Counseling About Prostate Cancer Treatment Decisions Should Include
a Man's Partner
Bringing a man's wife into discussions about prostate cancer treatments
and side effects can ease her anxiety and improve the couple's coping
ability after treatment, according to innovative research reported recently.
In the study, researchers conducted various psychosocial assessments
among 103 prostate cancer patients and their spouses. The investigators
found that the wives had higher rates of depression, distress, and other
negative emotions than the men did.
The assessments also revealed differing perceptions among the partners
concerning sexual functioning and sexual performance. For example, the
wives perceived more sexual problems in the relationship, rating the
men's ability to achieve an erection and to perform sexually lower than
the men did.
British Journal of Urology International,
Vol. 95, p. 780, April 2005
QUALITY OF LIFE IN PROSTATE CANCER SURVIVORS
VARIES WITH INITIAL
TREATMENT TYPE
Men with prostate cancer treated with
radical prostatectonly have, in general,
the highest scores on health-related
quality of life measurements 10 years
after treatment, while men who underwent hormone therapy generally have
the lowest quality of life scores.
Those findings come from a population-based
study of men in the Eindhoyen Cancer Registry in the Netherlands, conducted
by Dr. M. L. EssinkBot and colleagues affiliated with the Registry, and
published in the November 1st issue of Cancer (Vol. 107, pp. 2186-96).
The researchers administered the 36-item Short Form Health Survey and
the Quality of Life-Cancer Survivors
questionnaire to 964 men diagnosed
with prostate cancer between 1994 and
1998. Mean follow-up time was 1O
years.
General Health Perceptions scores
were worse but Mental Health scores
were better for cancer survivors compared with age-matched normative
controls.
Quality of life scores were similar
between cancer survivors and controls.
However, when analyzed by type of
treatment received for prostate cancer,
Dr. Essink-Bot's team found that "the
long-term quality of life can vary significantly as a function of the
type of primary treatment."
Men who underwent radical prostatectomy had the highest physical healthrelated
quality of life scores and men who received hormone therapy had the
lowest scores. Men who underwent
radiotherapy or watchful waiting fell
between these two groups.
The researchers acknowledge that data
on the baseline differences between
treatment groups were not included in
this study, and such differences (rather
than treatment per se) might explain
the variation in quality of life.
Reuters Health
1 December 2006
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PROSTATE CANCER
PATIENT
SUPPORT
1 800 80 Us TOO
NEW RESEARCH
Strict Diet and Lifestyle Changes
May Reduce the Risk of Progression
in Early Prostate Cancer
Men with early prostate cancer
who follow a strict vegetarian diet,
exercise regularly, and practice
stress reduction techniques may
be able to lower their PSA levels
and their risk of cancer progression, according to a new study.
Researchers wanted to test the
ability of a very low-fat diet (10%
or less of daily calories) to slow or
prevent worsening of early pros-
tate cancer. The diet followed was
a variation on the Omish diet, orig-
inally designed by Dean Omish,
M.D., to reduce heart disease risk.
The 93 study participants were
men with early-stage prostate
cancer who had chosen "watchful
waiting" instead of active treat-
ment. The men were randomly
assigned to the Ornish program or
to usual care.
During the 1-year study, 6 men
in the usual care group underwent
conventional treatment because of
rising PSA levels (an indication of
disease progression) or evidence
of progression on magnetic resonance imaging (MRI). In contrast,
none of the men in the comprehensive lifestyle group required
treatment. PSA levels decreased
4% in the lifestyle group, whereas
PSA levels increased 6% in the
usual care group. In addition, cell
culture studies showed that blood
from men in the lifestyle group
inhibited the growth of prostate
cancer cells by 70%, compared to
9% for men receiving usual care.
JOURNAL OF UROLOGY
Volume 174,
Page 1065 September 2005
SURVIVAL RATE HIGHEST WITH PROSTATECTOMY FOR LOCALIZED PROSTATE CANCER
Both radical prostatectomy (RP) and radiotherapy appear to result in
significantly higher survival rates compared with conservative management
in patients with clinically localized prostate cancer, according to the
results of a large study conducted at the Henry Ford Health System in
Detroit.
Dr. Ashutosh Tewari, of New York Presbyterian Hospital-Weill Cornell
Medical Center in New York, and colleagues studied 3,159 men, who were
75 years of age or younger with biopsy-confirmed, clinically localized
prostate cancer, treated between 1980 and 1997.
The overall 15-year survival rate was 35% with conservative management,
50% with radiotherapy and 65% with RP, the investigators report in the
December issue of Urology (Vol. 68, pp. 1268-74, 2007).
Prostate cancer-specific survival rates were 79%, 87% and 92% with conservative
management, radiotherapy and RP, respectively. The adjusted relative
risk of death at 15 years was 0.67 for radiotherapy and 0.41 for RP compared
with conservative management.
Survival duration was increased by 4.6 and 8.6 years for radiotherapy
and RP, respectively compared with conservative management.
The investigators point out that one of the strengths of this study
was the size, the lengthy follow-up and the inclusion of black patients.
Subgroup analysis showed that risk ratios were the same across all subgroups
analyzed, including race, age, tumor grade, co-existing morbidities and
income.
Due to this trial's retrospective design, Dr. Tewari and colleagues
caution that randomized clinical trials are still needed confirm survival
benefits of each of these 3 treatment approaches.
Reuters Health,
23 January 2007 |