Quality of life following prostate cancer treatments

Purpose Although it is the most powerful predictor of early prostate cancer treatment-related complications and quality-of-life (QOL) outcomes, most studies do not stratify results by baseline function. Further, reporting functional outcomes as averaged numerical results may obscure informatively disparate courses. Using levels of treatment-related dysfunction, we address these problems and present the final QOL outcomes of our prospective cohort study of patients with early prostate cancer. Methods We created categories for sexual, bowel, and urinary function, measured using numerical scores of the validated Prostate Cancer Symptom Indices and stratified into “normal,” “intermediate” and “poor” levels of function by incorporating patient-reported symptom and distress information. We present QOL outcomes for 409 patients 36 months after radical prostatectomy, external-beam radiation therapy, and brachytherapy. Results Different levels of baseline sexual, bowel, and urinary function produced distinctive treatment-related changes from baseline to 36 months. In general, the average scale increases in dysfunction were greatest among patients with normal baseline function, although patients with normal and intermediate baseline function had similar increases in sexual dysfunction. For patients whose baseline urinary obstruction/irritation was poor, both average scale scores and most patients' level of function improved after treatment, particularly after surgery. Conclusion The use of functional levels to stratify treatment-related outcomes by pretreatment functional status and to display the proportions of patients with improved, stable, or worsened function after treatment provides information that more specifically conveys the expected impact of treatment to patients choosing among localized prostate cancer treatments.

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Out of the Black Box: Expansion of a Theory-Based Intervention to Self-Manage the Uncertainty Associated With Active Surveillance (AS) for Prostate Cancer

Research and Theory for Nursing Practice ◽

10.1891/1541-6577.24.2.101 ◽

2010 ◽

Vol 24 (2) ◽

pp. 101-112 ◽

Cited By ~ 8

Author(s):

Meredith Wallace Kazer ◽

Donald E. Bailey ◽

Robin Whittemore

Keyword(s):

Prostate Cancer ◽

Active Surveillance ◽

Management Approach ◽

Cancer Treatments ◽

Illness Uncertainty ◽

Management Intervention ◽

Alternative Approach ◽

Cancer Intervention ◽

Prostate Cancer Treatments

Active surveillance (AS) (sometimes referred to as watchful waiting) is an alternative approach to managing low-risk forms of prostate cancer. This management approach allows men to avoid expensive prostate cancer treatments and their well-documented adverse events of erectile dysfunction and incontinence. However, AS is associated with illness uncertainty and reduced quality of life (QOL; Wallace, 2003). An uncertainty management intervention (UMI) was developed by Mishel et al. (2002) to manage uncertainty in women treated for breast cancer and men treated for prostate cancer. However, the UMI was not developed for men undergoing AS for prostate cancer and has not been adequately tested in this population. This article reports on the expansion of a theory-based intervention to manage the uncertainty associated with AS for prostate cancer. Intervention Theory (Sidani & Braden, 1998) is discussed as a framework for revising the UMI intervention for men undergoing AS for prostate cancer (UMI-AS). The article concludes with plans for testing of the expanded intervention and implications for the extended theory.

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Genistein in Prostate Cancer Prevention and Treatment

Proceedings ◽

10.3390/proceedings2019040049 ◽

2020 ◽

Vol 40 (1) ◽

pp. 49

Author(s):

Kucuk

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Radiation Therapy ◽

Cancer Prevention ◽

Hormone Therapy ◽

Soy Isoflavones ◽

Cancer Development ◽

Cancer Treatments ◽

Prevention And Treatment

Botanical compounds have been found to modulate genetic and epigenetic pathways of cancer development and progression. We have studied nutritional interventions, with emphasis on soy isoflavones. Preclinical and clinical translational research have been conducted investigating the potential use of natural compounds, particularly soy isoflavones, in the prevention and treatment of cancer. Clinical trials with soy isoflavones in prostate cancer patients have shown that they are potent anti-cancer agents that may be useful in preventing and slowing the progression of prostate cancer. Soy isoflavones could also prevent chemotherapy and radiation therapy toxicities. Furthermore, soy isoflavones may enhance the efficacy of chemotherapy and radiation therapy in patients with prostate cancer. Soy food intake has been associated with a low risk of several cancers. In addition, soy food consumption during cancer treatment may result in better outcomes and longer survival. These observations led to in vitro and in vivo mechanistic studies to elucidate the biological actions of various compounds in soybeans. Soy isoflavones have been found to have profound biological effects and modulate many of the pathways involved in cancer development and progression. In addition to their selective estrogen receptor modulatory effects, these compounds have anti-oxidant, anti-inflammatory and epigenetic effects, which may explain their potential role in cancer prevention and treatment. Soy foods and soy isoflavones can be easily taken together with conventional cancer treatments such as surgery, radiation, chemotherapy, hormone therapy, targeted agents and immunotherapeutic agents. They may enhance the efficacy and reduce the toxicities of radiation therapy, chemotherapy, hormone therapy and other conventional cancer treatments. Natural products such as soy isoflavones could be used to improve treatment effects and quality of life of patients. Soy isoflavones should be investigated in symptom control, quality of life, palliative care and survivorship research.

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