Long-Term Symptoms Beyond 10 Years Experienced by Prostate Cancer Survivors
Years after receiving treatment, many patients who survive prostate cancer continue to experience treatment-related symptoms, according to the findings of a study by Darwish-Yassine et al published in the Journal of Cancer Survivorship. These findings highlight the need for improvements in survivor care over an extended period of time.
Study Overview
Although great strides have been made in the early detection and treatment of prostate cancer, the nearly 12 million American men who survive prostate cancer continue to face a number of problems including physiologic effects, psychological issues, and socioeconomic concerns. Combined, these problems can greatly affect the quality of life of many of these survivors.
For this study, conducted by the Michigan Public Health Institute in collaboration with the Michigan Department of Community Health, the investigators used a patient-centered survey to evaluate the continued side effects associated with prostate cancer treatment and patients’ access to preventive care. Patients were asked to indicate whether they continued to receive preventive care measures such as prostate-specific antigen analysis and digital rectal examinations. A total of 2,499 completed surveys were included in the analysis.
Based on medical records of surviving patients treated for prostate cancer between 1985 and 2004, the median duration between the diagnosis of prostate cancer diagnosis and the survey response was 9 years. Approximately 80% of these respondents were diagnosed at an early stage. Overall, 75.5% of survivors were white, 18.6% were black, and 5.9% were considered to be multiracial or unspecified.
Most patients (90%) experienced sexually related symptoms within 4 weeks of completing the survey. Other symptoms reported by survey respondents included urinary difficulties (frequency and leakage), bowel issues (urgency), and vitality concerns (hot flashes, breast tenderness, depression, and change in body weight). These symptoms were more often seen in men aged 75 years and older.
Regarding the type of specialty care follow-up these survivors received after completing treatment, 33% of respondents with urinary symptoms and 57% of respondents with sexual symptoms answered none. After such an extended period of time, survivors were no longer being monitored by specialists, but 88% indicated they were currently seeing a primary care provider. In addition, the use of supportive services, such as a sexual therapist, was limited.
In terms of access to preventive care services, 88% of the survivors had a prostate-specific antigen analysis since diagnosis, with 93% indicating that they completed an analysis at least once a year. Almost 83% of patients noted receiving some form of information on prostate cancer from their health-care provider.
Clinical Implications
The results from this study indicate a high level of symptoms at both 5 and 10 years in prostate cancer survivors. These findings suggest a strong, but often unmet, need for symptom management many years after successful treatment of prostate cancer. It is highly recommended that clinicians develop a survivorship plan in conjunction with their patients to guide both parties in managing future symptom occurrences. Since most survivors of prostate cancer noted they were no longer receiving specialty care at 5 to 10 years after treatment, it likely will fall on primary care health professionals to guide continued preventive and supportive care.
The investigators concluded, “Prostate cancer survivors continue to endure long-term physical symptoms, even years after the completion of cancer treatment. These findings support the need for the health care community to focus on, and provide the resources for, delivery of urologic care to prostate cancer survivors years post treatment to ensure that they continue to enjoy a high quality of life years out.”
May Darwish-Yassine, PhD, of the Cancer Control Services Program of the Michigan Public Health Institute, is the corresponding author for the article in the Journal of Cancer Survivorship.
The study received funding from the Centers for Disease Control and Prevention.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
