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Factors associated with current and severe physical side-effects after prostate cancer treatment, what men report

Steentjes, L. (2015) Factors associated with current and severe physical side-effects after prostate cancer treatment, what men report.

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Abstract:Background: Prostate cancer (PCa) is the second most common cancer in the developed world and numbers are increasing. 75% of PCa survivors report ongoing side-effects 2-18 years after treatment in a population based research. Part of the PiCTure study, we aim to identify patient and disease characteristics associated with ‘current’ physical side-effects of any severity and severe side-effects ‘ever’ experienced, to support decision-making processes for men and clinicians. Methods: In 2012, 6,937 men diagnosed with PCa (C61) 2-18 years ago, identified through cancer registries in Northern Ireland (NI) and Republic of Ireland (RoI), were invited to participate in a survey on symptoms at diagnosis, primary treatments and physical side-effects; urinary incontinence, reduced libido, impotence, bowel problems, breast changes, hot flushes and fatigue. Men were grouped according to early (localized) and late (locally advanced and advanced) disease at diagnosis. Univariate and multivariate logistic regression analysis were performed to identify the factors associated with side-effects, such as age at diagnosis, pre-treatment function, comorbidities, treatment, education, living alone, jurisdiction (RoI/NI), TURPs, complications after biopsy (bleeding into bladder/rectum or infection) and time since diagnosis. Results: Radical prostatectomy, was a factor associated with most side-effects both ‘current’ and ‘severe’. In early disease, brachytherapy was associated with a lower risk of ‘current’ fatigue and ‘severe/very severe’ impotence. Active surveillance/watchful-waiting demonstrated lower risk of several ‘current’ side-effects in early disease. Pre-treatment symptom were also associated with a higher risk of side-effects. Complications post-biopsy were associated with a higher risk of libido loss, impotence, bowel problems and breast changes. No complications post-biopsy was also associated with a higher risk of ‘current’ impotence in both early and late disease. Conclusion: Treatment is the most important factor associated with side-effects. Tailored information on these side-effects and specific monitoring should be available to patients/clinicians to make the best decision on treatment.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/68725
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