In a recent Canadian survey, researchers found that slightly more than one-third of all men living with prostate cancer say the disease has impacted their ability to participate in daily activities, such as using the bathroom, being physically active, and travelling. Such limitations, though, do not stop most men. A full 84 percent of the surveyed men, including those living with both early-stage and advanced-stage prostate cancer, feel they are living their lives to the fullest.
Methodology and Statistical Results
To explore the theme of how prostate cancer affects the quality of life of patients and their caregivers, the researchers used an online questionnaire to poll 517 Canadian men who have either recently been diagnosed/are undergoing prostate cancer treatment or men who reported having had the disease in the past. The range of participants consisted of 73 men with stage one or two (early-stage) prostate cancer, 26 men with stage three or four (advanced-stage) prostate cancer, and 418 men who either preferred not to declare their stage or who currently have no evidence of the disease (meaning, they finished treatment and show no signs of it returning). The survey also included information from 256 caregivers.
Overall, the physical concern most frequently reported by the participants was being unable to maintain an erection — a full 64 percent recorded their dissatisfaction in this area. Among those men with advanced stages of prostate cancer (stages three and four), such physical concerns came in second to psychological issues, which plagued more than two-thirds of the participants (69 percent). Exactly half of the advanced-stage patients admitted social concerns, including feelings of loss of masculinity, loss of dignity, loss of identity, and missing out on important life events.
Those living with advanced prostate cancer also reported greater impact on their quality of life as compared to those living with early-stage prostate cancer. For instance, only 39 percent of those with advanced prostate cancer reported having an excellent or very good quality of life compared with 70 percent of early-stage patients. Early-stage reporters cited sexual dysfunction, urinary incontinence, and fatigue as their most common physical challenges.
Risk Factors For Prostate Cancer
The prostate is a gland found only in men and is located at the base of the bladder, near the rectum. The prostate produces a milky fluid that is a component of the seminal liquid which carries and protects sperm during ejaculation. The tube (urethra) through which a man passes urine runs straight down the center of this gland. As a man ages, his prostate gland can get bigger and press on the urethra, causing urination problems.
One in six American men will develop prostate cancer, the most common cancer among men, during his lifetime. (In Canada and in most of Europe, that number is one in eight.) During 2009 in the U.S., 206,640 men were diagnosed with prostate cancer, while a total of 28,088 men died from it. Risk factors include age — most prostate cancer occurs in men older than 65, and generally the older the man, the greater his risk. Prostate cancer seems to have a genetic basis as any man whose father, brother, or son has had prostate cancer is two to three times more likely to develop the disease. Prostate cancer is also more common among African American men, who are more often diagnosed at more advanced stages and are less likely to survive. A sedentary lifestyle increases the risk of having the disease as does a high-fat diet. Finally, for unknown reasons, New England and the northwest region of the U.S. report higher incidence numbers.
The Role Played By Caregivers
The Canadian survey, which was conducted on behalf of Janssen Inc. and the Canadian Cancer Survivor Network and published earlier this year, found that the majority of caregivers (69 percent) are spouses. Beyond providing encouragement and emotional support, almost eight out of 10 caregivers (65 per cent) attend doctor visits and on average they provide approximately 25 hours of care per week.
Most significantly, the majority of caregivers (57 percent) are directly involved in treatment decisions. In fact, one-third of all caregivers update their information on medication and treatment options on a monthly basis. More than half of all the men surveyed (56 percent) as well as caregivers surveyed (57 percent) stated a wish for better treatment options. Among those diagnosed with advanced prostate cancer, this figure totaled a full 92 percent of all men surveyed.
A common option when diagnosed with very low-risk prostate cancer is ‘active surveillance,’ which is basically a method of watching and waiting. Such an approach to the disease, although beneficial to men of most races, may place African American men at greater risk because they are more likely to have an aggressive version of the disease that goes unrecognized with current diagnostic approaches — so reports a Johns Hopkins study of more than 1,800 men (1,473 white and 256 African American) aged 52 to 62. For this particular study, the researchers analyzed records of men selected from a group of 19,142 prostate cancer patients who had surgery between 1992 and 2012 to remove the prostate gland and some of the tissue around it.
Source: Sundi D, Ross AE, Humphreys EB, et al. African American Men With Very Low–Risk Prostate Cancer Exhibit Adverse Oncologic Outcomes After Radical Prostatectomy: Should Active Surveillance Still Be an Option for Them? Journal of Clinical Oncology. 2013.