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- Henningsohn, L, et al.
(författare)
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Relative importance of sources of symptom-induced distress in urinary bladder cancer survivors
- 2003
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Ingår i: European Urology. - 0302-2838 .- 1873-7560. ; 43:6, s. 651-662
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The influence of specific symptoms on emotions and social activities in the individual patient vanes. Little is known about this variation in urinary bladder cancer survivors (in other words, about the relative importance of sources of symptom-induced distress). Methods: We attempted to enrol 404 surgical patients treated with cystectomy and a conduit or reservoir in four Swedish towns (Stockholm, Orebro, Jonkoping, Linkoping), 101 surgical patients treated with cystectomy and orthotopic neobladder at the Herlev Hospital in Copenhagen, Denmark, and 71 patients treated with radical radiotherapy for bladder cancer, as well as 581 men and women controls in Stockholm and Copenhagen. An anonymous postal questionnaire was used to collect the information. Results: A total of 503 out of 576 (87%) treated patients and 422 out of 581 (73%) controls participated but 59 patients were excluded. The primary source of self-assessed distress among cystectomised patients was compromised sexual function, reduced intercourse frequency caused great distress in 19% of the conduit patients, 20% of the reservoir patients and 19% of the bladder substitute patients. The primary source of self-assessed distress in patients treated with radical radiotherapy was symptoms from the bowel, 17% reported great distress due to diarrhoea, 16% due to abdominal pain, 14% due to defecation urgency and 14% due to faecal leakage. The highest proportion of subjects being distressed was 93% (substantial: 43%, moderate: 29% and little: 21%) for treated upper or lower urinary retention (indwelling catheter or nephrostomy). Conclusion: The distress caused by a specific symptom varies considerably and the prevalence of symptoms causing great distress differs between treatments in bladder cancer survivors. It is possible that patient care and clinical research can be made more effective by focusing on important sources of symptom-induced distress. (C) 2003 Elsevier Science B.V. All rights reserved.
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- Hopfgarten, T., et al.
(författare)
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The choice between a therapy-induced long-term symptom and shortened survival due to prostate cancer
- 2006
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Ingår i: Eur Urol. - : Elsevier BV. - 0302-2838. ; 50:2, s. 280-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: A patient with newly diagnosed localized prostate cancer can choose from an array of therapies. A patient's willingness to trade life for freedom from therapy-induced long-term symptoms is poorly investigated. METHODS: In October 2002, we attempted to collect information from the 591 men who had been diagnosed and registered with prostate cancer in 1999 in Stockholm County. In a postal questionnaire, men were asked to balance absence or presence of certain therapy-induced long-term symptoms against varying lengths of survival gain as a consequence of the therapy. RESULTS: Information was provided by 511 (86%) of the 591 men. A large majority of the men participating in this study ended up in one of two extreme categories: either they accepted the therapy-induced symptom to gain survival or they did not. For fecal leakage, 78% of the men chose one of two extreme categories compared with 74% for urinary leakage, 71% for tender enlarged breasts, 73% for erectile dysfunction, and 78% for restricted diet. Thirty-seven percent of the men in the study were willing to accept fecal leakage if there was only the slightest chance to gain survival, comparing percentages for urinary leakage, tender enlarged breasts, restricted diet, and erectile dysfunction and were 48%, 53%, 55%, and 64%, respectively. CONCLUSION: Willingness to accept therapy-induced long-term symptoms to avoid a shortened survival due to prostate cancer varies dramatically among men with localized prostate cancer and a large majority of men are in one of two extreme categories. Among symptoms, long-term fecal leakage was the one fewest men were willing to accept to gain survival.
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