Glasgow, UK: Men who have been newly diagnosed with prostate cancer say they would trade some improvement in their odds of survival for improvements in side effects and quality of life, according to research presented at the 2018 NCRI Cancer Conference.
Prostate cancer is one of the most common forms of the disease in men but in many cases it is a slow growing disease with relatively good survival, even if left untreated. Treatment can include surgery or radiotherapy, but both can cause urinary incontinence and a loss of sexual function. Some patients will spend weeks or months recovering from treatments and some may need a second round of treatment.
The new study suggests that, while patients value a longer life, they also value quality of life and may be willing to choose less treatment on that basis.
The study was presented by Hashim Ahmed, Chair and Professor of Urology, Imperial College London and Chair of NCRI's Prostate Cancer Clinical Studies Group. He explained: "Men with early prostate cancer have to choose between active surveillance, with regular check-ups, and more invasive therapy, such as removal of the prostate gland or radiotherapy. Previous research suggests that men with low-risk prostate cancer do not gain improvements in survival at ten years following treatment. Men with high-risk prostate cancer gain a five per cent improvement in ten-year survival with treatment. In men with medium-risk disease there is uncertainty over whether treatment affects survival.
"Men who have treatment do suffer side effects including urine incontinence, requiring daily use of pads, loss of erectile function, despite medication like Viagra, and some will require further treatment.
"We know men wish to live longer, but many men get depressed following treatment and their quality of life and personal relationships are affected."
Professor Ahmed and his colleagues worked with 634 men who had been newly diagnosed with prostate cancer at UK hospitals. The men had only been told their diagnosis and given general information. They had not yet discussed any specific treatment with their clinicians.
In all cases, the cancer had not yet spread. Seventy-four per cent had low or medium risk cancer and 26 per cent had high risk cancer.
Men were presented with two different hypothetical treatments that were different in terms of their likely impact on survival, incontinence, impotence, recovery time and the chance of needing further treatment. The men were asked to say which of the two hypothetical treatments they would pick and this was repeated several times with varying impacts on survival and side effects.
