urinary and sexual function.

The study, presented at COSA by Associate Professor Nicholas Ralph, from Cancer Council Queensland and the University of Southern Queensland’s Centre for Health Research, concluded that men should be assessed for risk factors and provided with life-long prostate cancer survivorship care.

“In our study, treatment with ADT, the presence of multiple comorbidities, and socioeconomic disadvantage are risk indicators for poorer long-term HRQoL and life satisfaction after a prostate cancer diagnosis.”

“Given a substantive group with these factors reported constant comparatively poorer long-term outcomes over ten years, men should be assessed for these factors and provided with suitable supportive care.

“In particular, steps to ameliorate the side-effects of ADT are needed given the lasting effects of this treatment on men contributing to poorer long-term physical HRQoL.”

“These steps may include interventions such as tailored exercise to reduce symptoms like fatigue, sexual dysfunction, sarcopenia, and weight gain.”

The Prostate Cancer Foundation of Australia’s recent position statement on screening for distress and psychosocial care and a monograph on a psychosocial care model are available on the PCFA website.

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