Impacto do tratamento de câncer prostático avançado na qualidade de vida e função sexual

Abstract

Introduction: Remnant prostate cancer (PC) occurs in 30% of patients after initial treatment. Quality of life is a multidimensional issue and is subject to the balance between real and desirable life. Studying quality of life for the treatment of localized PC, as well as advanced stages of the disease, has been a priority in Oncology. Objective: To evaluate the impact on quality of life and sexual function of the different treatment options for remnant PC. Method: 200 patients with remnant PC after initial treatment were distributed into four groups according to the treatment of the tumor remnant: group 1 –prostatectomy and antiandrogen deprivation hormone therapy; group 2 – prostatectomy associated with radiotherapy and antiandrogen deprivation hormone therapy; group 3 – antiandrogen deprivation hormonal therapy alone; group 4 – radiotherapy associated with antiandrogen deprivation hormone therapy. All patients answered two questionnaires validated for Brazil related to the quality of life, the European Quality of Life Questionnaire in five dimensions and five levels (EQ-5D5L), and the International Index of Erectile Function (IIEF-5). The presence of urinary tract infection, hematuria, hematochezia, urinary incontinence and urethral structure after the treatments were also investigated. Results: The results of this study observed worse mobility and selfcare, greater limitations of usual activities in the EQ-5D5L, higher incidence of urinary incontinence in patients that underwent prostatectomy associated with radiotherapy and antiandrogen deprivation hormone therapy. Erectile dysfunction was observed in all groups, but it was worse in patients submitted to prostatectomy. Conclusion: The association of radiotherapy with other treatments in remnant prostate cancer leads to worst quality of life. Prostatectomy was the most harmful treatment for sexual function.