A recent study by Barocas et al, presented at the 2017 AUA annual meeting and reported in Urology Times, examined the side effects of various treatments for localized prostate cancer. For the purposes of this interview, let’s discuss post-treatment urinary incontinence specifically and the role of the nurse or other nonphysician provider. What do you think are the key take-aways from this study in this regard?
First, a short overview of the study. This was a prospective population-based cohort study of 2,550 men undertaken to compare functional outcomes and adverse effects associated with three prostate cancer treatments: radical prostatectomy, external beam radiation therapy, and active surveillance. Men were ages 60-80 years, had been diagnosed with clinical stage cT1 T2 (localized) prostate cancer, and their PSA levels were <50 ng/mL.
Also by Dr. Hooper: Men’s health issues often extend beyond the physical
Patients were within 6 months of diagnosis and had received treatment within 1 year. The study took place over 36 months, which may be a limitation of the study.
Regarding the study’s findings on incontinence only, with baseline domain scores being similar across all three groups, postoperative radical prostatectomy (RP) patients reported significantly greater urinary incontinence than did those patients treated with external beam radiation therapy (EBRT) or active surveillance.
To answer your question, nurses and other providers should utilize the results of this and other similar studies to counsel and inform their patients during the shared decision-making process. Keep in mind that men often base their treatment decisions on the potential side effects of the proposed treatment.