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Knowledge and Attitudes Regarding Surgical Castration in Men Receiving Androgen Deprivation Therapy for Metastatic Prostate Cancer and Their Relationship to Health-Related Quality of Life.
Schubbe, Morgan E; Gellhaus, Paul T; Tobert, Conrad M; Mott, Sarah L; Garje, Rohan; Erickson, Bradley A.
  • Schubbe ME; Department of Urology, University of Iowa Carver College of Medicine, Iowa City, IA.
  • Gellhaus PT; Department of Urology, University of Iowa Carver College of Medicine, Iowa City, IA.
  • Tobert CM; Department of Urology, University of Iowa Carver College of Medicine, Iowa City, IA.
  • Mott SL; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA.
  • Garje R; Department of Urology, University of Iowa Carver College of Medicine, Iowa City, IA.
  • Erickson BA; Department of Urology, University of Iowa Carver College of Medicine, Iowa City, IA. Electronic address: brad-erickson@uiowa.edu.
Urology ; 155: 179-185, 2021 09.
Article in English | MEDLINE | ID: covidwho-1411044
ABSTRACT

OBJECTIVE:

To determine the attitudes and education regarding surgical castration in men receiving androgen deprivation therapy (ADT) for metastatic prostate cancer (mCaP).

METHODS:

We identified 142 patients receiving ADT for mCaP at our institution without prior orchiectomy who were then sent 2 surveys via mail (1) A questionnaire to assess knowledge and understanding of ADT treatment alternatives and (2) the functional assessment of cancer therapy - prostate (FACT-P) questionnaire which determines health-related quality of life (HRQOL). Two cohorts were created based on the answer to "would you be interested in surgical orchiectomy?" and demographic, CaP and HRQOL were compared between the surgical castration yes (SC+) and surgical castration no (SC-) cohorts. A second analysis identified predictors of worse HRQOL.

RESULTS:

Of 68 (47.9%) patients that responded to the survey, only 39 (59.1%) recalled a discussion regarding treatment alternatives to ADT and only 22 (33.3%) recalled a discussion regarding orchiectomy. There were 24 (40.0%) patients that stated interest in undergoing orchiectomy (SC+) as an alternative to ADT with the only independent risk factor being "…bother from the number of clinical appointments required for ADT…" Patients most bothered by side effects and cosmetic changes associated with ADT reported lower HRQOL scores on the FACT-P.

CONCLUSIONS:

Few men on ADT knew about surgical alternatives, implying that educational deficits may be a significant factor in the decline in the utilization of orchiectomy. Changes in healthcare economics, utilization and delivery brought on by a global pandemic should warrant a fresh look at the use of surgical castration.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Prostatic Neoplasms / Quality of Life / Orchiectomy / Health Knowledge, Attitudes, Practice Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Humans / Male Language: English Journal: Urology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Prostatic Neoplasms / Quality of Life / Orchiectomy / Health Knowledge, Attitudes, Practice Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Humans / Male Language: English Journal: Urology Year: 2021 Document Type: Article