BACKGROUND: While ADT can delay cancer progression and reduce tumor burden, its use can be limited by adverse side effects. The current study evaluated the effect of ADT on mental and emotional well-being in men with non-metastatic prostate cancer.
METHODS: Participants were enrolled in the national CaPSURE registry and treated by RP, EBRT, or BT with no ADT (local); local with ADT (combination); or primary ADT (PADT). Emotional quality of life (QoL)was evaluated by SF-36social function, role emotional, vitality, and mental health subscales before and up to 24 months after treatment. Subscales were assessed as continuous scores and as clinically meaningful declines of at least one half standard deviation since pre-treatment. Associations between treatment and QoL changes over time were evaluated with mixed modeling. QoL declines were evaluated with logistic regression.
RESULTS: Among 3,068 men, the combination and PADT groups were older, single, with less education, and higher clinical CAPRA risk than the local group, all p < 0.01. ADT exposure was associated with significant changes over time in adjusted role emotional (-8.4 points, p=0.01) and vitality (-9.2 points,p=0.02) scores. Treatment group was not associated with any clinically meaningful QoL declines.A potential limitation is the observational nature of the study.
CONCLUSIONS: ADT use was associated with changes in mental and emotional well-being but did not result in clinically meaningful declines at 24 months. Patients must be counseled on possible ADT-related QoL changes, as well as interventions to attenuate these effects, prior to treatment for prostate cancer.
Written by:
Cary KC, Singla N, Cowan JE, Carroll PR, Cooperberg MR. Are you the author?
Department of Urology, University of California San Francisco; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA.
Reference: J Urol. 2013 Oct 29. pii: S0022-5347(13)05837-0.
doi: 10.1016/j.juro.2013.10.098
PubMed Abstract
PMID: 24184370
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