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Wu S, Li K, Zhang Y, Wang L, Zhu B, Wang W. Men's symptom experience throughout androgen deprivation therapy for prostate cancer: A systematic review and meta-aggregation. Int J Nurs Stud 2024; 157:104796. [PMID: 38824718 DOI: 10.1016/j.ijnurstu.2024.104796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/20/2024] [Accepted: 05/02/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Androgen deprivation therapy is a common treatment for men with advanced prostate cancer. They have experienced many complex symptoms that affect their quality of life. However, qualitative reviews that synthesize the symptom experience for men with prostate cancer are lacking. OBJECTIVE To explore the men's symptom experience throughout androgen deprivation therapy for prostate cancer. DESIGN A qualitative evidence synthesis using meta-aggregation. DATA RESOURCES Published and unpublished literature between January 2001 and August 2023 were identified from PubMed, Embase (Ovid), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library, ProQuest, Google Scholar, China National Knowledge Infrastructure (CNKI), Wang Fang, and VIP. REVIEW METHODS Two reviewers independently conducted screening, study selection and data extraction, and quality appraisal was performed using the Joanna Briggs Institutes Critical Appraisal Checklist for Qualitative Research. Data synthesis was conducted using meta-aggregative approach. RESULTS 24 articles of moderate to high methodological quality were included. A total of 98 findings were extracted with 59 unequivocal or equivocal findings eligible for meta-aggregation, aggregated into nine categories, and developed four synthesized findings: (1) production of symptoms: unrecognized and underestimated, (2) perception of symptoms: varied and complicated, (3) meaning of symptoms: threatened and affected, and (4) response to symptoms: push and pull. CONCLUSIONS Men throughout androgen deprivation for prostate cancer experience the four crisis-packed stages in their symptomatic journey. Health care provider need to understand the men's thoughts whether in the process of shared decision-making or in the course of the chosen therapy. Future research should develop individual suitable interventions and offer practical strategies for managing symptom. PROSPERO registration: CRD42023449129.
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Affiliation(s)
- Siyuan Wu
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kun Li
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Zhang
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lijuan Wang
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Binbin Zhu
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Wang
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
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Lim J, Ng CF, Wei Y, Ong TA, Chu PSK, Chan WKW, Huang CY, Feng KK, Teoh JYC, Xu N, Low JW, Yeoh WS, Chiu PKF, Yee CH, Leung SCH. Health-Related Quality of Life Assessment in Prostate Cancer Patient Undergoing Androgen Deprivation Therapy: Real-World Experience in the READT Study. World J Mens Health 2024; 42:449-459. [PMID: 37853536 PMCID: PMC10949021 DOI: 10.5534/wjmh.230042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/22/2023] [Accepted: 06/08/2023] [Indexed: 10/20/2023] Open
Abstract
PURPOSE To investigate the effect of androgen deprivation therapy (ADT) on health-related quality of life (HRQOL) in Asian men with all stages of prostate cancer. MATERIALS AND METHODS READT (real-life evaluation of the effect of ADT in prostate cancer patients in Asia) was a multi-center, prospective observational study involving six sites across four Asian populations. We enrolled eligible prostate cancer patients, who opted for ADT alone or in combination without prior neoadjuvant or adjuvant ADT within 12 months. The EuroQoL-5 dimensions, 5 level scale (EQ-5D-5L) utility index scores and visual analog scale (VAS) were evaluated at baseline, month 6 and month 12. RESULTS A total of 504 patients were recruited into READT between September 2016 and May 2020 with 52.9% diagnosed with metastatic prostate cancer. The EQ-5D-5L was evaluable in 442/504 (87.7%) of patients. Overall baseline EQ-5D-5L utility index score was 0.924 (interquartile range [IQR] 0.876-1.000). We observed a statistically significant difference in baseline EQ-5D-5L utility index score among different populations with a median EQ-5D-5L utility index score of 1 for Taiwan & Hong Kong, 0.897 for China and 0.838 for Malaysia. Similar trend was observed throughout multiple treatment time-points. Stage IV prostate cancer were significantly associated with a lower baseline EQ-5D-5L utility index score compared to stage I-III prostate cancer, producing a median disutility value of -0.080. Participants had a high median VAS (80, IQR 70-90), indicating good overall health on average during ADT initiation. CONCLUSIONS The study highlights the differences in health state utility index scores among various Asian prostate cancer patients receiving ADT at real-world setting. Our findings will be informative and useful in cost-effectiveness evaluation and policy decision making.
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Affiliation(s)
- Jasmine Lim
- Urology Unit, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chi-Fai Ng
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China.
| | - Yong Wei
- Department of Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Teng Aik Ong
- Urology Unit, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | | | | | - Chao Yuan Huang
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuo-Kang Feng
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jeremy Yuen-Chun Teoh
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China
| | - Ning Xu
- Department of Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jer Wei Low
- Urology Unit, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wei Sien Yeoh
- Urology Unit, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Peter Ka-Fung Chiu
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi-Hang Yee
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China
| | - Steven Chi Ho Leung
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China
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Dissing N, Fode M, Østergren P, Sønksen J. Changes in Quality of Life and Sexual Function After Luteinizing Hormone-Releasing Hormone (LHRH) Agonists and Orchiectomy in Men With Metastatic Prostate Cancer: Results From a Randomized Trial. Cureus 2024; 16:e55934. [PMID: 38601370 PMCID: PMC11004837 DOI: 10.7759/cureus.55934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/12/2024] Open
Abstract
Purpose To examine changes in quality of life (QoL) in men diagnosed with metastatic prostate cancer undergoing androgen deprivation therapy (ADT). Methods This was a phase IV trial where patients were randomized to either triptorelin or subcapsular orchiectomy. We report changes in QoL, functional and symptom scales, and sexual function. These were assessed using the validated questionnaires, namely, the European Organisation for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (EORTC-QLQ-C30), European Organization of Research and Treatment of Cancer Quality of Life Questionnaire Prostate Cancer 25 (EORTC-QLQ-PR25), and Erectile Hardness Scale (EHS) before treatment and at 12, 24, and 48 weeks, respectively. Data were analyzed using linear mixed models for repeated measures. Results Fifty-seven men with a median age of 74 years were randomized. The pooled analyses showed that QoL (p=0.003), emotional function (p<0.001), urinary symptoms (p=0.011), and hormonal treatment-related symptoms (p<0.001) changed significantly between visits. Improvement from baseline in QoL (mean change: 6.8 points (95% confidence interval (CI 95% CI): 2.1; 11.5)), emotional function (6.9 points: 3.3, 10.6), and urinary symptoms (-7.7 points (-12.3; -3.0)) was most pronounced at 24 weeks. Hormonal treatment-related symptoms (8.9 points (95% CI: 5.9; 12.0)) worsened. No significant differences between treatment groups were observed. At baseline, 29 men (51%) reported interest in sex, 18 were sexually active, and 12 had erections hard enough for penetration. At 48 weeks seven reported interest in sex, five were sexually active, and one man had a hard enough erection for penetration. Conclusions Men with newly diagnosed metastatic prostate cancer experience improved QoL and emotional function after starting ADT. Urinary symptoms improved, while hormonal treatment-related symptoms worsened. Interest in sex and sexual activity was retained in a proportion of men despite ADT.
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Affiliation(s)
- Niklas Dissing
- Department of Urology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Copenhagen, DNK
| | - Mikkel Fode
- Department of Urology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Copenhagen, DNK
| | - Peter Østergren
- Department of Urology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Copenhagen, DNK
| | - Jens Sønksen
- Department of Urology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Copenhagen, DNK
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Liu Z, Kuang S, Chen Q. A review focusing on the role of pyroptosis in prostate cancer. Medicine (Baltimore) 2023; 102:e36605. [PMID: 38115248 PMCID: PMC10727670 DOI: 10.1097/md.0000000000036605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/10/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023] Open
Abstract
As one of the types of programmed cell death, pyroptosis has become a focus of research in recent years. Numerous studies have shown that pyroptosis plays a regulatory role in tumor cell invasiveness, differentiation, proliferation, and metastasis. It has been demonstrated that pyroptosis is involved in the regulation of signaling pathways implicated in the pathogenesis of prostate cancer (PCa). Furthermore, the loss of expression of pyroptosis-related genes in PCa has been reported, and pyroptosis-related genes have demonstrated a considerable ability in predicting the prognosis of PCa. Therefore, the potential role of pyroptosis in regulating the development of PCa warrants further investigation and attention. In this review, we summarize the basics of the role of pyroptosis and also discuss research into the mechanisms of action associated with pyroptosis in PCa. It is hoped that by exploring the potential of the pyroptosis pathway in intervening in PCa, it will provide a viable direction for the diversification of PCa treatment.
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Affiliation(s)
- Zhewen Liu
- Hunan University of Chinese Medicine, Changsha, People’s Republic of China
- The First Affiliated Hospital, Hunan University of Chinese Medicine, Changsha, People’s Republic of China
| | - Shida Kuang
- Hunan University of Chinese Medicine, Changsha, People’s Republic of China
| | - Qihua Chen
- Hunan University of Chinese Medicine, Changsha, People’s Republic of China
- The First Affiliated Hospital, Hunan University of Chinese Medicine, Changsha, People’s Republic of China
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5
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Leaning D, Kaur G, Morgans AK, Ghouse R, Mirante O, Chowdhury S. Treatment landscape and burden of disease in metastatic castration-resistant prostate cancer: systematic and structured literature reviews. Front Oncol 2023; 13:1240864. [PMID: 37829336 PMCID: PMC10565658 DOI: 10.3389/fonc.2023.1240864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/09/2023] [Indexed: 10/14/2023] Open
Abstract
Purpose Metastatic castration-resistant prostate cancer (mCRPC) is a lethal disease that imposes a major burden on patients and healthcare systems. Three structured literature reviews (treatment guidelines, treatment landscape, and human/clinical/patient burden) and one systematic literature review (economic burden) were conducted to better understand the disease burden and unmet needs for patients with late-stage mCRPC, for whom optimal treatment options are unclear. Methods Embase®, MEDLINE®, MEDLINE® In-Process, the CENTRAL database (structured and systematic reviews), and the Centre for Reviews and Dissemination database (systematic review only) were searched for English-language records from 2009 to 2021 to identify mCRPC treatment guidelines and studies related to the treatment landscape and the humanistic/economic burden of mCRPC in adult men (aged ≥18 years) of any ethnicity. Results In total, six records were included for the treatment patterns review, 14 records for humanistic burden, nine records for economic burden, three records (two studies) for efficacy, and eight records for safety. Real-world treatment patterns were broadly aligned with treatment guidelines and provided no optimal treatment sequencing beyond second line other than palliative care. Current post-docetaxel treatments in mCRPC are associated with adverse events that cause relatively high rates of treatment discontinuation or disruption. The humanistic and economic burdens associated with mCRPC are high. Conclusion The findings highlight a lack of treatment options with novel mechanisms of action and more tolerable safety profiles that satisfy a risk-to-benefit ratio aligned with patient needs and preferences for patients with late-stage mCRPC. Treatment approaches that improve survival and health-related quality of life are needed, ideally while simultaneously reducing costs and healthcare resource utilization.
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Affiliation(s)
- Darren Leaning
- Department of Radiology and Oncology, James Cook University Hospital, South Tees NHS Trust, Middlesbrough, United Kingdom
| | - Gagandeep Kaur
- Parexel Access Consulting, Parexel International, Mohali, Punjab, India
| | - Alicia K. Morgans
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Ray Ghouse
- Advanced Accelerator Applications, a Novartis Company, Genève, Switzerland
| | - Osvaldo Mirante
- Advanced Accelerator Applications, a Novartis Company, Genève, Switzerland
| | - Simon Chowdhury
- Department of Urological Cancer, Guy’s, King’s, and St. Thomas’ Hospitals, and Sarah Cannon Research Institute, London, United Kingdom
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Nishimura K, Shiota M, Eto M, Satoh T, Stroupe A, Seo C, Uzumcu A, Ledesma DA. Conceptual assessment of HRQOL among Japanese non-metastatic castration-resistant prostate cancer (nmCRPC) patients. Cancer Med 2022; 12:1762-1778. [PMID: 35770744 PMCID: PMC9883429 DOI: 10.1002/cam4.4955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE The study objectives were to understand how patients view the quality of life in non-metastatic castration-resistant prostate cancer (nmCRPC), including unmet needs and what patients consider most important in treatment outcomes. A gap analysis was conducted on existing patient-reported outcomes (PROs) measures versus what is missing from the patient perspective, to guide future development of PRO-based real-world evidence for nmCRPC in Japan. A conceptual model for nmCRPC Japanese patients' HRQOL was also created. METHODS This non-interventional, qualitative study consisted of a targeted literature review, PRO instrument review, and interviews with 20 nmCRPC patients and five treating physicians. Triangulation of the gap analysis, evidence from the targeted review of the literature, and qualitative interview findings were employed to assess the comprehensiveness of current nmCRPC and HRQOL measures. RESULTS Symptoms most reported by patients were frequent urination (70%), nocturia (65%), and general pain (65%). Others reported included lack of strength (30%). HRQOL impacts most reported were anxiety (45%) and worry (50%) about their diagnosis. Additional impacts mentioned were weight changes, loss of sleep, difficulty walking, loss of appetite, and difficulty traveling and seeking toilets in public. The gap analysis revealed 31 symptoms and 33 impacts not covered in existing prostate cancer-specific PRO instruments. Patients mentioned musculoskeletal symptoms such as fractures, leg pain, cramps, numbness, and loss of leg bone strength. Impacts not previously discussed in the literature or in outcome measures were feelings of self-consciousness around diagnosis, stigma around illness, and the impact on mobility including traveling. CONCLUSION Key results reveal pain and urinary symptoms are the most experienced by Japanese nmCRPC patients. The diagnosis and treatment of disease leads to significant impacts in patient lives. Analysis revealed that symptoms and life impacts are missing in the current literature and outcome measures. Testing and debriefing of specific items could further substantiate these dimensions.
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Affiliation(s)
- Kazuo Nishimura
- Department of UrologyOsaka International Cancer InstituteOsakaJapan
| | - Masaki Shiota
- Department of Urology, Graduate School of Medical SciencesKyushu UniversityKyushuJapan
| | - Masatoshi Eto
- Department of Urology, Graduate School of Medical SciencesKyushu UniversityKyushuJapan
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7
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Bowie J, Brunckhorst O, Stewart R, Dasgupta P, Ahmed K. Body image, self-esteem, and sense of masculinity in patients with prostate cancer: a qualitative meta-synthesis. J Cancer Surviv 2022; 16:95-110. [PMID: 33963973 PMCID: PMC8881246 DOI: 10.1007/s11764-021-01007-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/17/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Body image, self-esteem, and masculinity are three interconnected constructs in men with prostate cancer, with profound effects on quality of life. This meta-synthesis aimed to evaluate all known qualitative studies published studying the effect of prostate cancer on these constructs. METHODS A systematic review utilising PubMed, Embase, MEDLINE, and PsycINFO databases up to May 2020 was conducted in line with PRISMA and ENTREQ guidelines. All qualitative studies of men's experiences with body image, self-esteem, and masculinity whilst living with prostate cancer were included. A thematic meta-synthesis was conducted to identify emergent descriptive and analytical themes under the main study constructs. RESULTS Of 2188 articles identified, 68 were included. Eight descriptive themes were identified under two analytical themes: 'Becoming a Prostate Cancer Patient' and 'Becoming a Prostate Cancer Survivor'. These described the distress caused by changes to body image, sexual functioning, sense of masculinity, and self-esteem, and the subsequent discourses men engaged with to cope with and manage their disease. A key element was increased flexibility in masculinity definitions, and finding other ways to re-affirm masculinity. CONCLUSIONS Prostate cancer has an important effect on men's health post-diagnosis, and we identified strong relationships between each construct evaluated. The role of hegemonic masculinity is important when considering men's coping mechanisms and is also a key factor when addressing these constructs in counselling post-treatment. IMPLICATIONS FOR CANCER SURVIVORS This meta-synthesis provides key topics that uniquely affect prostate cancer survivors, enabling these patients to be effectively counselled, and have their concerns recognised by clinicians.
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Affiliation(s)
- Jessica Bowie
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Robert Stewart
- King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK.
- Department of Urology, King's College Hospital, London, UK.
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Ashraf MAB, Zahid A, Ashraf S, Waquar S, Iqbal S, Malik A. Implication of Prophetic Variables and their Impulsive Interplay in CA Prostate Patients Experiencing Osteo-Metastasis. Anticancer Agents Med Chem 2021; 20:2106-2113. [PMID: 32718298 DOI: 10.2174/1871520620666200727094430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/06/2020] [Accepted: 06/11/2020] [Indexed: 12/30/2022]
Abstract
AIMS To identify variables having a critical role in prostate cancer patients experiencing osteometastasis. BACKGROUND Prostatic carcinoma is a multifactorial complex disorder that exhibits an increased propensity to develop bone metastasis. An interplay of inflammatory and bone remodeling parameters promotes the formation of pre-metastatic niches in bones of patients, which could render them more vulnerable to skeletal disabilities. OBJECTIVE To evaluate the multi-dynamic inter-relationship of circulating variables in prostate cancer patients experiencing osteo-metastasis. MATERIALS AND METHODS Fifty-seven (n=57) men with clinically confirmed prostate cancer, fifty-nine (n=59) with skeletal metastases, and one hundred (n=100) healthy subjects i.e., men aging from 53-84 years with no clinical evidence of prostate were recruited from the Jinnah Hospital Lahore, Pakistan. Informed consent was obtained, and a venous blood sample was drawn and stored at -70oC until assayed. Levels of variables were evaluated using appropriate methods. Levels of Matrix Metalloproteinases (MMPs), Osteopontin (OPN), TGH- β, and sRANKL were estimated by the ELISA method. Each sample was suspended and the given protocol was employed. ELISA readings were obtained for the estimation of all variables. RESULTS Highly significant (P˂0.05) differential expression of oxidative stress, inflammatory cytokines, and bone remodeling variables were observed in localized and osteo-metastatic CA prostate patients. A strong positive correlation was revealed among OPN, sRANKL, MMP-7, MMP-9, PSA, and TGF-β (OPN vs. MMP-7, r=0.698* and OPN vs. MMP-9, r=0.765**, OPN vs. RANKL, =0.856*, sRANKL vs. MMP-9, r=0.825**, TGF- β vs. RANKL, r=0.868* and PSA vs. TGF- β, r=0.752*); lower levels of OPG were estimated in metastasized patients, showing that both osteolytic and osteoblastic phases of bone remodeling occur simultaneously. CONCLUSION The altered oxidative and inflammatory responses endorse Matrix Metalloproteinases (MMPs) increased activity, RANKL/OPG imbalance, and enhanced bone matrix proteins turnover, which can foster the process of osteo-metastasis. The perturbed RANKL/OPG drift and enhanced PSA levels are associated with increased TGF-β activity to aggravate Epithelial Mesenchymal transition (EM) and osteo-tropism of prostate cancer. Thus, designing novel targets of these major variables can minimize the incidence of prostate cancer patients.
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Affiliation(s)
- Muhammad A B Ashraf
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan
| | - Ayesha Zahid
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan
| | - Shazia Ashraf
- Department of Pathology, Independent Medical College, Faisalabad, Pakistan
| | - Sulayman Waquar
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan
| | - Saima Iqbal
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan
| | - Arif Malik
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan
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Muthanna FMS, Karuppannan M, Hassan BAR, Mohammed AH. Impact of fatigue on quality of life among breast cancer patients receiving chemotherapy. Osong Public Health Res Perspect 2021; 12:115-125. [PMID: 33980002 PMCID: PMC8102880 DOI: 10.24171/j.phrp.2021.12.2.09] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/27/2021] [Indexed: 02/07/2023] Open
Abstract
Objectives Fatigue is the most frequently reported symptom experienced by cancer patients and has a profound effect on their quality of life (QOL). The study aimed to determine the impact of fatigue on QOL among breast cancer patients receiving chemotherapy and to identify the risk factors associated with severe fatigue incidence. Methods This was an observational prospective study carried out at multiple centers. In total, 172 breast cancer patients were included. The Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire was used to measure QOL, while the Brief Fatigue Inventory (BFI) was used to assess the severity of fatigue. Results The total average mean and standard deviation of QOL were 84.58±18.07 and 4.65±1.14 for BFI scores, respectively. A significant association between fatigue and QOL was found in linear and multiple regression analyses. The relationships between fatigue severity and cancer stage, chemotherapy dose delay, dose reduction, chemotherapy regimen, and ethnicity were determined using binary logistic regression analysis. Conclusion The findings of this study are believed to be useful for helping oncologists effectively evaluate, monitor, and treat fatigue related to QOL changes.
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Affiliation(s)
- Fares Mohammed Saeed Muthanna
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA, Cawangan Selangor, Kampus Puncak Alam, Selangor, Malaysia
| | - Mahmathi Karuppannan
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA, Cawangan Selangor, Kampus Puncak Alam, Selangor, Malaysia
| | | | - Ali Haider Mohammed
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Selangor, Malaysia
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Rebello RJ, Oing C, Knudsen KE, Loeb S, Johnson DC, Reiter RE, Gillessen S, Van der Kwast T, Bristow RG. Prostate cancer. Nat Rev Dis Primers 2021. [PMID: 33542230 DOI: 10.1038/s41572-020-0024.3-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2023]
Abstract
Prostate cancer is a complex disease that affects millions of men globally, predominantly in high human development index regions. Patients with localized disease at a low to intermediate risk of recurrence generally have a favourable outcome of 99% overall survival for 10 years if the disease is detected and treated at an early stage. Key genetic alterations include fusions of TMPRSS2 with ETS family genes, amplification of the MYC oncogene, deletion and/or mutation of PTEN and TP53 and, in advanced disease, amplification and/or mutation of the androgen receptor (AR). Prostate cancer is usually diagnosed by prostate biopsy prompted by a blood test to measure prostate-specific antigen levels and/or digital rectal examination. Treatment for localized disease includes active surveillance, radical prostatectomy or ablative radiotherapy as curative approaches. Men whose disease relapses after prostatectomy are treated with salvage radiotherapy and/or androgen deprivation therapy (ADT) for local relapse, or with ADT combined with chemotherapy or novel androgen signalling-targeted agents for systemic relapse. Advanced prostate cancer often progresses despite androgen ablation and is then considered castration-resistant and incurable. Current treatment options include AR-targeted agents, chemotherapy, radionuclides and the poly(ADP-ribose) inhibitor olaparib. Current research aims to improve prostate cancer detection, management and outcomes, including understanding the fundamental biology at all stages of the disease.
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Affiliation(s)
- Richard J Rebello
- Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester, UK
| | - Christoph Oing
- Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester, UK
- Department of Oncology, Haematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Centre Eppendorf, Hamburg, Germany
| | - Karen E Knudsen
- Sidney Kimmel Cancer Center at Jefferson Health and Thomas Jefferson University, Philadelphia, PA, USA
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, Manhattan, NY, USA
| | - David C Johnson
- Department of Urology, University of North Carolina, Chapel Hill, NC, USA
| | - Robert E Reiter
- Department of Urology, Jonssen Comprehensive Cancer Center UCLA, Los Angeles, CA, USA
| | | | - Theodorus Van der Kwast
- Laboratory Medicine Program, Princess Margaret Cancer Center, University Health Network, Toronto, Canada
| | - Robert G Bristow
- Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester, UK.
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Abstract
Prostate cancer is a complex disease that affects millions of men globally, predominantly in high human development index regions. Patients with localized disease at a low to intermediate risk of recurrence generally have a favourable outcome of 99% overall survival for 10 years if the disease is detected and treated at an early stage. Key genetic alterations include fusions of TMPRSS2 with ETS family genes, amplification of the MYC oncogene, deletion and/or mutation of PTEN and TP53 and, in advanced disease, amplification and/or mutation of the androgen receptor (AR). Prostate cancer is usually diagnosed by prostate biopsy prompted by a blood test to measure prostate-specific antigen levels and/or digital rectal examination. Treatment for localized disease includes active surveillance, radical prostatectomy or ablative radiotherapy as curative approaches. Men whose disease relapses after prostatectomy are treated with salvage radiotherapy and/or androgen deprivation therapy (ADT) for local relapse, or with ADT combined with chemotherapy or novel androgen signalling-targeted agents for systemic relapse. Advanced prostate cancer often progresses despite androgen ablation and is then considered castration-resistant and incurable. Current treatment options include AR-targeted agents, chemotherapy, radionuclides and the poly(ADP-ribose) inhibitor olaparib. Current research aims to improve prostate cancer detection, management and outcomes, including understanding the fundamental biology at all stages of the disease.
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EDITORIAL COMMENT. Urology 2021; 148:140. [PMID: 33549206 DOI: 10.1016/j.urology.2020.08.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hollenbeck BK, Oerline M, Kaufman SR, Caram MEV, Dusetzina SB, Ryan AM, Shahinian VB. Promotional Payments Made to Urologists by the Pharmaceutical Industry and Prescribing Patterns for Targeted Therapies. Urology 2020; 148:134-140. [PMID: 33075381 DOI: 10.1016/j.urology.2020.08.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/29/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To measure the association between market-level promotional payments to urologists by the manufacturers of abiraterone and enzalutamide and national prescribing patterns. METHODS A 20% national sample of the 2015 Part D event file was used to identify patients filling their first prescription for abiraterone and enzalutamide and their prescribing physicians. The 2015 Open Payments data were used to characterize promotional payments made to physicians at the market level. Generalized linear models were then used to measure the relationship between market-level payments to urologists and the physician specialty prescribing abiraterone or enzalutamide for the first time RESULTS: In 2015, 2318 men filled a prescription for abiraterone or enzalutamide by a urologist or medical oncologist. Increasing market-level promotional payments to urologists for abiraterone or enzalutamide was strongly associated with a urologist prescribing either drug-24.3% versus 5.8% of those residing in the markets with highest and lowest level of promotional payments to urologists, respectively (P <.01). Neither the number of urologists residing in a market nor other promotional payment measures (ie, to medical oncologists for these drugs, or to all physicians for all other drugs) were associated with a urologist prescribing either drug. CONCLUSION Promotional payments to urologists at the market level are strongly associated with the specialty of the physician prescribing abiraterone or enzalutamide for the first time. Future work should elucidate the effects of the shift in prescribing patterns on quality of care and financial hardship for men with advanced prostate cancer.
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Affiliation(s)
| | - Mary Oerline
- Departments of Urology, University of Michigan, Ann Arbor, MI
| | | | | | - Stacie B Dusetzina
- Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN
| | - Andy M Ryan
- Health Management and Policy, University of Michigan, Ann Arbor, MI
| | - Vahakn B Shahinian
- Departments of Urology, University of Michigan, Ann Arbor, MI; Medicine, University of Michigan, Ann Arbor, MI
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Evans HEL, Forbes CC, Vandelanotte C, Galvão DA, Newton RU, Wittert G, Chambers S, Kichenadasse G, Brook N, Girard D, Short CE. Examining the Priorities, Needs and Preferences of Men with Metastatic Prostate Cancer in Designing a Personalised eHealth Exercise Intervention. Int J Behav Med 2020; 28:431-443. [PMID: 32968943 DOI: 10.1007/s12529-020-09932-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Few individuals with metastatic prostate cancer have access to prostate cancer-specific exercise support, despite demonstrated benefits. eHealth tools, such as websites, may be viable options for increasing access. To be effective and acceptable, future eHealth websites need to consider end-users' perspectives, capacity and needs. We aim to provide insight into these factors by exploring daily priorities, activities and health literacy of individuals with metastatic prostate cancer and their perspectives towards exercise and exercise-based web-based eHealth interventions. METHODS Semi-structured interviews explored participant's experiences and understanding of their disease, exercise levels, advice received from health care providers, as well as acceptability of and suggested content for an eHealth tool. A thematic analysis was undertaken. RESULTS Interviews were conducted with eighteen Australians (55-83 years; M = 71.5, SD = 8.9) living with metastatic prostate cancer. Needing to perform daily responsibilities was a key priority. Participants had limited understanding of the benefits of prostate cancer-specific exercise, and less than half discussed exercise with their health team. Fourteen men felt they could report metastases location, but only four could provide detailed information, which has clinical implications for exercise prescription. A potential web-based intervention was considered acceptable by seventeen men for reasons such as affordability, accessibility and convenience. User-friendly design and practitioner support were important. CONCLUSIONS Results identified key aspects useful for person-centred design of exercise programs. Participants were positive towards the proposed web-based tool and expressed the need for individualised, user-friendly and reliable information with support from a professional embedded. Lastly, not all participants could accurately report metastasis locations.
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Affiliation(s)
- Holly E L Evans
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, PO Box 11060, Adelaide, South Australia, 5001, Australia.
| | - Cynthia C Forbes
- Wolfson Palliative Care Research Centre, University of Hull, Hull, HU6 7RX, UK
| | - Corneel Vandelanotte
- School of Health, Medical and Applied Sciences, Appleton Institute, Physical Activity Research Group, Central Queensland University, Bruce Highway, North Rockhampton, Queensland, 4702, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Gary Wittert
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, PO Box 11060, Adelaide, South Australia, 5001, Australia
| | - Suzanne Chambers
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, Sydney, New South Wales, 2007, Australia
| | - Ganessan Kichenadasse
- College of Medicine and Public Health, Flinders Centre for Innovation in Cancer, GPO Box 2100, Adelaide, South Australia, 5001, Australia
| | - Nicholas Brook
- Department of Surgery, University of Adelaide, Corner of North Terrace & George Street, Adelaide, South Australia, 5000, Australia
| | - Danielle Girard
- School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia
| | - Camille E Short
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, PO Box 11060, Adelaide, South Australia, 5001, Australia.,Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences and Melbourne School of Health Sciences, University of Melbourne, Barry Building, Tin Alley, Parkville, Victoria, 3010, Australia
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Exploring the Positive Thinking of Patients With Prostate Cancer: Self-efficacy as a Mediator. Cancer Nurs 2020; 45:E329-E337. [PMID: 32649333 DOI: 10.1097/ncc.0000000000000868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research has explored the effectiveness of positive thinking on individuals, but only a few studies have investigated the factors that influence individual positive thinking, particularly among patients with prostate cancer. OBJECTIVES The aim of this study was to understand the factors that affect positive thinking among patients with prostate cancer and the mediating role of self-efficacy. METHODS A cross-sectional design and a convenience sampling method were used to recruit patients with prostate cancer from 2 hospitals in Taiwan. Structured scales were used for data collection, including the General Self-efficacy Scale, Expanded Prostate Cancer Index Composite, Positive Thinking Scale, and Social Support Scale. RESULTS The total average score for positive thinking among 201 patients was 66.1 (SD, 9.4). The factors that influenced the positive thinking of patients with prostate cancer included self-efficacy, treatment satisfaction, perceived health status, marital status, and appraisal support. The effects of treatment satisfaction and appraisal support on positive thinking were partly achieved through self-efficacy (partial mediation). CONCLUSIONS Self-efficacy is a mediator that affects the relationship of treatment satisfaction, appraisal support, and positive thinking. IMPLICATIONS FOR PRACTICE In the course of the disease, healthcare providers can help patients with prostate cancer to promote and maintain appropriate positive thinking by improving treatment satisfaction; increasing appraisal support from family, relatives, and friends; strengthening self-efficacy; and modifying unrealistic expectations.
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Matheson L, Nayoan J, Rivas C, Brett J, Wright P, Butcher H, Jordan P, Gavin A, Glaser A, Mason M, Wagland R, Watson E. Strategies for living well with hormone-responsive advanced prostate cancer-a qualitative exploration. Support Care Cancer 2020; 29:1317-1325. [PMID: 32632762 DOI: 10.1007/s00520-020-05594-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 06/23/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Due to recent treatment advances, men are increasingly living longer with advanced prostate cancer (PCa). This study sought to understand men's experiences of living with and adjusting to advanced hormone-responsive PCa and how this influenced their quality of life (QoL), in order to highlight how support could be optimized. METHODS Participants were recruited through a UK wide survey-the 'Life After Prostate Cancer Diagnosis' study. In-depth telephone interviews were conducted with 24 men (aged 46-77 years) with advanced (stage IV) hormone-responsive PCa diagnosed 18-42 months previously. Thematic analysis was undertaken using a framework approach. RESULTS Most participants perceived their QoL to be relatively good, which was influenced by the following factors (enablers to 'living well' with PCa): a sense of connectedness to others, engagement in meaningful activities, resources (social, cognitive, financial), ability to manage uncertainty, utilization of adjustment strategies and support, communication and information from health professionals. Barriers to 'living well' with PCa were often the converse of these factors. These also included more troublesome PCa-related symptoms and stronger perceptions of loss and restriction. CONCLUSIONS In our study, men living with advanced hormone-responsive PCa often reported a good QoL. Exploring the influences on QoL in men with advanced PCa indicates how future interventions might improve the QoL of men who are struggling. Further research is required to develop and test interventions that enhance QoL for these men.
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Affiliation(s)
- Lauren Matheson
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, OX3 0FL, UK
| | - Jo Nayoan
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK.,European Centre for Environment and Human Health (ECEHH), University of Exeter, Truro, TR1 3HD, UK
| | - Carol Rivas
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK.,Department of Social Science, University College London (UCL), London, WC1H 0NR, UK
| | - Jo Brett
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, OX3 0FL, UK
| | - Penny Wright
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | | | | | - Anna Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - Adam Glaser
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, Leeds, LS2 9JT, UK
| | - Malcolm Mason
- Scool of Medicine, Cardiff University, Cardiff, CF14 2TL, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Eila Watson
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, OX3 0FL, UK.
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Bhindi B, Lokeshwar SD, Klaassen Z, Klotz L, Wallis CJD. Systematic review and meta-analysis of trials evaluating the role of adjuvant radiation after radical prostatectomy for prostate cancer: Implications for early salvage. Can Urol Assoc J 2020; 14:330-336. [PMID: 32432529 DOI: 10.5489/cuaj.6440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Recent reports suggest that early salvage radiation (esRT) is non-inferior to adjuvant radiation (aRT) for adverse pathological features at radical prostatectomy. However, aRT was accepted as a standard treatment primarily based on effects on biochemical progression-free survival (bPFS). In order to understand the merits of esRT, the objective was to reassess if aRT vs. observation is associated with improved overall survival (OS). METHODS A systematic review and meta-analysis of published randomized trials evaluating aRT was performed. The primary outcome was OS. Secondary outcomes were metastasis-free survival (MFS), loco-regional recurrence-free survival (RFS), bPFS, and adverse events. We performed a random-effects meta-analysis. RESULTS Four randomized trials including 2068 patients with a median followup of 8.7-12.6 years were identified. While all trials reported a bPFS benefit, only one reported an OS benefit. Upon meta-analysis, no significant OS benefit was detected with aRT vs. observation (hazard ratio [HR] 0.90, 95% confidence interval [CI] 0.61-1.33), although consistent bPFS (HR 0.47, 95% CI 0.41-0.54) and local-RFS (HR 0.54, 95% CI 0.39-0.73) benefits were noted. There is an uncertain MFS benefit with aRT (HR 0.79, 95% CI 0.62-1.01), and the effect is largely driven by one trial with a notable risk of bias. There was also a risk of overtreatment, with 35-60% of patients being biochemical recurrence-free with observation alone. Adverse events risk was greater with aRT vs. observation. CONCLUSIONS Although aRT vs. observation provides a bPFS benefit related to local control, there is no clear OS or MFS benefit, a greater risk of adverse events, and a risk of overtreatment. By extension, these data have implications for patient selection and counselling for esRT.
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Affiliation(s)
- Bimal Bhindi
- Department of Surgery, Section of Urology, University of Calgary, Calgary, AB, Canada.,Southern Alberta Institute of Urology, Calgary, AB, Canada
| | - Soum D Lokeshwar
- Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Zachary Klaassen
- Division of Urology, Department of Surgery, Medical College of Georgia at Augusta University, Augusta, GA, United States.,Georgia Cancer Center, Augusta, GA, United States
| | - Laurence Klotz
- Division of Urology, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Christopher J D Wallis
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.,Department of Urology, Vanderbilt University Medical Center, Nashville, TN, United States
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Kudryavtseva AV, Lukyanova EN, Kharitonov SL, Nyushko KM, Krasheninnikov AA, Pudova EA, Guvatova ZG, Alekseev BY, Kiseleva MV, Kaprin AD, Dmitriev AA, Snezhkina AV, Krasnov GS. Bioinformatic identification of differentially expressed genes associated with prognosis of locally advanced lymph node-positive prostate cancer. J Bioinform Comput Biol 2020; 17:1950003. [PMID: 30866732 DOI: 10.1142/s0219720019500033] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Prostate cancer (PCa) is one of the primary causes of cancer-related mortality in men worldwide. Patients with locally advanced PCa with metastases in regional lymph nodes are usually marked as a high-risk group. One of the chief concerns for this group is to make an informed decision about the necessity of conducting adjuvant androgen deprivation therapy after radical surgical treatment. During the oncogenic transformation and progression of the disease, the expression of many genes is altered. Some of these genes can serve as markers for diagnosis, predicting the prognosis or effectiveness of drug therapy, as well as possible therapeutic targets. We undertook bioinformatic analysis of the RNA-seq data deposited in The Cancer Genome Atlas consortium database to identify possible prognostic markers. We compared the groups with favorable and unfavorable prognosis for the cohort of patients with PCa showing lymph node metastasis (pT2N1M0, pT3N1M0, and pT4N1M0) and for the most common molecular type carrying the fusion transcript TMPRSS2-ERG. For the entire cohort, we revealed at least six potential markers (IDO1, UGT2B15, IFNG, MUC6, CXCL11, and GBP1). Most of these genes are involved in the positive regulation of immune response. For the TMPRSS2-ERG subtype, we also identified six genes, the expression of which may be associated with prognosis: TOB1, GALNT7, INAFM1, APELA, RAC3, and NNMT. The identified genes, after additional studies and validation in the extended cohort, could serve as a prognostic marker of locally advanced lymph node-positive PCa.
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Affiliation(s)
- Anna V Kudryavtseva
- * Laboratory of Postgenomic Research, Engelhardt Institute of Molecular Biology Russian Academy of Sciences, Vavilova 32, Moscow 119991, Russian Federation
| | - Elena N Lukyanova
- * Laboratory of Postgenomic Research, Engelhardt Institute of Molecular Biology Russian Academy of Sciences, Vavilova 32, Moscow 119991, Russian Federation
| | - Sergey L Kharitonov
- * Laboratory of Postgenomic Research, Engelhardt Institute of Molecular Biology Russian Academy of Sciences, Vavilova 32, Moscow 119991, Russian Federation
| | - Kirill M Nyushko
- † Federal State Budgetary Institution, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 4 Korolev Str., Obninsk 249036, Russian Federation
| | - Alexey A Krasheninnikov
- † Federal State Budgetary Institution, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 4 Korolev Str., Obninsk 249036, Russian Federation
| | - Elena A Pudova
- * Laboratory of Postgenomic Research, Engelhardt Institute of Molecular Biology Russian Academy of Sciences, Vavilova 32, Moscow 119991, Russian Federation
| | - Zulfiya G Guvatova
- * Laboratory of Postgenomic Research, Engelhardt Institute of Molecular Biology Russian Academy of Sciences, Vavilova 32, Moscow 119991, Russian Federation
| | - Boris Y Alekseev
- † Federal State Budgetary Institution, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 4 Korolev Str., Obninsk 249036, Russian Federation
| | - Marina V Kiseleva
- † Federal State Budgetary Institution, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 4 Korolev Str., Obninsk 249036, Russian Federation
| | - Andrey D Kaprin
- † Federal State Budgetary Institution, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 4 Korolev Str., Obninsk 249036, Russian Federation
| | - Alexey A Dmitriev
- * Laboratory of Postgenomic Research, Engelhardt Institute of Molecular Biology Russian Academy of Sciences, Vavilova 32, Moscow 119991, Russian Federation
| | - Anastasiya V Snezhkina
- * Laboratory of Postgenomic Research, Engelhardt Institute of Molecular Biology Russian Academy of Sciences, Vavilova 32, Moscow 119991, Russian Federation
| | - George S Krasnov
- * Laboratory of Postgenomic Research, Engelhardt Institute of Molecular Biology Russian Academy of Sciences, Vavilova 32, Moscow 119991, Russian Federation
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Holmstrom S, Naidoo S, Turnbull J, Hawryluk E, Paty J, Morlock R. Symptoms and Impacts in Metastatic Castration-Resistant Prostate Cancer: Qualitative Findings from Patient and Physician Interviews. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2019; 12:57-67. [PMID: 30519830 DOI: 10.1007/s40271-018-0349-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND There is little information available on health-related quality of life in patients with chemotherapy-naïve metastatic castration-resistant prostate cancer. This study aimed to develop a conceptual model that describes patients' experiences of living with this condition. METHODS This was a cross-sectional, non-interventional qualitative research study. Sixty-minute semi-structured interviews were conducted with physicians experienced in treating metastatic castration-resistant prostate cancer and with chemotherapy-naïve patients with metastatic castration-resistant prostate cancer. Interviews were audio-recorded and transcripts were analysed to identify the key symptoms and impacts on quality of life. Results were used to expand a previously published conceptual model for non-metastatic castration-resistant prostate cancer. RESULTS Three physicians and 19 patients with metastatic castration-resistant prostate cancer were interviewed. Physicians identified several symptoms frequently mentioned by their patients: fatigue, bone pain, anxiety, stress, depression and interference with daily activities. The most salient symptoms emerging from the patient interviews were urinary frequency and urgency, fatigue, pain/stiffness and sexual dysfunction. The most salient impacts were interference with daily activities, frustration, anxiety and sleep problems. Compared with non-metastatic castration-resistant prostate cancer, some symptoms and impacts in metastatic castration-resistant prostate cancer were more common and rated as more disturbing (e.g. fatigue, pain, urinary frequency, interference with daily activities and frustration). New concepts that were added to the non-metastatic castration-resistant prostate cancer model, to more accurately reflect the experiences of patients with metastatic disease, were enlarged breasts, muscle loss/deconditioning, inability to focus/mental slowing, body image perception, interference with work and lack of ambition/motivation. CONCLUSIONS Chemotherapy-naïve patients with metastatic castration-resistant prostate cancer experience a substantial burden from their condition. Furthermore, as castration-resistant prostate cancer progresses from the non-metastatic stage to the early metastatic (pre-chemotherapy) stage, certain symptoms become more common and disturb patients' lives to a greater extent. The resulting conceptual model for metastatic castration-resistant prostate cancer highlights areas that are not adequately assessed with current patient-reported outcome instruments.
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Affiliation(s)
| | | | - James Turnbull
- IQVIA, 26th Floor, 485 Lexington Ave, New York, NY, 10017, USA
| | - Emily Hawryluk
- IQVIA, 26th Floor, 485 Lexington Ave, New York, NY, 10017, USA.
| | - Jean Paty
- IQVIA, 26th Floor, 485 Lexington Ave, New York, NY, 10017, USA
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Estimating utilities/disutilities for high-risk metastatic hormone-sensitive prostate cancer (mHSPC) and treatment-related adverse events. Qual Life Res 2019; 28:1191-1199. [PMID: 30767088 PMCID: PMC6470112 DOI: 10.1007/s11136-019-02117-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2019] [Indexed: 01/19/2023]
Abstract
PURPOSE To capture UK societal health utility values for high-risk metastatic hormone-sensitive prostate cancer (mHSPC) and the disutility associated with treatment-related adverse events (AEs) to inform future cost-utility analyses. METHODS A literature review, and patient and clinical expert interviews informed the development of health states characterising mHSPC symptoms and the impact of treatment-related AEs on health-related quality of life (HRQL). Three base health states were developed describing a typical patient with high-risk mHSPC: receiving androgen deprivation therapy (ADT) [Base State 1]; receiving docetaxel plus ADT [Base State 2]; completed docetaxel and still receiving ADT whose disease has not yet progressed [Base State 3]. Six additional health states described treatment-related AEs. The health states were validated with experts and piloted with general public participants. Health state utilities were obtained using the time trade-off (TTO) method with 200 members of the UK general population. A generalised estimating equation (GEE) model was used to estimate disutility weights. RESULTS Mean TTO scores for Base State 1 to 3 were 0.71 (SD = 0.26), 0.64 (SD = 0.27), and 0.68 (SD = 0.26), respectively, indicating that receiving docetaxel plus ADT was most impactful on HRQL. The GEE model indicated when compared to Base State 2 that the nausea and vomiting AE had the most impact on HRQL (- 0.21), while alopecia was least burdensome (- 0.04). CONCLUSIONS The study highlights the differences in utility between base health states and the significant impact of treatment-related AEs on the HRQL of patients with mHSPC. These findings underline the importance of accounting for impaired HRQL when assessing treatments for mHSPC.
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de Freitas HM, Ito T, Hadi M, Al-Jassar G, Henry-Szatkowski M, Nafees B, Lloyd AJ. Patient Preferences for Metastatic Hormone-Sensitive Prostate Cancer Treatments: A Discrete Choice Experiment Among Men in Three European Countries. Adv Ther 2019; 36:318-332. [PMID: 30617763 PMCID: PMC6824341 DOI: 10.1007/s12325-018-0861-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Indexed: 12/31/2022]
Abstract
Introduction Various treatment options are available for metastatic hormone-sensitive prostate cancer. This study aimed to quantify how men with prostate cancer in the United Kingdom (UK), Germany, and Spain perceive the risks and benefits of hypothetical abiraterone acetate plus prednisone treatment and docetaxel-based chemotherapy treatment options. Methods A targeted literature review, exploratory interviews with prostate cancer patients and oncologists, and pre-test interviews were used to develop a discrete choice experiments (DCE). The final DCE included 32 choice sets, selected using a main-effects orthogonal design, divided into two survey blocks. Paired profiles presented hypothetical treatments for prostate cancer through six attributes that could be presented at two or four levels each. Preference estimates were estimated using a conditional logit regression model. Preference results were stratified by cancer stage. Results A total of 152 participants (mean age 69 years) completed the DCE in the UK, Germany, and Spain. Treatment effectiveness was the main concern for the patients (difference in preference estimates between 8 and 32 months 1.443). Participants wanted to avoid pain that was not well controlled (preference dummy coding estimate − 1.157). Participants valued a change from an oral medication to an intravenous treatment (change in preference estimate − 0.416) more negatively than a change from a 1% to a 5% risk of infection (change in preference estimate − 0.313). Conclusions This study shows that treatment effectiveness and pain control were the most important attributes for patients with prostate cancer. These two attributes influenced more than 50% of their decision-making in this study. The risk of fatigue and mode of administration were least prioritised by patients. This study highlights the relative importance that Spanish, German, and British patients place on various aspects of treatment options for prostate cancer. Understanding patient preference and taking them into consideration shall help physicians when developing their treatment strategies for their patients. Funding Janssen. Electronic supplementary material The online version of this article (10.1007/s12325-018-0861-3) contains supplementary material, which is available to authorized users.
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Gomez-Iturriaga A, Crook J. High-Risk Localized Prostate Cancer: How Important Is the Addition of Brachytherapy to External-Beam Radiotherapy? J Clin Oncol 2018; 36:JCO1800704. [PMID: 30212300 DOI: 10.1200/jco.18.00704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Affiliation(s)
- Alfonso Gomez-Iturriaga
- Alfonso Gomez-Iturriaga, Hospital Universitario Cruces, Barakaldo, Spain; and Juanita Crook, British Columbia Cancer Agency, Kelowna, British Columbia, Canada
| | - Juanita Crook
- Alfonso Gomez-Iturriaga, Hospital Universitario Cruces, Barakaldo, Spain; and Juanita Crook, British Columbia Cancer Agency, Kelowna, British Columbia, Canada
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Xin X, Gu Y, Chen Y, Huang Y, Mo Z, Hu Y. Functional analysis implicating the SNP rs61552325 in ERBB2 as an effector for androgen-insensitive prostate cancer cell invasion. Oncotarget 2018; 8:33745-33755. [PMID: 28422721 PMCID: PMC5464908 DOI: 10.18632/oncotarget.16807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 03/11/2017] [Indexed: 11/25/2022] Open
Abstract
Background As one of the most common cancers in men, the pathogenesis of prostate cancer has been widely researched. Aberrant activation of the erb-b2 receptor tyrosine kinase 2 (ERBB2) has been found to play a critical role in metastatic prostate cancer. In our previous study, we demonstrated that rs61552325 (Pro1140Ala) located in ERBB2 is strongly correlated to prostate cancer. Therefore, we initially studied the effect of rs61552325 on androgen-independent prostate cancer cell metastasis. Results Bioinformatic results demonstrated that the mutant Pro1140Ala likely decrease the stability of the ERBB2 protein and its interactions. The mean migration rate after 6 h for PC3 minor variant cells which carried the G allele was 1.28-fold higher than major variant PC3 cells that carried the C allele (P = 0.016). The mean invasion rate of DU145 putative minor variant cells was 0.40 reducer than negative control cells (P = 5.9E-04). Methods rs61552325 major variant (C allele) and minor variant (G allele) were produced by site directed mutagenesis and transfected into DU145 and PC3 cells. A wound healing assay was performed to compare migration abilities between alleles. After knocking down endogenous ERBB2 and then expressing the rs61552325 minor variant, invasion abilities were evaluated with a transwell assay using DU145 and PC3 cells. Conclusions Our data showed that the rs61552325 major variant decreases PC3 cell migration and its minor variant depresses DU145 cell invasion, suggesting that rs61552325 is likely an important change during prostate cancer invasion.
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Affiliation(s)
- Xianxiang Xin
- Experimental Centre of Medical Sciences, Guangxi Medical University, Nanning, Guangxi, China.,Commission for Discipline Inspection, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Yinmin Gu
- Experimental Centre of Medical Sciences, Guangxi Medical University, Nanning, Guangxi, China
| | - Yang Chen
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Yuanjie Huang
- Experimental Centre of Medical Sciences, Guangxi Medical University, Nanning, Guangxi, China
| | - Zengnan Mo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Yanling Hu
- Experimental Centre of Medical Sciences, Guangxi Medical University, Nanning, Guangxi, China.,Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China.,Guangxi Colleges and Universities Key Laboratory of Biological Molecular Medicine Research, Guangxi Medical University, Nanning, Guangxi, China
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Tomaszewski EL, Moise P, Krupnick RN, Downing J, Meyer M, Naidoo S, Holmstrom S. Symptoms and Impacts in Non-Metastatic Castration-Resistant Prostate Cancer: Qualitative Study Findings. THE PATIENT 2017; 10:567-578. [PMID: 28285412 PMCID: PMC5605614 DOI: 10.1007/s40271-017-0227-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES We developed a conceptual model to define key concepts associated with patients' experiences with the signs, symptoms, and impacts of non-metastatic castration-resistant prostate cancer (M0-CRPC). METHODS A targeted review of peer-reviewed literature, and other publicly available information, identified and categorized symptoms and impacts related to early-stage prostate cancer. Semi-structured interviews with five clinical experts helped determine the most relevant and important concepts for patients with M0-CRPC. Qualitative interviews with 17 patients with M0-CRPC identified the most frequently experienced symptoms and impacts, and their degree of interference with patients' lives. The findings from these three lines of evidence were summarized in a conceptual model. RESULTS Literature searches identified mainly urinary, intestinal, and sexual symptoms. Experts noted the symptoms most frequently mentioned by patients include erectile dysfunction, loss of sexual desire or interest, incontinence/leaking, urgency, and hot flashes. Patient interviews confirmed the high frequency of erectile dysfunction, loss of libido, urinary urgency, and incontinence. The most frequently mentioned impacts expressed by patients were the need to monitor/plan for urinary frequency, interference with/restriction of daily activities, and frustration or anxiety over diagnosis, symptoms, or treatment. Symptoms and impacts most frequently experienced by patients were typically not those with the greatest effects on their lives; rather, those with the greatest consequences were related to treatment. CONCLUSIONS The leading concerns associated with M0-CRPC were related to voiding and sexual dysfunction. The most relevant symptoms and impacts expressed by patients may be a consequence of therapy rather than of the disease.
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Affiliation(s)
| | - Pierre Moise
- QuintilesIMS Inc., 3-5 rue Maurice Ravel, Levallois-Perret, 92594, Paris, France.
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Advanced prostate cancer survival in Spain according to the Gleason score, age and stage. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.acuroe.2016.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Campá J, Mar-Barrutia G, Extramiana J, Arróspide A, Mar J. Advanced prostate cancer survival in Spain according to the Gleason score, age and stage. Actas Urol Esp 2016; 40:499-506. [PMID: 27174571 DOI: 10.1016/j.acuro.2016.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 03/23/2016] [Accepted: 03/28/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aim of this study was to determine the overall and disaggregated survival based on the Gleason score, age and extent of a patient cohort diagnosed with advanced prostate cancer according to standard clinical practice. MATERIAL AND METHOD We used an observational and retrospective design for the study. For each patient, we recorded clinical variables such as the extent (metastatic or locally advanced), Gleason score, age, date of diagnosis, date of last contact with the health system and the vital status during the last contact. We used univariate and multivariate statistical techniques of survival. The parametric survival methods enabled us to calculate the mean survival using extrapolation. We analysed 219 patients treated in the public health system between 2008 and 2011. The analysis showed statistically significant differences in survival depending on Gleason score, age and stage. The longest survival was in the subgroup younger than 75 years, with a local extent and a low-risk category on the Gleason scale (19.41 years), and the shortest survival (0.97 years) was in the 75 years or older group. The survival of the other subgroups ranged between these outliers. CONCLUSION The main contribution of this study is that it is the first to calculate the mean survival of advanced prostate cancer in Spain in terms of the variables of our study population. This information helps clinicians predict the life expectancy of each patient according to their prognostic factors.
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Cancer Related Fatigue and Quality of Life in Patients with Advanced Prostate Cancer Undergoing Chemotherapy. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3989286. [PMID: 26981530 PMCID: PMC4769736 DOI: 10.1155/2016/3989286] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/17/2016] [Indexed: 12/02/2022]
Abstract
Cancer related fatigue (CRF) is a common and debilitating symptom that can influence quality of life (QoL) in cancer patients. The increase in survival times stresses for a better understanding of how CRF affects patients' QoL. This was a cross-sectional descriptive study with 148 randomly recruited prostate cancer patients aiming to explore CRF and its impact on QoL. Assessments included the Cancer Fatigue Scale, EORTC QLQ-C30, and EORTC QLQ-PR25. Additionally, 15 in-depth structured interviews were performed. Quantitative data were analyzed with simple and multiple regression analysis and independent samples t-test. Qualitative data were analyzed with the use of thematic content analysis. The 66.9% of the patients experienced CRF with higher levels being recorded for the affective subscale. Statistically significant differences were found between the patients reporting CRF and lower levels of QoL (mean = 49.1) and those that did not report fatigue and had higher levels of QoL (mean = 72.1). The interviews emphasized CRF's profound impact on the patients' lives that was reflected on the following themes: “dependency on others,” “loss of power over decision making,” and “daily living disruption.” Cancer related fatigue is a significant problem for patients with advanced prostate cancer and one that affects their QoL in various ways.
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