Burden of focal cryoablation versus brachytherapy versus active surveillance in the treatment of very low-risk prostate cancer: a preliminary head-to-head comprehensive assessment.
Focal cryoablation (FC), brachytherapy (B) and active surveillance (AS) were offered to patients diagnosed with very low-risk prostate cancer (VLRPC) in an equal access protocol. Comprehensive validated self-report questionnaires accessed patients' erectile (IIEF-5) and voiding (IPSS) functions, Beck scales measured anxiety (BAI), hopelessness (BHS) and depression (BDI), SF-36 reflected patients' quality of life added to the emotional thermometers including five visual analogue scales (distress, anxiety, depression, anger and need for help). Kruskal-Wallis or ANOVA tests and Spearman's correlations were obtained among groups and studied variables. Thirty patients were included, median follow-up 18 months (15-21). Those on AS (n = 11) were older, presented higher hopelessness (BHS) and lower general health perceptions (SF-36) scores than patients opting for FC (n = 10) and B (n = 9), P = 0.0014, P = 0.0268 and P = 0.0168 respectively. Patients on B had higher IPSS scores compared to those under FC and AC, P = 0.0223. For all 30 included patients, Spearman's correlation (rs ) was very strong between BHS and general health perceptions (rs  = -0.800, P < 0.0001), and weak/moderate between age and BHS (rs  = 0.405, P = 0.026) and age and general health perceptions (rs  = -0.564, P = 0.001). The sample power was >60%. To be considered in patients' counselling and care, current study supports the hypothesis that even VLRPC when untreated undermines psychosocial domains.
Urology Department, Pontifical Catholic University of Campinas (PUC-Campinas), Campinas, São Paulo, Brazil.|Urology Department, School of Medical Sciences, University of Campinas (Unicamp), Campinas, São Paulo, Brazil.
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de Cerqueira
Urology Department, School of Medical Sciences, University of Campinas (Unicamp), Campinas, São Paulo, Brazil.
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Laranja
Urology Department, School of Medical Sciences, University of Campinas (Unicamp), Campinas, São Paulo, Brazil.
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Sanches
Radium Institute, Campinas, São Paulo, Brazil.
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Monti
Urology Department, School of Medical Sciences, University of Campinas (Unicamp), Campinas, São Paulo, Brazil.|Faculty of Medicine (Urology), Center for Life Sciences, Pontifical Catholic University of Campinas (PUC-Campinas), Campinas, São Paulo, Brazil.
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http://orcid.org/0000-0003-2092-414X
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Reis
D000368:Aged; D000786:Anger; D001007:Anxiety / Q000523:psychology*; D001918:Brachytherapy / Q000523:psychology*; D003452:Cryosurgery / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D051517:Digital Rectal Examination; D019468:Disease Management; D007172:Erectile Dysfunction; D006304:Health Status; D065026:Hope; D006801:Humans; D007610:Kallikreins / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D014555:Urination Disorders; D057832:Watchful Waiting
C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
health; impact; instruments; load; low toxicity; minimally invasive; prostate cancer; psychological; psychometric; psychosocial; quality of life; questionnaires; self-report; survey; treatment