#DONOVAN ROTH REGISTRATION#
Men diagnosed with PCa between 18 and 42 months previously were identified through national cancer registration systems in England, Wales, and Northern Ireland, and through hospital activity data in Scotland. The LAPCD study design has been detailed previously. submitted).Īim: As part of the LAPCD study, we aim to investigate which cancer-related symptoms and health-related quality of life (HRQL) variables are associated with mental well-being and psychological distress in men 18-42 months post diagnosis of PCa who reported receiving ADT.
Qualitative interviews conducted alongside the quantitative LAPCD survey have also supported ADT treatment as being related to changes in mood along with bodily changes, such as mood swings and loss of muscle mass, which were related to distress (Matheson et al. While previous studies have investigated cancer-related symptoms and psychological outcomes in PCa, no large-scale study has focused its attention on treatments involving ADT.
recently reported that later-stage PCa was associated with fatigue and sexual dysfunction and this was suggested to be due to receiving ADT. As part of the LAPCD study, Downing et al. The Life After Prostate Cancer Diagnosis (LAPCD) study is a UK-wide, population-based, cross-sectional study investigating a range of quality of life (QoL) outcomes in men 18–42 months post diagnosis of PCa. The use of Patient-Reported Outcome Measures (PROMs) in large surveys allows clinicians to generate more confident estimates of this kind and therefore allow the planning of appropriate clinical responses. There is some suggestion that ADT may indirectly affect risk of psychological distress through an overall reduction in quality of life. However, little work has been done regarding the associations with cancer-related symptoms in patients receiving ADT despite its links to physical (vitality, energy, and fatigue) and sexual dysfunction. Previous studies of PCa have indicated the relationship between the severity of cancer-related symptoms experienced and poorer mental well-being and/or severe psychological distress. It therefore provides an indicator of potential mental health problems. Non-specific psychological distress occurs in a range of mental health disorders, but is not specific to any one disorder. Mental well-being is a broad concept, which has been described as the positive aspects of mental health. Further studies have shown that 19.6% of men on ADT report clinically significant anxiety and that increasing ADT length is associated with poorer quality of life, and increased risk of anxiety. The largest study to date of 100,000 men with and without PCa also supported this association however, when controlling for age, comorbidity, and tumour characteristics, this relationship was no longer significant. A recent meta-analysis of 18 studies found that risk of depression increased by 41% in men on ADT. There are known associations between ADT and depression, memory difficulties, and fatigue among prostate cancer patients. One group that may be at greater risk of experiencing the negative psychological impact of PCa is the increasingly prevalent group of men, particularly with earlier stage of disease, treated with Androgen Deprivation Therapy (ADT). The National Cancer Research Institute (NCRI) has identified the UK Top 10 Living With and Beyond Cancer research priorities, which includes understanding the short- and long-term psychological impacts of cancer. With increasing numbers living for long periods with and beyond their diagnosis, understanding and improving the experience of patients post diagnosis and treatment are growing priorities. Over the last 40 years, the number of men living with a diagnosis of PCa survival has tripled. Prostate cancer (PCa) is the most common cancer in men in the UK.