Quality of life 2 years after salvage cryosurgery for the treatment of local recurrence of prostate cancer after radiotherapy

Robinson, John W.; Donnelly, Bryan J.; Coupland, Kerry; Siever, Jodi E.; Saliken, John C.; Scott, Cheryl; Brasher, P.M.A.; Ernst, D. Scott

doi:10.1016/j.urolonc.2006.03.007

« Previous Next »Urologic Oncology: Seminars and Original Investigations
Volume 24, Issue 6 , Pages 472-486, November 2006

Quality of life 2 years after salvage cryosurgery for the treatment of local recurrence of prostate cancer after radiotherapy☆

John W. Robinson, Ph.D., R.Psych.
- Department of Oncology and Program in Clinical Psychology, University of Calgary, and Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta, Canada
- Corresponding author. Tel.: +1-403-355-3211; fax: +1-403-355-3206.
Bryan J. Donnelly, M.D., M.Sc., F.R.C.S.(C)
- Departments of Surgery and Oncology, University of Calgary, and Department of Urology, Calgary Health Region, Calgary, Alberta, Canada
Kerry Coupland, B.A.(Hon), M.Sc.
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
Jodi E. Siever, M.Sc.
- Decision Support Research Team, Calgary Health Region, Calgary, Alberta, Canada
John C. Saliken, M.D., F.R.C.P.(C)
- Department of Diagnostic Radiology, Nanaimo Regional Hospital, Nanaimo, British Columbia, Canada
Cheryl Scott, R.N.
- Clinical Trial Unit, Tom Baker Cancer Center, Calgary, Alberta, Canada
P.M.A. Brasher, Ph.D.
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
D. Scott Ernst, M.D., F.R.C.P.(C)
- Department of Medicine, Division of Medical Oncology and Internal Medicine, Tom Baker Cancer Centre and University of Calgary, Calgary, Alberta, Canada

Received 18 August 2005; received in revised form 27 March 2006; accepted 28 March 2006.

Abstract

Purpose

Previous research has raised concerns that although salvage cryosurgery may be an effective treatment to prevent the progression of prostate cancer after radiotherapy failure, the quality of life cost many be so severe as to prevent its acceptance as a viable treatment. The present study’s purpose was to further the understanding of the quality of life outcomes of salvage cryosurgery.

Materials and Methods

A total of 46 men with locally recurrent prostate cancer after radiotherapy were recruited to participate in a prospective Phase II clinical trial using salvage cryosurgery. There were 2 questionnaires (i.e., the European Organization of Research and Treatment of Cancer QLQ C30 and the Prostate Cancer Index) administered before cryosurgery, and at 1.5, 3, 6, 12, 18, and 24 months after treatment.

Results

Quality of life returned to preoperative levels by 24 months after cryosurgery in all domains, with the exception of urinary and sexual functioning. At 24 months, 29% of men reported urinary bother as a moderate-to-big problem, and 56% reported sexual bother as a moderate-to-big problem.

Conclusions

To our knowledge, this is the first study to evaluate prospectively men’s quality of life for 2 years after salvage cryosurgery for locally recurrent prostate cancer after radiotherapy. Long-term impairments in quality of life appear to be limited to the sexual and urinary function domains. Overall quality of life appears to be high. These results support salvage cryosurgery as a viable treatment option.

Keywords: Radiotherapy, Cryosurgery, Cryoablation, Cryotherapy, Prostate cancer, Salvage treatment, Health-Related Quality of Life