Researchers wanted to determine if concurrent the development of morbidity issues ( i.e.- myocardial infarction, congestive heart failure, angina, diabetes, stroke, circulation problems, inflammatory bowel disease, or amputation) is associated with treatment regret among men with PSA recurrence following failed primary therapy for prostate cancer.

The 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 which importance of discussing morbidity when counseling patients about prostate cancer treatment options.

Men must be clearly and informed about their potential for post-treatment toxicity along with the possibility of developing treatment regret. This only points out the need for serious consideration of the possibility of using active surveillance as a primary treatment modality for prostate cancer.

2011 Genitourinary Cancers Symposium
General Poster Session B: Prostate Cancer
Abstract No:187
J Clin Oncol 29: 2011 (suppl 7; abstr 187) ;P. L. Nguyen, etal.