Reduced function in prostate cancer patients receiving radiotherapy
medwireNews: Men treated with a combination of intensity-modulated radiotherapy (IMRT) and androgen deprivation therapy (ADT) for locally advanced prostate cancer suffer from long-term reductions in urinary, bowel, and sexual function, show study findings.
In addition, the results showed that urinary, bowel, and sexual bother were increased 3 months after treatment, with an improvement at 12 months only observed for urinary bother, report Wolfgang Lilleby (Oslo University Hospital, Norway) and colleagues.
"To our knowledge this is the first report evaluating the patients' self-rating of typical function and bother when applying pelvic IMRT for men with locally advanced PCa [prostate cancer]," says the team.
The researchers conducted a 12-month follow-up study of 91 patients who received IMRT in addition to ADT that they had initiated 6 months previously. Patients completed questionnaires before treatment (baseline) and 3 and 12 months afterwards to self-report on urinary, bowel, and sexual function and bother, as well as quality of life (QoL), fatigue, and mental distress.
As reported in The Prostate, the 3-month mean function scores for urinary, bowel, and sexual function were significantly reduced from baseline, at 75.8 versus 82.0, 78.4 versus 89.9, and 10.9 versus 47.9, respectively, as assessed by the University of California-Los Angeles Prostate Cancer Index. None of these scores showed significant improvement at 12 months, at means of 75.9, 81.2, and 9.0 for urinary, bowel, and sexual function, respectively.
In addition, mean bowel and sexual bother were significantly increased (as indicated by lower scores) from baseline at 3 months, from 89.2 to 65.6 and from 62.2 to 44.9, respectively. No significant change in score for urinary bother was observed, and only urinary bother was significantly reduced from baseline between 3 and 12 months.
Further analysis revealed that poor urinary function at 3 and 12 months was significantly associated with higher levels of anxiety but not with depression (as assessed by the Hospital Anxiety and Depression Scale) or total fatigue (as assessed by the fatigue questionnaire). By contrast, poor bowel function was associated with higher levels of all three measures at all three time points.
Some variables showed significant associations with sexual function but no consistent patterns were observed, reports the team.
By Sally Robertson, medwireNews Reporter