title: Patient-reported 'ever had' and 'current' long-term physical symptoms after prostate cancer treatments.
abstract: OBJECTIVE
  To investigate the prevalence of physical symptoms that were 'ever' and 'currently' experienced by survivors of prostate cancer at a population level, to assess burden and thus inform policy to support survivors.
  
  
  METHODS
  The study included 3 348 men surviving prostate cancer for 2-18 years after diagnosis. A cross-sectional, postal survey of 6 559 survivors diagnosed 2-18 years ago with primary, invasive prostate cancer (ICD10-C61) identified via national, population-based cancer registries in Northern Ireland and Republic of Ireland. Questions included symptoms at diagnosis, primary treatments and physical symptoms (erectile dysfunction [ED]/urinary incontinence [UI]/bowel problems/breast changes/loss of libido/hot flashes/fatigue) experienced 'ever' and at questionnaire completion ('current'). Symptom proportions were weighted by age, country and time since diagnosis. Bonferroni corrections were applied for multiple comparisons.
  
  
  RESULTS
  Adjusted response rate 54%; 75% reported at least one 'current' physical symptom ('ever' 90%), with 29% reporting at least three. Prevalence varied by treatment. Overall, 57% reported current ED and this was highest after radical prostatectomy (RP, 76%) followed by external beam radiotherapy with concurrent hormone therapy (HT, 64%). UI (overall 'current' 16%) was highest after RP ('current' 28%; 'ever' 70%). While 42% of brachytherapy patients reported no 'current' symptoms, 43% reported 'current' ED and 8% 'current' UI. 'Current' hot flashes (41%), breast changes (18%) and fatigue (28%) were reported more often by patients on HT.
  
  
  CONCLUSIONS
  Symptoms after prostate cancer treatment are common, often multiple, persist long-term and vary by treatment method. They represent a significant health burden. An estimated 1.6% of men aged >45 years are survivors of prostate cancer and currently experiencing an adverse physical symptom. Recognition and treatment of physical symptoms should be prioritised in patient follow-up. This information should facilitate men and clinicians when deciding about treatment as differences in survival between radical treatments is minimal.
authors.affiliation: Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Mulhouse Building, Belfast, Northern Ireland, UK.
authors.forename: Anna T
authors.initials: AT
authors.lastname: Gavin
authors.affiliation: National Cancer Registry Ireland, Building 6800, Airport Business Park, Cork, Ireland.
authors.forename: Frances J
authors.initials: FJ
authors.lastname: Drummond
authors.affiliation: Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Mulhouse Building, Belfast, Northern Ireland, UK.
authors.forename: Conan
authors.initials: C
authors.lastname: Donnelly
authors.affiliation: National Cancer Registry Ireland, Building 6800, Airport Business Park, Cork, Ireland.
authors.forename: Eamonn
authors.initials: E
authors.lastname: O'Leary
authors.affiliation: Institute of Health and Society, Newcastle University, Richardson Road, Newcastle upon Tyne, NE2 4AX, England, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Sharp
authors.affiliation: Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Mulhouse Building, Belfast, Northern Ireland, UK.
authors.forename: Heather R
authors.initials: HR
authors.lastname: Kinnear
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology* / Q000628:therapy; D011788:Quality of Life
keywords: patient-reported outcomes; population; prostate cancer