Europa Uomo is an umbrella organisation of European prostate cancer patient groups, which practices evidence-based patient advocacy and is active in EAU policy making regarding patient representation. When evidence of patient experience is lacking, organisations like Europa Uomo fill a critical gap in generating independent patient-reported outcomes.
In this case, the EUPROMS patient-driven QoL study included data from 2,943 men treated for prostate cancer from 24 countries (mean age 70 years at survey, mean age 64 years at diagnosis). Participants were asked to complete a 20-minute online survey to assay QoL of patients with or who had been treated for prostate cancer. The study used validated QoL questionnaires (i.e. EPIC-26, EORTC-QLQ-C30, and EQ-5D-5L) available in 19 languages. Of the respondents, two-third received 1 treatment for prostate cancer, 22% received 2 treatments, 19% received 3, and 2% received 4 or more.
Fatigue and insomnia were the most frequently reported complaints impacting QoL among participants. The data revealed that half of all respondents scored loss of sexual function (including the ability to have an erection or reach orgasm) as a “big” (28%) or “moderate” (22%) problem. Notably, the adverse impact of radiotherapy on sexual function was worse than that of radical prostatectomy. Alternatively, patients who underwent radical prostatectomy reported increased urinary incontinence compared with those undergoing radiation therapy. Radiation therapy doubled the reported fatigue compared with radical prostatectomy. Chemotherapy also led to an increase in reported fatigue. Insomnia appeared to be a function of progression of disease rather than the treatment received, except for chemotherapy, which did cause a marked increase in reported insomnia. Active surveillance had no impact on insomnia. As anticipated, chemotherapy resulted in the worst QoL outcomes.
Mr Deschamps concluded: “The data collected and the analysis done provide patients and healthcare professionals a snapshot on the impact of treatments based on the experiences of fellow patients. We hope that these results will be used to establish and disseminate realistic expectations on the effects of the different treatments for prostate cancer on QoL.”
Discussant Prof. Steven Joniau (University Hospital Leuven, Belgium) complimented the strengths of this study as being the large sample size, assessment at long-term follow-up (mean 6 years post diagnosis), and the use of validated questionnaire instruments. Weaknesses include the cross-sectional design, lack of a baseline assessment, and observational design. He continued to point out that because younger and healthier patients more likely underwent surgery and older, less healthy patients likely received radiation therapy, better insight into the baseline patient characteristics would help tease out relevant hypothesis-generating observations.
- Deschamps A, et al. EAU20 Virtual Congress, 17-26 July 2020. Game-changing Session 3.
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Table of Contents: EAU 2020
Featured articles
Surgical Techniques and Safety
The new adjustable artificial sphincter victo: Surgical technique and results after a follow-up of more than one year
New urosepsis data from the SERPENS study
Stones
Intra-operative cone-beam computed tomography for detecting residual stones in percutaneous nephrolithotomy
Pressure and temperature: do high-power lasers pose a threat?
Radiation stewardship for patient and endourologist
New lithotripter data: improved stone clearance
Renal Cancer
Beyond the limits of ultrasound: Three dimensional augmented reality robot assisted partial nephrectomy (3D AR-RAPN) for complex renal masses
Imaging guided surgery with augmented reality for robotic partial nephrectomy
KEYNOTE-426: no QoL differences pembrolizumab + axitinib versus sunitinib
Debate: upfront cytoreductive nephrectomy or not?
Robotic-assisted partial nephrectomy: lower morbidity
Bladder Cancer
Reduced BCG frequency, faster NMIBC recurrence
Nadofaragene firadenovec effective in BCG-unresponsive papillary NMIBC
Understanding MIBC biology for novel treatment options
Prostate Cancer & Imaging
Transperineal laser ablation of prostate
Prostatectomy: R-LRPE better than LRPE for continence
PSMA PET-CT staging is 27% more accurate
Docetaxel + hormonal therapy: improved prostate cancer PFS
ARAMIS subgroup analysis: darolutamide benefits across PSADT groups
Large patient-driven survey reveals QoL issues after prostate cancer treatment
Targeting steroid sulphatase in resistant prostate cancer cells
Good tolerance of post-RP radiotherapy ± short-term ADT
BPH & LUTS
Minimizing post-operative stress urinary incontinence after HoLEP: Our preliminary experience and short-term results of ‘’En Bloc’’ technique with early apical release
LUTS 2-year outcomes: aquablation versus TURP
HoLEP versus PVP in prospective randomised trial
Testis Cancer & Andrology
Peyronie’s disease: surgical options
Infertility and testis cancer risk: causal or association?
32% more men complain of reduced sex drive in 2019 versus 2009
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