Findings from the first international prostate cancer quality-of-life study showed that significant numbers of men treated for the disease are struggling with continence and sexual problems after treatment. Results suggest that any treatment apart from active surveillance may negatively affect quality of life and indicate that for many men, these effects may be greater than previously thought. The findings of the Europa Uomo Patient Reported Outcomes Study (EUPROMS) were presented at the European Association of Urology (EAU) Virtual Congress.
The findings of EUPROMS were presented by Europa Uomo Chairman André Deschamps, MD. He commented in a news release, “The analysis of survey responses showed that urinary incontinence and sexual function were the two areas where men reported the lowest quality-of-life scores—much lower compared to the averages reported in clinical studies.”
The EUPROMS survey was available in 19 languages via a link advertised by Europa Uomo’s member organizations, its website, a newsletter, and social media. Europa Uomo also used its network of urologists to promote the survey and encourage patients to complete it.
Respondents were asked to complete a 20-minute online survey, using three standard validated quality-of-life questionnaires: EPIC-26, EORTC-QLQ-C30, and EQ-5D-5L.
Analysis of the data was conducted by Monique Roobol, PhD, of the Erasmus University Medical Centre Department of Urology, Rotterdam, who commented, “This study is important because it was initiated by patients and meant for patients. The questionnaires were completed unrelated to a hospital visit, which means respondents had more freedom to answer…. [It] provides insight into the effect of treatment on quality of life over a longer period.”
EUPROMS gathered data from 2,943 European men from 25 countries. The respondents had an average age of 70 (all were older than 45), and on average had been diagnosed with prostate cancer at the age of 64, meaning that they were reporting on quality of life 6 years after treatment.
Overall, 50% of men who replied to the questionnaire and had been treated for prostate cancer said that loss of sexual function (including the ability to have an erection or reach orgasm) was a big (28%) or moderate (22%) problem for them.
“We often hear that decline in sexual functioning is a relatively small problem for [patients with] prostate cancer, and the effect on their quality of life should not be exaggerated,” said Dr. Deschamps. “We also hear that prostate cancer is typically a disease of ‘old men,’ implying that the loss of sexual function is less relevant. This survey paints a different picture.”
Respondents also reported that different treatments had different effects on quality of life; radical prostatectomy had the largest reported impact on urinary incontinence. Radiotherapy was shown to double the fatigue a patient experienced in comparison to surgery, whereas chemotherapy tripled the fatigue score. The impact of radiotherapy on sexual function was reported as worse than radical prostatectomy, but both were reported to have had a severe impact.
“Our findings provide patients and health-care professionals with a snapshot of the impact of treatments…. They show that the effects of prostate cancer often don’t stop after treatment, and even those who are treated successfully for their cancer may have significant problems.”— André Deschamps, MD
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Results indicated that the best quality-of-life scores were achieved when the cancer was discovered in an early, curable stage. “This means efforts toward early detection and awareness are essential to avoid unnecessary deterioration in quality of life. Wherever it is possible and safe, active surveillance should be considered [as] the first-line treatment to ensure best quality of life,” commented Dr. Deschamps.
He continued, “Our findings provide patients and health-care professionals with a snapshot of the impact of treatments. We hope they will be used to set realistic expectations of the effects of the different treatments for prostate cancer on quality of life. They show that the effects of prostate cancer often don’t stop after treatment, and even those who are treated successfully for their cancer may have significant problems.”
“The results of this survey are different from clinical studies using the same validated questionnaires. This doesn’t replace previous studies, but it does suggest further investigation is needed. This is a huge survey, which is the great strength of the work, so I’d like to say thank you to all patients and volunteers who spent hours making this survey a success,” he concluded.
Disclosure: For full disclosures of the study authors, visit resource-centre.uroweb.org.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®.