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Symptoms and quality of life among men starting treatment for metastatic castration-resistant prostate cancer: a prospective multicenter study
Umeå University, Faculty of Medicine, Department of Nursing. Department of Oncology, Sundsvall County Hospital, Sundsvall, Sweden.
Department of Nursing Sciences, Sophiahemmet University, Stockholm, Sweden; Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University College, Stockholm, Sweden.
Umeå University, Faculty of Medicine, Department of Nursing.ORCID iD: 0000-0002-1248-5581
Umeå University, Faculty of Medicine, Department of Radiation Sciences. Department of Oncology, Sundsvall County Hospital, Sundsvall, Sweden.
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2024 (English)In: BMC Palliative Care, E-ISSN 1472-684X, Vol. 23, no 1, article id 80Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Men with metastatic castration-resistant prostate cancer (mCRPC) have an incurable disease. Along with prolonging life, symptom management is one of the main goals with treatment. This is also important from a palliative care perspective where the life prolonging outcomes should be balanced with quality of life (QoL) in this late phase. It is also essential in symptom management to view different dimensions of symptoms, for example how severe or distressing symptoms are, to support best QoL. Therefore, more knowledge is needed about the symptom experience when these treatments are initiated and thus the aim of this study was to describe different dimensions of symptoms in men with mCRPC starting their first-line of life-prolonging treatment, and to describe the association between symptom burden and QoL.

METHODS: Baseline data from a prospective longitudinal study of 143 men with mCRPC starting their first-line life-prolonging treatment were used. Symptoms were measured using the Memorial Symptom Assessment Scale (MSAS) and global QoL was measured by the EORTC QLQ C-30. Data was analyzed using descriptive- and multivariable linear regression analyses.

RESULTS: On average, the men had more than 10 symptoms (range 0-31 of 33). 50% or more reported sweats, lack of energy, pain, problems with sexual activity and sexual desire. The symptoms they reported as most severe, or most distressing were not always the ones that were reported as most frequent. There was an association between QoL and physical symptoms, and also between QoL, and analgesic use and prostate-specific antigen (PSA) values.

CONCLUSION: Even if some men with mCRPC report many symptoms, the dimensions of severity and distress levels vary, and the most frequent symptoms was not always the most burdensome or distressing. There was an association between high physical symptom burden and QoL, suggesting that it is not the number of symptoms that affects QoL but rather the subjective perceived impact of the physical symptoms experienced. The knowledge of how men with mCRPC experience and perceive their symptoms may help health care professionals in symptom management aiming to improve QoL, which is a cornerstone in integrating early palliative care.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024. Vol. 23, no 1, article id 80
Keywords [en]
Early integrated palliative care, MSAS, Metastatic castration-resistant prostate cancer, Prostatic neoplasm, Quality of life, Symptom burden, Symptom management
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Nursing
Identifiers
URN: urn:nbn:se:umu:diva-223031DOI: 10.1186/s12904-024-01410-wISI: 001191215600001PubMedID: 38532425Scopus ID: 2-s2.0-85188672318OAI: oai:DiVA.org:umu-223031DiVA, id: diva2:1849689
Funder
ProstatacancerförbundetSjöberg Foundation, 2020-01-07-05The Kamprad Family Foundation, 2170260Available from: 2024-04-08 Created: 2024-04-08 Last updated: 2024-04-09Bibliographically approved

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Rönningås, UlrikaFransson, PerBeckman, Lars

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