The question of today’s post is do men with advanced prostate cancer develop treatment regrets concurrent to their development of morbidity issues ( i.e.- myocardial infarction, congestive heart failure, angina, diabetes, stroke, circulation problems, inflammatory bowel disease, or amputation)?
To answer this question researchers evaluated 795 men from the Comprehensive, Observational, Multicenter, Prostate Adenocarcinoma Registry (COMPARE) study who experienced PSA failure. The men who were assessed had a a median of 5.5 (interquartile range 2.8-9.1) years after prostatectomy (n=410), external beam radiation (n=237), brachytherapy (n=124), or primary androgen deprivation (n=24). Multivariable logistic regression was used to determine whether the morbidity level, socio-demographic factors, and other treatment factors were associated with treatment regret, as defined by a validated two-question screen.
1- Of 795 men, 14.8% reported regret. Men with significant morbidity issues were more likely to experience post-therapy bowel toxicity (p=0.029) and urinary problems (p=0.051).
2- On multivariable analysis, significant morbidity [adjusted odds ratio (AOR)=1.57 (95% CI:1.04-2.37); p = 0.033] and younger age [AOR: 0.965 (0.937-0.994) per year increase in age; p = 0.019] were associated with increased regret even after adjusting for post-therapy bowel and urinary complications.
The researcher found that in a population of men who experience a PSA recurrence, those with significant morbidity problems were particularly prone to also experiencing treatment regret. This emphasizes the importance of discussing morbidity when counseling patients about prostate cancer treatment options, especially men with advanced prostate cancer.
2011 Genitourinary Cancers Symposium
General Poster Session B: Prostate Cancer
J Clin Oncol 29: 2011 (suppl 7; abstr 187) ;P. L. Nguyen, etal.
Joel T Nowak, M.A., M.S.W.