Cancer

Original Article

Free Access

Quality of life after surgery, external beam irradiation, or brachytherapy for early‐stage prostate cancer

Corresponding Author

Department of Urology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, Los Angeles, California

Department of Health Services, School of Public Health, University of California‐Los Angeles, Los Angeles, California

Jonsson Comprehensive Cancer Center, University of California‐Los Angeles, Los Angeles, California

Fax: (310) 206‐5343

Department of Urology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, A2‐125 CHS, 10833 LeConte Avenue, Los Angeles, CA 90095===

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John L. Gore MD

Department of Urology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, Los Angeles, California

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Lorna Kwan MPH

Jonsson Comprehensive Cancer Center, University of California‐Los Angeles, Los Angeles, California

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Judson M. Brandeis MD

Department of Urology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, Los Angeles, California

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Steve P. Lee MD, PhD

Department of Radiation Oncology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, Los Angeles, California

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H. Rodney Withers MD, DSc

Department of Radiation Oncology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, Los Angeles, California

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Robert E. Reiter MD

Department of Urology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, Los Angeles, California

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Mark S. Litwin MD, MPH

Corresponding Author

E-mail address:mlitwin@mednet.ucla.edu

Department of Urology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, Los Angeles, California

Department of Health Services, School of Public Health, University of California‐Los Angeles, Los Angeles, California

Jonsson Comprehensive Cancer Center, University of California‐Los Angeles, Los Angeles, California

Fax: (310) 206‐5343

Department of Urology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, A2‐125 CHS, 10833 LeConte Avenue, Los Angeles, CA 90095===

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John L. Gore MD

Department of Urology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, Los Angeles, California

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Lorna Kwan MPH

Jonsson Comprehensive Cancer Center, University of California‐Los Angeles, Los Angeles, California

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Judson M. Brandeis MD

Department of Urology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, Los Angeles, California

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Steve P. Lee MD, PhD

Department of Radiation Oncology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, Los Angeles, California

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H. Rodney Withers MD, DSc

Department of Radiation Oncology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, Los Angeles, California

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Robert E. Reiter MD

Department of Urology, David Geffen School of Medicine at UCLA, University of California‐Los Angeles, Los Angeles, California

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First published: 18 May 2007

https://doi.org/10.1002/cncr.22676

Cited by: 182

BACKGROUND.

The primary treatments for clinically localized prostate cancer confer equivalent cancer control for most patients but disparate side effects. In the current study, the authors sought to compare health‐related quality of life (HRQOL) outcomes after the most commonly used treatments.

METHODS.

A total of 580 men completed the Medical Outcomes Study Short Form‐36, the University of California‐Los Angeles (UCLA) Prostate Cancer Index, and the American Urological Association Symptom Index before and through 24 months after treatment with radical prostatectomy (RP), external beam radiation therapy (EBRT), or brachytherapy (BT).

RESULTS.

General HRQOL did not appear to be affected by treatment. Obstructive and irritative urinary symptoms were more common after BT (P < .001). Urinary control and sexual function were better after EBRT than BT (P < .001 and P = .02, respectively) and better after BT than RP (P < .001 and P = .01, respectively). Among potent men, recovery of sexual function was best after EBRT and was equivalent after bilateral nerve‐sparing surgery or BT. Sexual bother was more common than urinary or bowel bother after all 3 treatments. Bowel dysfunction was more common after EBRT or BT than RP (P < .001).

CONCLUSIONS.

In the current study, treatment for localized prostate cancer was found to differentially affect HRQOL outcomes. Urinary control and sexual function were better after EBRT, although bilateral nerve‐sparing surgery diminished these differences among potent men undergoing RP. BT caused more obstructive and irritative symptoms, while both forms of radiation caused more bowel dysfunction. These results may inform medical decision‐making in men with localized prostate cancer. Cancer 2007. © 2007 American Cancer Society.

In 2006, greater than 234,000 American men were diagnosed with prostate cancer.1 Despite advances in the primary treatments for localized prostate cancer, no randomized controlled trial to date has proven the superiority of 1 modality in terms of cancer control.2 Hence, attention has been directed toward the side effects of treatment. Several investigations have included longitudinal health‐related quality of life (HRQOL) outcomes after treatment for localized prostate cancer3-18; however, most have used retrospective, cross‐sectional analyses. Among the studies presenting longitudinal recovery trends, most either lacked baseline data or acquired it retrospectively, thereby introducing recall bias.6-16 Assessing baseline function (known to be highly correlated with posttreatment outcomes) allows subjects to serve as their own controls.8, 10, 19

Impairments in HRQOL after treatment for clinically localized prostate cancer can be substantial. Utilities studies have shown that men devalue time gained from curative treatment if it is associated with diminished QOL.20, 21 With such an arresting impact on patient perception, the effects of treatment on HRQOL need to be characterized more accurately. We prospectively evaluated general and disease‐specific HRQOL after treatment for localized prostate cancer with radical prostatectomy (RP), external beam radiation therapy (EBRT), or brachytherapy (BT).

MATERIALS AND METHODS

Study Sample

Participants were recruited from March 1999 through January 2003. Eligible men had clinically localized (clinical TNM classification T1, T2, or limited T3), biopsy‐proven adenocarcinoma of the prostate and chose curative treatment with RP (n = 307 patients), EBRT (n = 78 patients), or interstitial seed BT (n = 90 patients). Exclusion criteria included prior treatment for prostate cancer, the presence of metastatic disease on imaging studies, the receipt of neoadjuvant androgen ablation before registration, and an inability to read or understand English.

All recruitment and research protocols were approved by the University of California‐Los Angeles (UCLA) Institutional Review Board and were Health Insurance Portability and Accountability Act (HIPAA)‐compliant; informed consent was obtained from each participant. Clinical information collected from the medical record included pretreatment serum prostate‐specific antigen (PSA) level, clinical T classification, and biopsy Gleason score. For recipients of EBRT, we collected total radiation dose and noted the use of neoadjuvant or adjuvant hormone therapy. For recipients of BT, we noted the isotope used, the number of seeds delivered, and the use of neoadjuvant or adjuvant hormone therapy. Recipients of combination BT with EBRT were grouped with BT recipients for analysis.

Follow‐up assessments were completed 1 month, 2 months, 4 months, 8 months, 12 months, 18 months, and 24 months after treatment. Subjects who sought primary treatment elsewhere or did not return follow‐up questionnaires beyond the initial assessment were excluded from this analysis.

Outcome Measures

We evaluated general HRQOL with the Medical Outcomes Study Short Form‐36 (SF‐36).22 The SF‐36 consolidates 8 individual domains into Physical (PCS) and Mental (MCS) Composite Summary scores, which are standardized to the general population with a normative mean of 50 and a standard deviation of 10. The SF‐36 has been extensively tested and shown to be reliable and valid in various populations (test‐retest reliability coefficients ≥0.78 and internal consistency Cronbach α coefficients of 0.78–0.93).22, 23

We evaluated disease‐specific QOL using the UCLA Prostate Cancer Index (PCI) and the American Urological Association Symptom Index (AUASI).24, 25 The PCI measures urinary, sexual, and bowel habits with function and bother scores. The urinary function domain reflects dryness rather than general voiding function, and is more accurately termed the urinary control domain. Bother scores measure the distress associated with dysfunction. Responses are scored from 0 to 100, with a higher score indicating better HRQOL. The PCI is reliable and valid in men with and without prostate cancer (test‐retest reliability coefficients ≥0.77 and internal consistency Cronbach α of 0.65–0.93).24 The AUASI measures obstructive and irritative urinary symptoms and is scored from 0 to 35, with a higher score indicating worse symptoms. A score <8 indicates mild symptoms, a score between 8 and 19 indicates moderate symptoms, and a score >19 indicates severe obstructive and irritative urinary symptoms. The AUASI demonstrates excellent reliability, validity, and responsiveness (test‐retest reliability coefficient of 0.92 and internal consistency Cronbach α coefficient of 0.86).25

Treatment Protocols

Subjects who opted for surgical therapy underwent an anatomic radical retropubic prostatectomy.26 The decision to perform cavernosal nerve‐sparing was made by the patient and surgeon. The degree to which the surgeon preserved the nerves was categorized as nonnerve‐sparing (n = 28 patients; 9.1%), unilateral nerve‐sparing (n = 31 patients; 10.1%), or bilateral nerve‐sparing (n = 248 patients; 80.8%).

Subjects who selected EBRT received either 3‐dimensional conformal therapy or intensity‐modulated radiation therapy, designed to maximize the radiation dose to the prostate and minimize exposure to surrounding structures, including the bladder and rectum.27, 28 Radiation to the prostate was delivered in fractionated doses divided over multiple treatments for a total dose to the prostate of 68 to 77 gray (Gy), in doses per fraction of 180 to 200 centigray (cGy) prescribed at 90% to 100% of the isodose line. Short‐term androgen deprivation therapy was administered concurrently to 46 EBRT subjects (59.0%).

Subjects who selected BT received either BT monotherapy (n = 67 patients; 74.4%) or BT in combination with EBRT (n = 23 patients; 25.6%) depending on the risk stratification of their prostate cancer. After preoperative volumetric analysis as a separate outpatient procedure, BT was performed through a transperineal approach with transrectal ultrasound guidance. According to preoperative dosimetric planning, a mean of 89 ± 34 radioactive seeds were implanted into the prostate. Plain radiography in the supine position confirmed seed placement. For high dose rate BT, transperineal catheters were placed for postoperative dosimetric planning. High‐dose radiation was then delivered through the catheters, which were removed after the completion of therapy. In subjects who received combination BT and EBRT, BT was preceded by an attenuated EBRT total dose of 45 Gy to the low pelvis, centered on the prostate. Two to 4 weeks after treatment, computed tomography (CT) imaging of the pelvis verified postimplant dosimetry. Short‐term androgen deprivation therapy was administered to 21 (23%) of the BT recipients.

Statistical Analysis

Demographic and clinical variables were compared among treatment arms with chi‐squared analysis for categorical variables and analysis of variance (ANOVA) for continuous variables. General and disease‐specific HRQOL were assessed using the principle of survival analysis with Cox proportional hazards models to characterize recovery trends. Models were created based on the occurrence of subjects' return to baseline score. A subject was considered to have returned to baseline if his domain score was at least 90% of his baseline. For the AUASI, in which a higher score indicates a worse outcome, a subject was considered to have returned to baseline if his domain score was ≤110% of his pretreatment score. Once a subject returned to baseline, his time to return was censored. Cox proportional hazards ratios were compared to detect differences in the return to baseline among treatment groups. When no significant difference was noted in the outcome measure between 2 treatment modalities, they were collapsed.

We performed a subset analysis of sexual function in men who were potent prior to treatment, defining potency as a sexual function score of at least 70.29 RP subjects were stratified into bilateral versus nonnerve‐sparing (unilateral nerve‐sparing cases were grouped with nonnerve‐sparing cases).

Multivariate models were created to determine factors associated with return to baseline for the HRQOL domains. In addition to treatment, covariates included age, ethnicity, relationship status, educational level, employment status, comorbid diseases, pretreatment serum PSA, and biopsy Gleason score. For ease of comparison, modalities were collapsed if no difference was noted in return to baseline for a given domain. Covariates were chosen a priori to incorporate variables known to influence QOL after prostate cancer treatment. Baseline scores for sexual function and AUASI, known to predict outcomes, also were included.8, 10, 19

We present PCI bother scores as the proportion of subjects reporting severe bother. We defined severe bother as a score of ≤25, which approximates 2 standard deviations below the mean baseline bother for urinary, sexual, and bowel domains. At each assessment point, chi‐square analysis was used to compare the proportion of subjects reporting severe bother among treatment modalities. All statistical analyses were performed with SAS 8.02 software (SAS Institute Inc., Cary, NC).

RESULTS

Of the 580 eligible participants who completed a baseline assessment, 475 (81.9%) completed follow‐up assessments and constitute the analytic sample (Table 1). Men undergoing surgery were younger and more frequently were employed. Although the number of comorbid conditions did not vary among treatment groups, fewer RP subjects reported a history of cardiovascular or peripheral vascular disease. EBRT subjects had a slightly higher mean PSA and biopsy Gleason score than RP subjects. Furthermore, a greater proportion of EBRT subjects had palpable disease (T2 or greater).

Table 1. Demographic and Clinical Characteristics of the Study Sample (n = 475)

	RP (n = 307)	EBRT (n = 78)	BT (n = 90)	P value
Age, y (mean ± SD)	60.1± 7.2	70.8± 7.3	68.4± 6.9	<.001
Ethnicity, no. (%)
White	262 (85.3)	66 (84.6)	71 (78.9)	.34
Nonwhite	45 (14.7)	12 (15.4)	19 (21.1)
Partner status, no. (%)
Partnered	256 (83.4)	64 (82.0)	72 (80.0)	.75
Not partnered	51 (16.6)	14 (18.0)	18 (20.0)
Education level, no. (%)
Less than college	80 (26.4)	22 (28.2)	36 (40.4)	.04
College or more	223 (73.6)	56 (71.8)	53 (59.6)
Employment, no. (%)
At least part‐time	218 (71.7)	24 (31.2)	39 (43.8)	<.001
Not employed	86 (28.3)	53 (68.8)	50 (56.2)
Comorbidity count, no. (%)
0	117 (38.1)	22 (28.2)	31 (34.4)	.25
1	109 (35.5)	32 (41.0)	34 (37.8)
>1	81 (26.4)	24 (30.8)	25 (27.8)
Comorbidity, no. (%)
Diabetes	15 (4.9)	5 (6.4)	9 (10.0)	.21
Cardiovascular disease	13 (4.2)	9 (11.5)	11 (12.2)	.007
Cerebrovascular disease	5 (1.6)	3 (3.9)	2 (2.2)	.41
Peripheral vasculopathy	10 (3.3)	8 (10.3)	7 (7.8)	.02
Pulmonary disease	46 (15.0)	14 (18.0)	12 (13.3)	.70
Gastrointestinal disease	51 (16.7)	9 (11.5)	15 (16.7)	.53
Major depression	23 (7.5)	5 (6.4)	3 (3.3)	.37
Alcohol problems	16 (5.2)	5 (6.4)	3 (3.3)	.65
Drug problems	7 (2.3)	0 (0.0)	0 (0.0)	.26
Tobacco use	131 (42.7)	34 (43.6)	35 (38.9)	.78
PSA (ng/mL)
Mean ± SD	7.3± 6.9	13.6± 21.6	10.6± 14.6	<.001
Median	7.6	8.0	6.0
Biopsy Gleason score
Mean ± SD	6.3± 0.9	6.7± 1.0	6.2± 0.8	.002
Median	6.0	6.0	6.0
Tumor stage, no. (%)
T1	216 (70.4)	42 (53.9)	71 (78.9)	.003
T2	90 (29.3)	34 (43.6)	17 (18.9)
T3	1 (0.0)	2 (2.6)	2 (2.2)

RP indicates radical prostatectomy; EBRT, external beam radiation therapy; BT, brachytherapy; SD, standard deviation; PSA, prostate‐specific antigen.

Figure 1 displays the domain means over time, all of which worsened noticeably at 1 month. EBRT and BT subjects fared similarly in all domains except the AUASI, with a higher proportion of BT recipients endorsing moderate to severe obstructive and irritative urinary symptoms. Although all HRQOL domains for EBRT and BT recipients soon plateaued, urinary control and sexual function scores among RP subjects continued to improve throughout the 24‐month postoperative period.

**Figure 1**
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Longitudinal changes in the health‐related quality of life (HRQOL) domain mean scores over time. EBRT indicates external beam radiation therapy; RP, radical prostatectomy; AUA, American Urological Association.

Caption
Longitudinal changes in the health‐related quality of life (HRQOL) domain mean scores over time. EBRT indicates external beam radiation therapy; RP, radical prostatectomy; AUA, American Urological Association.

Figure 2 presents Kaplan‐Meier curves representing return to baseline HRQOL scores. No significant difference across treatment groups was noted for either the physical or mental domain, with nearly the entire cohort returning to baseline functioning by 4 months after treatment. Although nearly all RP and EBRT subjects quickly returned to baseline AUASI, BT subjects had greater irritative and obstructive symptoms. Subjects who underwent RP had worse urinary control and sexual function than either radiation group. Nonnerve‐sparing surgery accounted for the majority of RP subjects with adverse sexual outcomes; of subjects undergoing bilateral nerve‐sparing surgery (many of whom had poor pretreatment sexual function), 39% returned to baseline. Bowel dysfunction affected significantly fewer RP subjects than those who underwent either form of radiation. Sensitivity analyses using 80% and 70% as thresholds for defining return to baseline did not change the results appreciably.

**Figure 2**
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Kaplan‐Meier analysis of the proportion of subjects returning to baseline health‐related quality of life (HRQOL) score over time. EBRT indicates external beam radiation therapy; RP, radical prostatectomy; AUA, American Urological Association.

Caption
Kaplan‐Meier analysis of the proportion of subjects returning to baseline health‐related quality of life (HRQOL) score over time. EBRT indicates external beam radiation therapy; RP, radical prostatectomy; AUA, American Urological Association.

Table 2 presents results from multivariate modeling of return to baseline HRQOL. No significant associations with general HRQOL were noted. For disease‐specific HRQOL, treatment effects predominated. EBRT and RP subjects returned to baseline AUASI scores more rapidly. Compared with BT, urinary control and sexual function were better among EBRT recipients but were worse among those undergoing RP. Bilateral nerve‐sparing RP was 2.3 times more likely to be associated with the return of baseline sexual function compared with nonnerve‐sparing RP (hazards ratio [HR] of 0.66 [95% confidence interval (95% CI), 0.44–0.97] vs HR of 0.29 [95% CI, 0.15–0.57]); however, BT subjects were more likely than either of the RP groups to recover baseline sexual function (P = .03 and P < .001, respectively). Bowel function outcomes were better among RP subjects than radiation subjects (P < .001).

Table 2. Multivariate Models Evaluating Predictors of Return to Baseline by 24 Months After Treatment for Various HRQOL Domains

	Medical outcomes study short form 36		AUA symptom index*	UCLA prostate cancer index
	PCS	MCS	AUA symptom index*	Urinary control	Sexual function	Bowel function
	HR (95% CI)	HR (95% CI)	HR (95% CI)	HR (95% CI)	HR (95%CI)	HR (95%CI)
Age	1.16 (0.92–1.47)	0.92 (0.73–1.16)	1.09 (0.86–1.38)	0.90 (0.69–1.16)	0.69 (0.48–0.98)	0.84 (0.67–1.05)
Ethnicity (vs white)
Nonwhite	1.01 (0.78–1.31)	0.78 (0.60–1.02)	0.98 (0.74–1.30)	0.76 (0.55–1.05)	1.36 (0.95–1.94)	0.88 (0.67–1.14)
Relationship (vs Partnered)
Single	1.01 (0.78–1.30)	0.99 (0.77–1.27)	0.91 (0.70–1.19)	0.95 (0.71–1.26)	0.99 (0.69–1.41)	0.88 (0.69–1.13)
Education (vs college)
Less than college	1.12 (0.90–1.39)	0.85 (0.69–1.06)	0.99 (0.79–1.24)	1.00 (0.78–1.27)	1.09 (0.81–1.47)	1.01 (0.81–1.25)
Employment (vs employed)
Not employed	0.87 (0.69–1.10)	0.93 (0.75–1.16)	0.95 (0.75–1.18)	0.94 (0.73–1.20)	0.93 (0.67–1.28)	0.94 (0.76–1.17)
Comorbidity (vs none)
At least 1	0.96 (0.79–1.18)	0.98 (0.81–1.20)	0.87 (0.71–1.07)	0.78 (0.63–0.98)	0.76 (0.57–1.01)	1.04 (0.86–1.27)
Baseline function*	ND	ND	1.04 (1.03–1.06)	ND	0.98 (0.98–0.99)	ND
PSA (vs <10)
≥10	0.96 (0.74–1.25)	0.95 (0.74–1.23)	0.95 (0.73–1.24)	0.91 (0.68–1.22)	0.81 (0.55–1.20)	0.90 (0.70–1.17)
Gleason score (vs <7)
≥7	0.87 (0.70–1.07)	1.15 (0.93–1.41)	0.94 (0.75–1.17)	1.02 (0.80–1.29)	0.84 (0.61–1.15)	0.98 (0.99–1.54)
Primary treatment (vs BT)
EBRT	0.97 (0.70–1.35)	1.06 (0.77–1.47)	2.35 (1.77–3.13)	1.86 (1.33–2.61)	1.59 (1.07–2.37)	1.23 (0.99–1.54)
RP	0.82 (0.63–1.07)	1.08 (0.83–1.40)		0.41 (0.31–0.54)	0.32 (0.14–0.77)

HRQOL indicates health‐related quality of life; PCS, physical composite score; MCS, mental composite score; AUA, American Urological Association; UCLA, University of California‐Los Angeles; HR, hazards ratio; 95% CI, 95% confidence interval; ND, not done; PSA, prostate‐specific antigen; BT, brachytherapy; EBRT, external beam radiation therapy; RP, radical prostatectomy.
* Baseline sexual function and the AUA symptom index were incorporated into the multivariate models evaluating predictors of return to baseline for sexual function and AUA symptom index.
Bold type indicates statistical significance.

Among men who were potent prior to treatment (155 in the RP group [50.5%], 14 in the EBRT group [17.9%], and 18 in the BT group [20.0%]), those who underwent bilateral nerve‐sparing RP had a greater initial loss of sexual function than those undergoing EBRT or BT but greater long‐term improvement (Fig. 3). Multivariate modeling revealed that EBRT recipients were more likely than BT recipients to return to baseline sexual function (HR of 3.06 [95%CI, 1.01–9.28]). Conversely, RP subjects who underwent unilateral or nonnerve‐sparing procedures were less likely than those who underwent BT to return to baseline sexual function (HR of 0.14 [95% CI, 0.03–0.73]).

**Figure 3**
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Sexual function among men who were potent (with a University of California‐Los Angeles Prostate Cancer Index [PCI] sexual function score at least 70; n = 187 patients) at baseline. EBRT indicates external beam radiation therapy; RP, radical prostatectomy.

Caption
Sexual function among men who were potent (with a University of California‐Los Angeles Prostate Cancer Index [PCI] sexual function score at least 70; n = 187 patients) at baseline. EBRT indicates external beam radiation therapy; RP, radical prostatectomy.

Bother scores, which reflect patient distress related to urinary, sexual, or bowel dysfunction, are displayed in Figure 4. Posttreatment urinary bother among RP subjects compared favorably with BT recipients, although both groups had significantly greater bother than did recipients of EBRT immediately after therapy. Beyond 4 months posttreatment, the proportions of men reporting severe urinary bother did not differ significantly among treatment groups. Similarly, despite a delayed return to baseline sexual function, beyond 8 months posttreatment the proportions of men reporting severe sexual bother did not differ significantly among treatment groups. Sexual bother was much more common than urinary or bowel bother at all time points, regardless of primary therapy. Bowel bother was most pronounced in EBRT and BT recipients.

**Figure 4**
Open in figure viewer PowerPoint

Longitudinal changes in bother scores as measured by the University of California‐Los Angeles Prostate Cancer Index. Bars shown represent the proportion of subjects reporting severe bother (<25) at each respective time point, with a P value presenting the difference in proportion as measured by analysis of variance (ANOVA), if significant. Pct indicates percent; EBRT, external beam radiation therapy; RP, radical prostatectomy.

Caption
Longitudinal changes in bother scores as measured by the University of California‐Los Angeles Prostate Cancer Index. Bars shown represent the proportion of subjects reporting severe bother (<25) at each respective time point, with a P value presenting the difference in proportion as measured by analysis of variance (ANOVA), if significant. Pct indicates percent; EBRT, external beam radiation therapy; RP, radical prostatectomy.

DISCUSSION

The current study has several important findings. First, urinary function differed after the 3 treatment modalities. Men who underwent BT had moderate voiding symptoms throughout the 24 months after treatment. Urinary morbidity after BT typically involves obstructive symptoms, with urinary retention rates as high as 34% at 1 week and 10% at 6 months.30 Symptom severity is highest immediately after treatment; however, up to one‐third of patients undergoing BT experience an exacerbation of obstructive symptoms 24 months after treatment.31

RP was associated with worse urinary control in the immediate postoperative period, a known side effect of surgery given the proximity of the external urinary sphincter, a structure less affected by radiation. And although urinary control continues to improve beyond 2 years after RP,32 postprostatectomy incontinence rates based on patient‐centered assessments vary from 8.4% to 35%, with lower rates of severe incontinence reported among younger subjects.8, 9 Our EBRT subjects were rarely incontinent, corroborating previous investigations.4, 7, 9, 12, 17

The urinary bother scores for our RP group compared favorably with those of our BT group. Beyond 4 months, differences in urinary bother among treatment groups were negligible. Urinary bother outcomes in our sample confirmed prior investigations of urinary symptoms in recipients of RP, EBRT, and BT.4, 12, 17 Data from CaPSURE, a national prostate cancer registry, showed that urinary bother does not correlate with pad use, suggesting that bother is more affected by irritative and obstructive symptoms than by incontinence.12 Our findings highlight the need to differentiate urinary control measures from measures of obstructive and irritative symptoms because treatments differentially affect outcomes for these domains.

Second, although treatment with RP may adversely affect sexual function, surprisingly few men in all 3 groups were fully potent before treatment. Long‐term sexual function scores were better among RP subjects. However, because the baseline scores of the RP subjects were so much higher, fewer were able to regain their baseline function by 24 months. Nonetheless, their mean sexual function scores continued to improve throughout the 24‐month postoperative period. Return‐to‐baseline analyses revealed more rapid recovery of baseline sexual function in EBRT subjects than in either RP or BT subjects, regardless of the use of erectile aids. Nerve‐sparing surgery was found to have a marked positive effect on sexual outcomes after RP. However, caution should be exercised when interpreting our results because so few men in our EBRT and BT groups were actually potent at baseline. Severe sexual bother was similarly prevalent in all treatment groups at 24 months.

Our sexual function outcomes corroborated previous investigations of HRQOL after treatment for localized prostate cancer.5, 8, 16, 17 However, many of those investigations lacked baseline data regarding sexual function, an important prognosticator.8, 10 Furthermore, those investigations did not identify and analyze potent subsets. Although investigators have previously shown high rates of erectile dysfunction after RP,5, 8, 9, 11, 17, 32 our RP subjects who were potent preoperatively regained their sexual function at rates similar to those receiving BT or EBRT, especially after bilateral nerve‐sparing RP. Prior analyses that have stratified the degree of nerve‐sparing lacked comparison groups of men undergoing radiation.33 Our EBRT recipients had better sexual function than our RP and BT recipients; however, sexual function after EBRT declines for at least 5 years after treatment.34, 35

Third, bowel impairment was more common among subjects undergoing radiation therapy, with similar recovery profiles noted among recipients of EBRT and BT. Although urinary and sexual bother scores equilibrated with time across treatment groups, moderate bowel bother persisted in men receiving EBRT or BT. Indeed, 80% of RP subjects returned to baseline bowel function within 2 months of surgery. Our data corroborate outcomes from Wei et al.17 and from CaPSURE,13 both of which showed a minimal effect on bowel symptoms after RP. Although studies of the adverse effects of radiation therapy typically employ provider‐defined QOL outcomes, limiting comparison of our results to those of other radiation series, the impairments we have documented appear to corroborate the literature.

The current study has several limitations. First, we did not control for several factors that might have biased our outcomes. Men undergoing EBRT or BT commonly receive neoadjuvant androgen ablation, especially in the presence of adverse clinical risk factors, and this can differentially impair sexual outcomes in men undergoing radiation.36, 37 In addition, men with aggressive clinical features may receive combined radiation therapy with an attenuated dose of EBRT prior to BT. Other investigations have shown that men treated with combined EBRT and BT have worse HRQOL outcomes than those treated with either one alone.4, 16, 38 That we included these subjects in our BT group may explain why our BT outcomes were slightly worse than published studies, especially with respect to bowel symptoms.13, 17 Newer EBRT protocols that apply a higher total radiation dose may further affect HRQOL results.

Second, we did not account for the impact of disease progression on the HRQOL of our subjects. Few investigations published to date have focused on HRQOL outcomes in men who experience biochemical recurrence after treatment for localized prostate cancer. Wei et al. showed that those patients who develop disease recurrence have diminished HRQOL in both general and disease‐specific domains.17 Although we did not control for this factor, our intent was to describe longitudinal HRQOL outcomes after treatment for early‐stage prostate cancer. Selection of a particular modality confers the risk that a patient may require concurrent or subsequent hormone therapy or salvage therapy.

Finally, although we evaluated outcomes prospectively, subjects selected their own treatment prior to study entry, a bias apparent in the demographics of our cohort. Those undergoing radiation were older, and age is associated with worse sexual and bowel outcomes after surgery and radiation.8, 10, 11, 13, 37 Furthermore, men undergoing radiation were more likely to report a history of cardiovascular or peripheral vascular disease, both of which are associated with erectile dysfunction.39 The preponderance of these comorbid conditions may have further biased our radiation cohorts toward worse sexual function.

Despite these limitations, the current study offers a prospective, longitudinal analysis of HRQOL outcomes after the 3 most commonly used treatments for early‐stage prostate cancer. The study design allowed us to characterize 2‐year recovery profiles in our subjects. With reliable baseline information, we were able to identify predictors of recovery of general and disease‐specific HRQOL, and to differentiate treatment‐related effects.

The findings of the current study address patients' clarion call for physicians to be more responsive to concerns about the quality of life, not only its quantity, after prostate cancer treatment. The remaining challenge lies in using the results of purely descriptive studies to optimize medical decision‐making for future patients. To that end, it is critical to understand the difference between dysfunction and distress in the urinary, bowel, and sexual domains. Leveraging descriptive data to guide interventions that improve outcomes adds value to the clinical care we provide during the long survivorship period most patients experience. In addition, the current era of total quality improvement in medical care demands the perspicacious use of quality‐of‐life information to develop performance measures for providers.

Acknowledgements

Supported by a grant from the California Department of Health Services Cancer Research Program.

REFERENCES

1 Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin. 2006; 56: 106–130.
Wiley Online Library PubMed Web of Science®Google Scholar
2 D'Amico AV, Whittington R, Malkowicz SB, et al. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA. 1998; 280: 969–974.
Crossref CAS PubMed Web of Science®Google Scholar
3 Bacon CG, Giovannucci E, Testa M, et al. The impact of cancer treatment on quality of life outcomes for patients with localized prostate cancer. J Urol. 2001; 166: 1804–1810.
Crossref CAS PubMed Web of Science®Google Scholar
4 Brandeis JM, Litwin MS, Burnison CM, et al. Quality of life outcomes after brachytherapy for early stage prostate cancer. J Urol. 2000; 163: 851–857.
Crossref CAS PubMed Web of Science®Google Scholar
5 Davis JW, Kuban DA, Lynch DF, et al. Quality of life after treatment for localized prostate cancer: differences based on treatment modality. J Urol. 2001; 166: 947–952.
Crossref CAS PubMed Web of Science®Google Scholar
6 Potosky AL, Legler J, Albertsen PC, et al. Health outcomes after prostatectomy or radiotherapy for prostate cancer: results from the Prostate Cancer Outcomes Study. J Natl Cancer Inst. 2000; 92: 1582–1592.
Crossref CAS PubMed Web of Science®Google Scholar
7 Potosky AL, Davis WW, Hoffman RM, et al. Five‐year outcomes after prostatectomy or radiotherapy for prostate cancer: the prostate cancer outcomes study. J Natl Cancer Inst. 2004; 96: 1358–1367.
Crossref PubMed Web of Science®Google Scholar
8 Stanford JL, Feng Z, Hamilton AS, et al. Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA. 2000; 283: 354–360.
Crossref CAS PubMed Web of Science®Google Scholar
9 Talcott JA, Rieker P, Clark JA, et al. Patient‐reported symptoms after primary therapy for early prostate cancer: results of a prospective cohort study. J Clin Oncol. 1998; 16: 275–283.
Crossref CAS PubMed Web of Science®Google Scholar
10 Talcott JA, Manola J, Clark JA, et al. Time course and predictors of symptoms after primary prostate cancer therapy. J Clin Oncol. 2003; 21: 3979–3986.
Crossref PubMed Web of Science®Google Scholar
11 Litwin MS, Flanders SC, Pasta DJ, et al. Sexual function and bother after radical prostatectomy or radiation for prostate cancer: multivariate quality‐of‐life analysis from CaPSURE. Cancer of the Prostate Strategic Urologic Research Endeavor. Urology. 1999; 54: 503–508.
Crossref CAS PubMed Web of Science®Google Scholar
12 Litwin MS, Pasta DJ, Yu J, et al. Urinary function and bother after radical prostatectomy or radiation for prostate cancer: a longitudinal, multivariate quality of life analysis from the Cancer of the Prostate Strategic Urologic Research Endeavor. J Urol. 2000; 164: 1973–1977.
Crossref CAS PubMed Web of Science®Google Scholar
13 Litwin MS, Sadetsky N, Pasta DJ, et al. Bowel function and bother after treatment for early stage prostate cancer: a longitudinal quality of life analysis from CaPSURE. J Urol. 2004; 172: 515–519.
Crossref PubMed Web of Science®Google Scholar
14 Lubeck DP, Litwin MS, Henning JM, et al. Changes in health‐related quality of life in the first year after treatment for prostate cancer: results from CaPSURE. Urology. 1999; 53: 180–186.
Crossref CAS PubMed Web of Science®Google Scholar
15 Penson DF, Feng Z, Kuniyuki A, et al. General quality of life 2 years following treatment for prostate cancer: what influences outcomes? Results from the prostate cancer outcomes study. J Clin Oncol. 2003; 21: 1147–1154.
Crossref PubMed Web of Science®Google Scholar
16 Speight JL, Elkin EP, Pasta DJ, et al. Longitudinal assessment of changes in sexual function and bother in patients treated with external beam radiotherapy or brachytherapy, with and without neoadjuvant androgen ablation: data from CaPSURE. Int J Radiat Oncol Biol Phys. 2004; 60: 1066–1075.
Crossref PubMed Web of Science®Google Scholar
17 Wei JT, Dunn RL, Sandler HM, et al. Comprehensive comparison of health‐related quality of life after contemporary therapies for localized prostate cancer. J Clin Oncol. 2002; 20: 557–566.
Crossref PubMed Web of Science®Google Scholar
18 Steineck G, Helgesen F, Adolfsson J, et al. Quality of life after radical prostatectomy or watchful waiting. N Engl J Med. 2002; 347: 790–796.
Crossref PubMed Web of Science®Google Scholar
19 Gelblum DY, Potters L, Ashley R, et al. Urinary morbidity following ultrasound‐guided transperineal prostate seed implantation. Int J Radiat Oncol Biol Phys. 1999; 45: 59–67.
Crossref CAS PubMed Web of Science®Google Scholar
20 Singer PA, Tasch ES, Stocking C, et al. Sex or survival: trade‐offs between quality and quantity of life. J Clin Oncol. 1991; 9: 328–334.
Crossref CAS PubMed Web of Science®Google Scholar
21 Saigal CS, Gornbein J, Nease R, et al. Predictors of utilities for health states in early stage prostate cancer. J Urol. 2001; 166: 942–946.
Crossref CAS PubMed Web of Science®Google Scholar
22 Ware JEJr. SF‐36 Health Survey: Manual and Interpretation Guide. Boston: The Health Institute, New England Medical Center; 1993.
Crossref PubMed Web of Science®Google Scholar
23 Ware JEJr, Sherbourne CD. The MOS 36‐item short‐form health survey (SF‐36). I. Conceptual framework and item selection. Med Care. 1992; 30: 473–483.
Crossref CAS PubMed Web of Science®Google Scholar
24 Litwin MS, Hays RD, Fink A, et al. The UCLA Prostate Cancer Index: development, reliability, and validity of a health‐related quality of life measure. Med Care. 1998; 36: 1002–1012.
Crossref CAS PubMed Web of Science®Google Scholar
25 Barry MJ, Fowler FJJr, O'Leary MP, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992; 148: 1549–1557; discussion, 1564.
Crossref CAS PubMed Web of Science®Google Scholar
26 Walsh PC. Anatomic radical retropubic prostatectomy. In: Walsh PC, Retik AB, Vaughan ED, et al. editors. Campbell's Urology. 8th ed. Philadelphia: W.B. Saunders; 2002.
Google Scholar
27 Fukunaga‐Johnson N, Sandler HM, McLaughlin PW, et al. Results of 3D conformal radiotherapy in the treatment of localized prostate cancer. Int J Radiat Oncol Biol Phys. 1997; 38: 311–317.
Crossref CAS PubMed Web of Science®Google Scholar
28 Burman C, Chui CS, Kutcher G, et al. Planning, delivery, and quality assurance of intensity‐modulated radiotherapy using dynamic multileaf collimator: a strategy for large‐scale implementation for the treatment of carcinoma of the prostate. Int J Radiat Oncol Biol Phys. 1997; 39: 863–873.
Crossref CAS PubMed Web of Science®Google Scholar
29 Krupski TL, Saigal CS, Litwin MS. Variation in continence and potency by definition. J Urol. 2003; 170: 1291–1294.
Crossref PubMed Web of Science®Google Scholar
30 Locke J, Ellis W, Wallner K, et al. Risk factors for acute urinary retention requiring temporary intermittent catheterization after prostate brachytherapy: a prospective study. Int J Radiat Oncol Biol Phys. 2002; 52: 712–719.
Crossref PubMed Web of Science®Google Scholar
31 Cesaretti JA, Stone NN, Stock RG. Urinary symptom flare following I‐125 prostate brachytherapy. Int J Radiat Oncol Biol Phys. 2003; 56: 1085–1092.
Crossref PubMed Web of Science®Google Scholar
32 Litwin MS, Melmed GY, Nakazon T. Life after radical prostatectomy: a longitudinal study. J Urol. 2001; 166: 587–592.
Crossref CAS PubMed Web of Science®Google Scholar
33 Hollenbeck BK, Dunn RL, Wei JT, et al. Determinants of long‐term sexual health outcome after radical prostatectomy measured by a validated instrument. J Urol. 2003; 169: 1453–1457.
Crossref PubMed Web of Science®Google Scholar
34 Mantz CA, Nautiyal J, Awan A, et al. Potency preservation following conformal radiotherapy for localized prostate cancer: impact of neoadjuvant androgen blockade, treatment technique, and patient‐related factors. Cancer J Sci Am. 1999; 5: 230–236.
CAS PubMed Web of Science®Google Scholar
35 Zelefsky MJ, Cowen D, Fuks Z, et al. Long term tolerance of high dose three‐dimensional conformal radiotherapy in patients with localized prostate carcinoma. Cancer. 1999; 85: 2460–2468.
Wiley Online Library CAS PubMed Web of Science®Google Scholar
36 Hollenbeck BK, Wei JT, Sanda MG, et al. Neoadjuvant hormonal therapy impairs sexual outcome among younger men who undergo external beam radiotherapy for localized prostate cancer. Urology. 2004; 63: 946–950.
Crossref PubMed Web of Science®Google Scholar
37 Hollenbeck BK, Dunn RL, Wei JT, et al. Neoadjuvant hormonal therapy and older age are associated with adverse sexual health‐related quality‐of‐life outcome after prostate brachytherapy. Urology. 2002; 59: 480–484.
Crossref PubMed Web of Science®Google Scholar
38 Merrick GS, Butler WM, Dorsey AT, et al. Rectal function following prostate brachytherapy. Int J Radiat Oncol Biol Phys. 2000; 48: 667–674.
Crossref CAS PubMed Web of Science®Google Scholar
39 Shamloul R, Ghanem HM, Salem A, et al. Correlation between penile duplex findings and stress electrocardiography in men with erectile dysfunction. Int J Impot Res. 2004; 16: 235–237.
Crossref CAS PubMed Web of Science®Google Scholar

Notes :

1 Fax: (310) 206‐5343
RP indicates radical prostatectomy; EBRT, external beam radiation therapy; BT, brachytherapy; SD, standard deviation; PSA, prostate‐specific antigen.
HRQOL indicates health‐related quality of life; PCS, physical composite score; MCS, mental composite score; AUA, American Urological Association; UCLA, University of California‐Los Angeles; HR, hazards ratio; 95% CI, 95% confidence interval; ND, not done; PSA, prostate‐specific antigen; BT, brachytherapy; EBRT, external beam radiation therapy; RP, radical prostatectomy.
* Baseline sexual function and the AUA symptom index were incorporated into the multivariate models evaluating predictors of return to baseline for sexual function and AUA symptom index.
Bold type indicates statistical significance.

Citing Literature

Number of times cited: 182

C. Thomas, A. C. Wootten, P. Robinson, P. C. F. Law and D. P. McKenzie, The impact of sexual orientation on body image, self‐esteem, urinary and sexual functions in the experience of prostate cancer, European Journal of Cancer Care, 27, 2, (2018).
Wiley Online Library
Gregory R. Warrell, Yan Xing, Tarun K. Podder, Bryan J. Traughber and Rodney J. Ellis, Reduction of seed motion using a bio‐absorbable polymer coating during permanent prostate brachytherapy using a mick applicator technique, Journal of Applied Clinical Medical Physics, 19, 3, (44-51), (2018).
Wiley Online Library
Reihaneh Moeini, Farshid Farhan, Bahram Mofid, Hossein Rezaeizadeh, Narjes Gorji, Ali Ghobadi, Amir Mohammad Jaladat and Mahnaz Khanavi, The effect of the combination of Malva sylvestris L. and Althaea digitata Boiss. on prevention of acute radiation proctitis in patients with prostate cancer, Journal of Herbal Medicine, (2018).
Crossref
Lingyue Sun, Wendy Smith, Abhijit Ghose and Charles Kirkby, A quantitative assessment of the consequences of allowing dose heterogeneity in prostate radiation therapy planning, Journal of Applied Clinical Medical Physics, 19, 5, (580-590), (2018).
Wiley Online Library
Bryce B. Reeve, Mian Wang, Kevin Weinfurt, Kathryn E. Flynn, Deborah S. Usinger and Ronald C. Chen, Psychometric Evaluation of PROMIS Sexual Function and Satisfaction Measures in a Longitudinal Population-Based Cohort of Men With Localized Prostate Cancer, The Journal of Sexual Medicine, 10.1016/j.jsxm.2018.09.015, (2018).
Crossref
Rong Wang, Amer M. Zeidan, James B. Yu, Pamela R. Soulos, Amy J. Davidoff, Steven D. Gore, Scott F. Huntington, Cary P. Gross and Xiaomei Ma, Myelodysplastic Syndromes and Acute Myeloid Leukemia After Radiotherapy for Prostate Cancer: A Population‐Based Study, The Prostate, 77, 5, (437-445), (2016).
Wiley Online Library
Joanna Brooks, Nigel King, Peter Branney, Clare Strickland, Frances Darby, Lisa White and Sunjay Jain, Exploring Men’s Experiences of Diagnosis and Treatment for Prostate Cancer, Applied Qualitative Research in Psychology, 10.1057/978-1-137-35913-1_4, (69-85), (2017).
Crossref
Aryeh Keehn, Ethan Ludmir, Jacob Taylor and Farhang Rabbani, Incidence of bladder cancer after radiation for prostate cancer as a function of time and radiation modality, World Journal of Urology, 35, 5, (713), (2017).
Crossref
Brindha Pillay, Daniel Moon, Christopher Love, Denny Meyer, Emma Ferguson, Helen Crowe, Nicholas Howard, Sarah Mann and Addie Wootten, Quality of Life, Psychological Functioning, and Treatment Satisfaction of Men Who Have Undergone Penile Prosthesis Surgery Following Robot-Assisted Radical Prostatectomy, The Journal of Sexual Medicine, 14, 12, (1612), (2017).
Crossref
Joanne W. Jang, Michael R. Drumm, Jason A. Efstathiou, Jonathan J. Paly, Andrzej Niemierko, Marek Ancukiewicz, James A. Talcott, Jack A. Clark and Anthony L. Zietman, Long‐term quality of life after definitive treatment for prostate cancer: patient‐reported outcomes in the second posttreatment decade, Cancer Medicine, 6, 7, (1827-1836), (2017).
Wiley Online Library
F. Gómez-Veiga, A. Rodríguez-Antolín, B. Miñana, C. Hernández, J.F. Suárez, J.M. Fernández-Gómez, M. Unda, J. Burgos, A. Alcaraz, P. Rodríguez, R. Medina, J. Castiñeiras, C. Moreno, E. Pedrosa and J.M. Cózar, Diagnóstico y tratamiento del cáncer de prostata clínicamente localizado. Adherencia a las guías clínicas en un estudio poblacional nacional – GESCAP, Actas Urológicas Españolas, 41, 6, (359), (2017).
Crossref
Peter Chang, Meredith M. Regan, Montserrat Ferrer, Ferran Guedea, Dattatraya Patil, John T. Wei, Larry A. Hembroff, Jeff M. Michalski, Chris S. Saigal, Mark S. Litwin, Daniel A. Hamstra, Irving D. Kaplan, Jay P. Ciezki, Eric A. Klein, Adam S. Kibel, Howard M. Sandler, Rodney L. Dunn, Catrina M. Crociani and Martin G. Sanda, Relief of Urinary Symptom Burden after Primary Prostate Cancer Treatment, The Journal of Urology, 197, 2, (376), (2017).
Crossref
F. Gómez-Veiga, A. Rodríguez-Antolín, B. Miñana, C. Hernández, J.F. Suárez, J.M. Fernández-Gómez, M. Unda, J. Burgos, A. Alcaraz, P. Rodríguez, R. Medina, J. Castiñeiras, C. Moreno, E. Pedrosa and J.M. Cózar, Diagnosis and treatment for clinically localized prostate cancer. Adherence to the European Association of Urology clinical guidelines in a nationwide population-based study – GESCAP group, Actas Urológicas Españolas (English Edition), 41, 6, (359), (2017).
Crossref
John S. Banerji, Lauren M. Hurwitz, Jennifer Cullen, Erika M. Wolff, Katherine E. Levie, Inger L. Rosner, Timothy C. Brand, James O. LʼEsperance, Joseph R. Sterbis and Christopher R. Porter, A prospective study of health-related quality-of-life outcomes for patients with low-risk prostate cancer managed by active surveillance or radiation therapy, Urologic Oncology: Seminars and Original Investigations, 35, 5, (234), (2017).
Crossref
Yu-Hsiang Chou, Yi-Hsin Yang, Hsiao-Ching Kuo, Kun-Yen Ho, Wen-Chen Wang and Kai-Fang Hu, Periodontal surgery improves oral health-related quality of life in chronic periodontitis patients in Asian population, The Kaohsiung Journal of Medical Sciences, 33, 10, (523), (2017).
Crossref
Patricia A. Parker, John W. Davis, David M. Latini, George Baum, Xuemei Wang, John F. Ward, Deborah Kuban, Steven J. Frank, Andrew K. Lee, Christopher J. Logothetis and Jeri Kim, Relationship between illness uncertainty, anxiety, fear of progression and quality of life in men with favourable‐risk prostate cancer undergoing active surveillance, BJU International, 117, 3, (469-477), (2015).
Wiley Online Library
B. Miñana, A. Rodríguez-Antolín, F. Gómez-Veiga, C. Hernández, J.F. Suárez, J.M. Fernández-Gómez, M. Unda, J. Burgos, A. Alcaraz, P. Rodríguez, C. Moreno, E. Pedrosa and J.M. Cózar, Treatment trends for clinically localized prostate cancer. National population analysis: GESCAP group, Actas Urológicas Españolas (English Edition), 40, 4, (209), (2016).
Crossref
Mitchell S. Anscher, Michael G. Chang, Drew Moghanaki, Mihaela Rosu, Ross B. Mikkelsen, Diane Holdford, Vicki Skinner, B. Mayer Grob, Arun Sanyal, Aiping Wang and Nitai D. Mukhopadhyay, Lovastatin may reduce the risk of erectile dysfunction following radiation therapy for prostate cancer, Acta Oncologica, 55, 12, (1500), (2016).
Crossref
Michael J. Zelefsky, Bing Ying Poon, James Eastham, Andrew Vickers, Xin Pei and Peter T. Scardino, Longitudinal assessment of quality of life after surgery, conformal brachytherapy, and intensity-modulated radiation therapy for prostate cancer, Radiotherapy and Oncology, 118, 1, (85), (2016).
Crossref
Jane Robertson, Phillip McNamee, Gerry Molloy, Gill Hubbard, Alan McNeill, Prasad Bollina, Daniel Kelly and Liz Forbat, Couple-Based Psychosexual Support Following Prostate Cancer Surgery: Results of a Feasibility Pilot Randomized Control Trial, The Journal of Sexual Medicine, 13, 8, (1233), (2016).
Crossref
P. M. Putora, D. Engeler, S. R. Haile, N. Graf, K. Buchauer, H. P. Schmid and L. Plasswilm, Erectile function following brachytherapy, external beam radiotherapy, or radical prostatectomy in prostate cancer patients, Strahlentherapie und Onkologie, 192, 3, (182), (2016).
Crossref
Anthony Ricco, Rachelle Lanciano and Alexandra Hanlon, Predictors of long-term survival for localized prostate cancer treated with high-dose IMRT stratified by NCCN 2015 guidelines in a community hospital setting, Journal of Radiation Oncology, 5, 1, (95), (2016).
Crossref
Virginia Becerra, Mónica Ávila, Jorge Jimenez, Laura Cortes-Sanabria, Yolanda Pardo, Olatz Garin, Angels Pont, Jordi Alonso, Francesc Cots and Montse Ferrer, Economic evaluation of treatments for patients with localized prostate cancer in Europe: a systematic review, BMC Health Services Research, 16, 1, (2016).
Crossref
Ashley J. F. Brandon, Matthew D. Ingham, Michael B. Williams and Michael D. Fabrizio, Quality of Life Evaluation: What Is Published and Practical for Routine Use, Robot-Assisted Radical Prostatectomy, 10.1007/978-3-319-32641-2_25, (247-255), (2016).
Crossref
Esther Castermans, Marcel Coenders, Hendrik P. Beerlage and Jolanda de Vries, Psychosocial screening for patients with prostate cancer: The development and validation of the psychosocial distress questionnaire-prostate cancer, Journal of Psychosocial Oncology, 10.1080/07347332.2016.1233925, 34, 6, (512-529), (2016).
Crossref
B. Miñana, A. Rodríguez-Antolín, F. Gómez-Veiga, C. Hernández, J.F. Suárez, J.M. Fernández-Gómez, M. Unda, J. Burgos, A. Alcaraz, P. Rodríguez, C. Moreno, E. Pedrosa and J.M. Cózar, Tendencias de tratamiento en el cáncer de próstata clínicamente localizado. Análisis poblacional a nivel nacional: grupo GESCAP, Actas Urológicas Españolas, 40, 4, (209), (2016).
Crossref
Kellie Paich, Rodney Dunn, Ted Skolarus, James Montie, Brent Hollenbeck, Ganesh Palapattu, David Wood Jr., Staci Mitchell, Victor Hola, Kim Erickson, Jennifer Shifferd and Daniela Wittmann, Preparing Patients and Partners for Recovery From the Side Effects of Prostate Cancer Surgery: A Group Approach, Urology, 88, (36), (2016).
Crossref
Hilke M. Rath, Anneke Ullrich, Ullrich Otto, Christa Kerschgens, Martin Raida, Christa Hagen-Aukamp, Uwe Koch and Corinna Bergelt, Psychosocial and physical outcomes of in- and outpatient rehabilitation in prostate cancer patients treated with radical prostatectomy, Supportive Care in Cancer, 24, 6, (2717), (2016).
Crossref
Yen-Chien Lee, Chung-Cheng Hsieh, Chung-Yi Li, Jen-Pin Chuang and Jenq-Chang Lee, Secondary Cancers After Radiation Therapy for Primary Prostate or Rectal Cancer, World Journal of Surgery, 40, 4, (895), (2016).
Crossref
Kevin Krughoff and Al Barqawi, Focused Targeted Therapy in Prostate Cancer, The Prostate Cancer Dilemma, 10.1007/978-3-319-21485-6_11, (153-166), (2016).
Crossref
Thomas J. Pugh, Usama Mahmood, David A. Swanson, Mark F. Munsell, Run Wang, Rajat J. Kudchadker, Teresa L. Bruno and Steven J. Frank, Sexual potency preservation and quality of life after prostate brachytherapy and low-dose tadalafil, Brachytherapy, 14, 2, (160), (2015).
Crossref
Nora Eisemann, Sandra Nolte, Maike Schnoor, Alexander Katalinic, Volker Rohde and Annika Waldmann, The ProCaSP study: quality of life outcomes of prostate cancer patients after radiotherapy or radical prostatectomy in a cohort study, BMC Urology, 15, 1, (2015).
Crossref
David R. Raleigh, Albert J. Chang, Bryan Tomlin, J. Adam Cunha, Steve E. Braunstein, Katsuto Shinohara, Alexander R. Gottschalk, Mack Roach and I-Chow Hsu, Patient- and treatment-specific predictors of genitourinary function after high-dose-rate monotherapy for favorable prostate cancer, Brachytherapy, 14, 6, (795), (2015).
Crossref
MARIE HJÄLM-ERIKSSON, BO LENNERNÄS, ANDERS ULLÉN, HEMMING JOHANSSON, JONAS HUGOSSON, STEN NILSSON and YVONNE BRANDBERG, Long-term health-related quality of life after curative treatment for prostate cancer: A regional cross-sectional comparison of two standard treatment modalities, International Journal of Oncology, 46, 1, (381), (2015).
Crossref
Zaker Rana, Robert L. Hong, Mustafa Abugideiri, Donald McRae, George Cernica, Robert Mordkin, Andrew B. Joel, Gregory Bernstein and Nadim M. Nasr, Sexual, irritative, and voiding outcomes, following stereotactic body radiation therapy for prostate cancer, Radiation Oncology, 10, 1, (2015).
Crossref
Marie K Gurka, Leonard N Chen, Aditi Bhagat, Rudy Moures, Joy S Kim, Thomas Yung, Siyuan Lei, Brian T Collins, Pranay Krishnan, Simeng Suy, Anatoly Dritschilo, John H Lynch and Sean P Collins, Hematuria following stereotactic body radiation therapy (SBRT) for clinically localized prostate cancer, Radiation Oncology, 10, 1, (44), (2015).
Crossref
Lixin Song, Christine Rini, Allison Deal, Matthew Nielsen,
Hao Chang, Patty Kinneer, Randall Teal, David Johnson,
Mary Dunn, Barbara Mark and Mary Palmer, Improving Couples’ Quality of Life Through  a Web-Based Prostate Cancer Education Intervention, Oncology Nursing Forum, 42, 2, (183), (2015).
Crossref
Frances Josephine Drummond, Heather Kinnear, Eamonn O’Leary, Donnelly, Anna Gavin and Linda Sharp, Long-term health-related quality of life of prostate cancer survivors varies by primary treatment. Results from the PiCTure (Prostate Cancer Treatment, your experience) study, Journal of Cancer Survivorship, 9, 2, (361), (2015).
Crossref
Shunichi Namiki, Yasuhiro Kaiho, Koji Mitsuzuka, Hideo Saito, Shigeyuki Yamada, Haruo Nakagawa, Akihiro Ito and Yoichi Arai, Long‐term quality of life after radical prostatectomy: 8‐Year longitudinal study in Japan, International Journal of Urology, 21, 12, (1220-1226), (2014).
Wiley Online Library
Ching‐Hui Chien, Cheng‐Keng Chuang, Kuan‐Lin Liu, Chia‐Lin Li and Hsueh‐Erh Liu, Changes in decisional conflict and decisional regret in patients with localised prostate cancer, Journal of Clinical Nursing, 23, 13-14, (1959-1969), (2013).
Wiley Online Library
Lixin Song, Yingchun Ji and Mathew E. Nielsen, Quality of Life and Health Status Among Prostate Cancer Survivors and Noncancer Population Controls, Urology, 83, 3, (658), (2014).
Crossref
Markus Hartenbach, Andreas Delker, Sabrina Hartenbach, Juli Schlichtiger, Sabrina Niedermoser, Carmen Wängler, Björn Wängler, Guido Böning, Franz Josef Gildehaus, Klement Neumaier, Kirsten Lauber, Klaus Kraft, Claus Belka, Marcus Hacker, Viktor Meineke and Peter Bartenstein, Dose-Dependent Uptake of 3′-deoxy-3′-[18 F]Fluorothymidine by the Bowel after Total-Body Irradiation, Molecular Imaging and Biology, 16, 6, (846), (2014).
Crossref
Jennifer A. Woo, Leonard N. Chen, Aditi Bhagat, Eric K. Oermann, Joy S. Kim, Rudy Moures, Thomas Yung, Siyuan Lei, Brian T. Collins, Deepak Kumar, Simeng Suy, Anatoly Dritschilo, John H. Lynch and Sean P. Collins, Clinical Characteristics and Management of Late Urinary Symptom Flare Following Stereotactic Body Radiation Therapy for Prostate Cancer, Frontiers in Oncology, 4, (2014).
Crossref
Maher M. El-Masri, Susan M. Fox-Wasylyshyn, Colvin D. Springer and Sheila Cameron, Exploring the Impact of Prostate Cancer Radiation Treatment on Functions, Bother, and Well-Being, Canadian Journal of Nursing Research, 46, 2, (42), (2014).
Crossref
Andrew J. Stephenson, Scott E. Eggener, Adrian V. Hernandez, Eric A. Klein, Michael W. Kattan, David P. Wood, Danny M. Rabah, James A. Eastham and Peter T. Scardino, Do Margins Matter? The Influence of Positive Surgical Margins on Prostate Cancer–Specific Mortality, European Urology, 65, 4, (675), (2014).
Crossref
Onita Bhattasali, Leonard N Chen, Jennifer Woo, Jee-Won Park, Joy S Kim, Rudy Moures, Thomas Yung, Siyuan Lei, Brian T Collins, Keith Kowalczyk, Simeng Suy, Anatoly Dritschilo, John H Lynch and Sean P Collins, Patient-reported outcomes following stereotactic body radiation therapy for clinically localized prostate cancer, Radiation Oncology, 10.1186/1748-717X-9-52, 9, 1, (52), (2014).
Crossref
Daniel Y Joh, Leonard N Chen, Gerald Porter, Aditi Bhagat, Sumit Sood, Joy S Kim, Rudy Moures, Thomas Yung, Siyuan Lei, Brian T Collins, Andrew W Ju, Simeng Suy, John Carroll, John H Lynch, Anatoly Dritschilo and Sean P Collins, Proctitis following stereotactic body radiation therapy for prostate cancer, Radiation Oncology, 9, 1, (2014).
Crossref
James A. Talcott, Judith Manola, Ronald C. Chen, Jack A. Clark, Irving Kaplan, Anthony V. D'Amico and Anthony L. Zietman, Using patient‐reported outcomes to assess and improve prostate cancer brachytherapy, BJU International, 114, 4, (511-516), (2014).
Wiley Online Library
Hiroyuki Katoh, Hiroshi Tsuji, Hitoshi Ishikawa, Tadashi Kamada, Masaru Wakatsuki, Naoki Hirasawa, Hiroyoshi Suzuki, Koichiro Akakura, Takashi Nakano, Jun Shimazaki and Hirohiko Tsujii, Health-related quality of life after carbon-ion radiotherapy for prostate cancer: A 3-year prospective study, International Journal of Urology, 21, 4, (370), (2014).
Crossref
Wee Loon Ong, Benjamin R. Hindson, Catherine Beaufort, Paul Pharoah and Jeremy L. Millar, Long-term erectile function following permanent seed brachytherapy treatment for localized prostate cancer, Radiotherapy and Oncology, 112, 1, (72), (2014).
Crossref
Marta Scorsetti, Filippo Alongi, Elena Clerici, Tiziana Comito, Antonella Fogliata, Cristina Iftode, Pietro Mancosu, Piera Navarria, Giacomo Reggiori, Stefano Tomatis, Elisa Villa and Luca Cozzi, Stereotactic body radiotherapy with flattening filter-free beams for prostate cancer: assessment of patient-reported quality of life, Journal of Cancer Research and Clinical Oncology, 140, 10, (1795), (2014).
Crossref
, Intensity-Modulated Radiation Therapy for Prostate Cancer, New England Journal of Medicine, 370, 7, (679), (2014).
Crossref
F. Peinemann, A. M. Labeit, C. Thielscher and M. Pinkawa, Failure to address potential bias in non-randomised controlled clinical trials may cause lack of evidence on patient-reported outcomes: a method study, BMJ Open, 4, 6, (e004720), (2014).
Crossref
Zaker Rana, Robyn A. Cyr, Leonard N. Chen, Brian S. Kim, Rudy A. Moures, Thomas M. Yung, Siyuan Lei, Brian T. Collins, Simeng Suy, Anatoly Dritschilo, John H. Lynch and Sean P. Collins, Improved Irritative Voiding Symptoms 3 Years after Stereotactic Body Radiation Therapy for Prostate Cancer, Frontiers in Oncology, 4, (2014).
Crossref
Mauro Gacci, Elisabetta Baldi, Lara Tamburrino, Beatrice Detti, Lorenzo Livi, Cosimo De Nunzio, Andrea Tubaro, Stavros Gravas, Marco Carini and Sergio Serni, Quality of Life and Sexual Health in the Aging of PCa Survivors, International Journal of Endocrinology, 10.1155/2014/470592, 2014, (1-16), (2014).
Crossref
Lara Bellardita, Silvia Villa and Riccardo Valdagni, Living with untreated prostate cancer, Current Opinion in Urology, 24, 3, (311), (2014).
Crossref
Stine E. Petersen, Sidse Bregendahl, Maria Langschwager, Søren Laurberg, Christina Brock, Asbjørn M. Drewes, Klaus Krogh, Morten Høyer and Lilli Lundby, Pathophysiology of late anorectal dysfunction following external beam radiotherapy for prostate cancer, Acta Oncologica, 53, 10, (1398), (2014).
Crossref
K E Bremner, N Mitsakakis, L Wilson and M D Krahn, Predicting utility scores for prostate cancer: mapping the Prostate Cancer Index to the Patient-Oriented Prostate Utility Scale (PORPUS), Prostate Cancer and Prostatic Diseases, 17, 1, (47), (2014).
Crossref
Andrew G. Matthew, Shabbir M. H. Alibhai, Tal Davidson, Kristen L. Currie, Haiyan Jiang, Murray Krahn, Neil E. Fleshner, Robin Kalnin, Alyssa S. Louis, B. Joyce Davison and John Trachtenberg, Health-related quality of life following radical prostatectomy: long-term outcomes, Quality of Life Research, 23, 8, (2309), (2014).
Crossref
Kimberly M. Davis, Scott P. Kelly, George Luta, Catherine Tomko, Anthony B. Miller and Kathryn L. Taylor, The Association of Long-term Treatment-related Side Effects With Cancer-specific and General Quality of Life Among Prostate Cancer Survivors, Urology, 84, 2, (300), (2014).
Crossref
Patrick E. Teloken and John P. Mulhall, Erectile Function Following Prostate Cancer Treatment: Factors Predicting Recovery, Sexual Medicine Reviews, 1, 2, (91-103), (2013).
Wiley Online Library
Giedrius Vanagas, Aušra Mickevičienė and Albertas Ulys, Does quality of life of prostate cancer patients differ by stage and treatment?, Scandinavian Journal of Public Health, 41, 1, (58), (2013).
Crossref
Dong Soo Park, In Hyuck Gong, Don Kyung Choi, Jin Ho Hwang, Hyun Soo Shin and Jong Jin Oh, Radical prostatectomy versus high dose permanent prostate brachytherapy using iodine-125 seeds for patients with high risk prostate cancer: a matched cohort analysis, World Journal of Urology, 31, 6, (1511), (2013).
Crossref
Sotaro Miwa, Atsushi Mizokami, Hiroyuki Konaka, Satoru Ueno, Yasuhide Kitagawa, Eitetsu Koh and Mikio Namiki, Prospective longitudinal comparative study of health-related quality of life and treatment satisfaction in patients treated with hormone therapy, radical retropubic prostatectomy, and high or low dose rate brachytherapy for prostate cancer, Prostate International, 1, 3, (117), (2013).
Crossref
Ryan P. Kopp, Lynn M. Marshall, Patty Y. Wang, Douglas C. Bauer, Elizabeth Barrett-Connor and J. Kellogg Parsons, The Burden of Urinary Incontinence and Urinary Bother Among Elderly Prostate Cancer Survivors, European Urology, 64, 4, (672), (2013).
Crossref
David Pfister, In favour of active surveillance—functional outcomes matter, Nature Reviews Urology, 10, 5, (263), (2013).
Crossref
Georgios Megas, Georgios Papadopoulos, Georgios Stathouros, Dimitrios Moschonas, Ioannis Gkialas and Konstantinos Ntoumas, Comparison of efficacy and satisfaction profile, between penile prosthesis implantation and oral PDE5 inhibitor Tadalafil therapy, in men with nerve‐sparing radical prostatectomy erectile dysfunction, BJU International, 112, 2, (E169-E176), (2012).
Wiley Online Library
Murray D. Krahn, Karen E. Bremner, Shabbir M. H. Alibhai, Andy Ni, George Tomlinson, Audrey Laporte and Gary Naglie, A reference set of health utilities for long-term survivors of prostate cancer: population-based data from Ontario, Canada, Quality of Life Research, 22, 10, (2951), (2013).
Crossref
C. Hennequin, L. Cormier, P. Richaud, C. Bastide, P. Beuzeboc, G. Fromont, P. Mongiat-Artus, M. Peyromaure, G. Ploussard, R. Renard-Penna, F. Rozet, M. Soulié and L. Salomon, Curiethérapie exclusive du cancer de la prostate par implants permanents : indications et résultats. Revue du CC-AFU, Progrès en Urologie, 23, 6, (378), (2013).
Crossref
Montse Ferrer, Ferran Guedea, José Francisco Suárez, Belén de Paula, Víctor Macías, Alfonso Mariño, Asunción Hervás, Ismael Herruzo, María José Ortiz, Javier Ponce de León, Gemma Sancho, Ana Boladeras, Adriana Ayala, Jordi Craven-Bratle, Mónica Ávila, Oriol Cunillera, Yolanda Pardo, Jordi Alonso and Ferran Aguiló, Quality of life impact of treatments for localized prostate cancer: Cohort study with a 5year follow-up, Radiotherapy and Oncology, 108, 2, (306), (2013).
Crossref
P.J. Hoskin, A.M. Rojas, P.J. Ostler, R. Hughes, G.J. Lowe and L. Bryant, Quality of Life after Radical Radiotherapy for Prostate Cancer: Longitudinal Study from a Randomised Trial of External Beam Radiotherapy Alone or in Combination with High Dose Rate Brachytherapy, Clinical Oncology, 25, 5, (321), (2013).
Crossref
Jean M. Mitchell, Urologists' Use of Intensity-Modulated Radiation Therapy for Prostate Cancer, New England Journal of Medicine, 369, 17, (1629), (2013).
Crossref
Olusola Obayomi-Davies, Leonard N Chen, Aditi Bhagat, Henry C Wright, Sunghae Uhm, Joy S Kim, Thomas M Yung, Siyuan Lei, Gerald P Batipps, John Pahira, Kevin G McGeagh, Brian T Collins, Keith Kowalczyk, Gaurav Bandi, Deepak Kumar, Simeng Suy, Anatoly Dritschilo, John H Lynch and Sean P Collins, Potency preservation following stereotactic body radiation therapy for prostate cancer, Radiation Oncology, 10.1186/1748-717X-8-256, 8, 1, (256), (2013).
Crossref
Andreas Stensvold, Alv A. Dahl, Bjørn Brennhovd, Milada Cvancarova Småstuen, Sophie D. Fosså, Wolfgang Lilleby, Andreas Steinsvik, Karol Axcrona and Sigbjørn Smeland, Bother problems in prostate cancer patients after curative treatment, Urologic Oncology: Seminars and Original Investigations, 31, 7, (1067), (2013).
Crossref
Randal H. Henderson, Bradford S. Hoppe, Robert B. Marcus, William M. Mendenhall, R. Charles Nichols, Zuofeng Li, Zhong Su, Christopher G. Morris, Christopher R. Williams, Joseph Costa and Nancy P. Mendenhall, Urinary functional outcomes and toxicity five years after proton therapy for low- and intermediate-risk prostate cancer: Results of two prospective trials, Acta Oncologica, 52, 3, (463), (2013).
Crossref
Nynikka R.A. Palmer, Janet A. Tooze, Aubrey R. Turner, Jianfeng Xu and Nancy E. Avis, African American prostate cancer survivors’ treatment decision-making and quality of life, Patient Education and Counseling, 90, 1, (61), (2013).
Crossref
Amr M. Emara, Eliot Chadwick, Jenny P. Nobes, Ather Mohamed Abdelbaky, Robert W. Laing and Stephen E.M. Langley, Long‐term toxicity and quality of life up to 10 years after low‐dose rate brachytherapy for prostate cancer, BJU International, 109, 7, (994-1000), (2011).
Wiley Online Library
Ruslan Korets, Catherine M. Seager, Max S. Pitman, Gregory W. Hruby, Mitchell C. Benson and James M. McKiernan, Effect of delaying surgery on radical prostatectomy outcomes: a contemporary analysis, BJU International, 110, 2, (211-216), (2011).
Wiley Online Library
Bryce B. Reeve, Angela M. Stover, Roxanne E. Jensen, Ronald C. Chen, Kathryn L. Taylor, Steven B. Clauser, Sean P. Collins and Arnold L. Potosky, Impact of diagnosis and treatment of clinically localized prostate cancer on health‐related quality of life for older Americans, Cancer, 118, 22, (5679-5687), (2012).
Wiley Online Library
Steffan Robstad Nilssen, Siv Mørkved, Mari Overgård, Stian Lydersen and Anders Angelsen, Does physiotherapist-guided pelvic floor muscle training increase the quality of life in patients after radical prostatectomy? A randomized clinical study, Scandinavian Journal of Urology and Nephrology, 46, 6, (397), (2012).
Crossref
Jeffrey Wu, Susan McCloskey and Michael L. Steinberg, Radiation Therapy for the Older Patient, Management of Cancer in the Older Patient, 10.1016/B978-1-4377-1398-5.10007-4, (65-77), (2012).
Crossref
Scott D. Ramsey, Steven B. Zeliadt, David K. Blough, Catherine R. Fedorenko, Megan E. Fairweather, Cara L. McDermott, David F. Penson, Stephen K. Van Den Eeden, Ann S. Hamilton and Neeraj K. Arora, Complementary and Alternative Medicine Use, Patient-reported Outcomes, and Treatment Satisfaction Among Men With Localized Prostate Cancer, Urology, 10.1016/j.urology.2012.01.023, 79, 5, (1034-1041), (2012).
Crossref
Stephen A. Boorjian, James A. Eastham, Markus Graefen, Bertrand Guillonneau, R. Jeffrey Karnes, Judd W. Moul, Edward M. Schaeffer, Christian Stief and Kevin C. Zorn, A Critical Analysis of the Long-Term Impact of Radical Prostatectomy on Cancer Control and Function Outcomes, European Urology, 61, 4, (664), (2012).
Crossref
Sheila Cameron, Colvin Springer, Susan Fox-Wasylyshyn and Maher M. El-Masri, A descriptive study of functions, symptoms, and perceived health state after radiotherapy for prostate cancer, European Journal of Oncology Nursing, 16, 3, (310), (2012).
Crossref
Katie Knapp, Bruce Cooper, Theresa Koetters, Janine Cataldo, Anand Dhruva, Steven M. Paul, Claudia West, Bradley E. Aouizerat and Christine Miaskowski, Trajectories and Predictors of Symptom Occurrence, Severity, and Distress in Prostate Cancer Patients Undergoing Radiation Therapy, Journal of Pain and Symptom Management, 10.1016/j.jpainsymman.2011.10.020, 44, 4, (486-507), (2012).
Crossref
J. Bergman and M. S. Litwin, Quality of Life in Men Undergoing Active Surveillance for Localized Prostate Cancer, JNCI Monographs, 10.1093/jncimonographs/lgs026, 2012, 45, (242-249), (2012).
Crossref
Jun Teishima, Hideo Iwamoto, Katsutoshi Miyamoto, Koichi Shoji, Hiroshi Masumoto, Shogo Inoue, Kanao Kobayashi, Mitsuru Kajiwara and Akio Matsubara, Impact of pre‐implant lower urinary tract symptoms on postoperative urinary morbidity after permanent prostate brachytherapy, International Journal of Urology, 19, 12, (1083-1089), (2012).
Wiley Online Library
Ronald C. Chen, Yuanye Zhang, Ming‐Hui Chen, Elizabeth McMahon, Marian Loffredo, Carol P. McPherson, Angela U. Nguyen, Paul L. Nguyen and Anthony V. D'Amico, Patient‐reported quality of life during radiation treatment for localized prostate cancer: results from a prospective phase II trial, BJU International, 110, 11, (1690-1695), (2012).
Wiley Online Library
George R. Schade, Jill Keller, Kim Ives, Xu Cheng, Thomas J. Rosol, Evan Keller and William W. Roberts, Histotripsy Focal Ablation of Implanted Prostate Tumor in an ACE-1 Canine Cancer Model, The Journal of Urology, 188, 5, (1957), (2012).
Crossref
E. David Crawford, Kyle O. Rove, Edouard J. Trabulsi, Junqi Qian, Krystyna P. Drewnowska, Jed C. Kaminetsky, Thomas K. Huisman, Mark L. Bilowus, Sheldon J. Freedman, W. Lloyd Glover and David G. Bostwick, Diagnostic Performance of PCA3 to Detect Prostate Cancer in Men with Increased Prostate Specific Antigen: A Prospective Study of 1,962 Cases, The Journal of Urology, 188, 5, (1726), (2012).
Crossref
Andreas Stensvold, Alv A. Dahl, Bjørn Brennhovd, Milada Cvancarova, Sophie D. Fosså, Wolfgang Lilleby, Karol Axcrona and Sigbjørn Smeland, Methods for prospective studies of adverse effects as applied to prostate cancer patients treated with surgery or radiotherapy without hormones, The Prostate, 72, 6, (668), (2012).
Crossref
Michael A Diefenbach, Nihal E Mohamed, Brian P Butz, Natan Bar-Chama, Richard Stock, Jamie Cesaretti, Waleed Hassan, David Samadi and Simon J Hall, Acceptability and Preliminary Feasibility of an Internet/CD-ROM-Based Education and Decision Program for Early-Stage Prostate Cancer Patients: Randomized Pilot Study, Journal of Medical Internet Research, 14, 1, (e6), (2012).
Crossref
Michael E. Galbraith, Laura Hays and Tanya Tanner, What Men Say About Surviving Prostate Cancer: Complexities Represented in a Decade of Comments, Clinical Journal of Oncology Nursing, 16, 1, (65), (2012).
Crossref
Andrea A. Thornton, Martin A. Perez, Sindy Oh and Laura Crocitto, Optimism and Prostate Cancer-Specific Expectations Predict Better Quality of Life after Robotic Prostatectomy, Journal of Clinical Psychology in Medical Settings, 19, 2, (165), (2012).
Crossref
Alan Katz, Montserrat Ferrer and José Suárez, Comparison of quality of life after stereotactic body radiotherapy and surgery for early-stage prostate cancer, Radiation Oncology, 7, 1, (194), (2012).
Crossref
Peter F. Orio, Gregory S. Merrick, Robert W. Galbreath, Wayne M. Butler, Jonathan Lief and Kent E. Wallner, Patient-reported long-term rectal function after permanent interstitial brachytherapy for clinically localized prostate cancer, Brachytherapy, 11, 5, (341), (2012).
Crossref
B. Joyce Davison and S. Larry Goldenberg, Patient acceptance of active surveillance as a treatment option for low‐risk prostate cancer, BJU International, 108, 11, (1787-1793), (2011).
Wiley Online Library
Michael J. Zelefsky, Yoshiya Yamada, Xin Pei, Margie Hunt, Gilad Cohen, Zhigang Zhang and Marco Zaider, Comparison of Tumor Control and Toxicity Outcomes of High-dose Intensity-modulated Radiotherapy and Brachytherapy for Patients With Favorable Risk Prostate Cancer, Urology, 77, 4, (986), (2011).
Crossref
Katsuyoshi Hashine, Akihito Yuasa, Kensuke Shinomori, Iku Ninomiya, Masaaki Kataoka and Natsumi Yamashita, Health‐related quality of life after radical retropubic prostatectomy and permanent prostate brachytherapy: A 3‐year follow‐up study, International Journal of Urology, 18, 12, (813-819), (2011).
Wiley Online Library
Shunichi Namiki and Yoichi Arai, Sexual quality of life for localized prostate cancer: a cross‐cultural study between Japanese and American men, Reproductive Medicine and Biology, 10, 2, (59-68), (2011).
Wiley Online Library
Renuka Malik, Ashesh B. Jani and Stanley L. Liauw, External Beam Radiotherapy for Prostate Cancer: Urinary Outcomes for Men With High International Prostate Symptom Scores (IPSS), International Journal of Radiation Oncology*Biology*Physics, 80, 4, (1080), (2011).
Crossref
Ranko Miocinovic, Ryan K. Berglund, Andrew J. Stephenson, J. Stephen Jones, Amr Fergany, Jihad Kaouk and Eric A. Klein, Avoiding Androgen Deprivation Therapy in Men With High-risk Prostate Cancer: The Role of Radical Prostatectomy as Initial Treatment, Urology, 77, 4, (946), (2011).
Crossref
M. Nicole Lamb, Lucrecia Trabinino and Alan Hackford, Patientsʼ Perspectives on Fecal Incontinence After Brachytherapy for Localized Prostate Cancer, Diseases of the Colon & Rectum, 54, 5, (615), (2011).
Crossref
Amitabh Chandra, David Cutler and Zirui Song, Who Ordered That? The Economics of Treatment Choices in Medical Care, , 10.1016/B978-0-444-53592-4.00006-2, (397-432), (2011).
Crossref
Chao-Pin Hsiao, Ida M. Moore, Kathleen C. Insel and Carrie J. Merkle, High Perceived Stress Is Linked to Afternoon Cortisol Levels and Greater Symptom Distress in Patients With Localized Prostate Cancer, Cancer Nursing, 34, 6, (470), (2011).
Crossref
June M. Chan, Vivian Weinberg, Mark J. Magbanua, Eduardo Sosa, Jeffry Simko, Katsuto Shinohara, Scot Federman, Mike Mattie, Millie Hughes-Fulford, Christopher Haqq and Peter R. Carroll, Nutritional supplements, COX-2 and IGF-1 expression in men on active surveillance for prostate cancer, Cancer Causes & Control, 22, 1, (141), (2011).
Crossref
K. Steenland, M. Goodman, J. Liff, C. DiIorio, S. Butler and P. Roberts, Quality of Life Among Men With Prostate Cancer in Rural Georgia, Urology, 77, 4, (927), (2011).
Crossref
Jonathan D. Grant, Mark S. Litwin, Lorna Kwan, Steve P. Lee, Michael L. Steinberg and Christopher R. King, Does Hormone Therapy Exacerbate the Adverse Effects of Radiotherapy in Men With Prostate Cancer? A Quality of Life Study, The Journal of Urology, 185, 5, (1674), (2011).
Crossref
R. Kirschner-Hermanns, T. Klementz, A. Haselhuhn, G. Jakse, A. Heidenreich and B. Brehmer, Drangsymptomatik nach onkologisch erfolgreicher Prostatakarzinomtherapie, Der Urologe, 50, 11, (1412), (2011).
Crossref
Shunichi Namiki, Tatsuo Tochigi, Shigeto Ishidoya, Akihiro Ito, Isao Numata and Yoichi Arai, Long-term quality of life following primary treatment in men with clinical stage T3 prostate cancer, Quality of Life Research, 20, 1, (111), (2011).
Crossref
Michaella M. Prasad, Sandip M. Prasad, Nathanael D. Hevelone, Xiangmei Gu, Aaron C. Weinberg, Stuart R. Lipsitz, Ganesh S. Palapattu and Jim C. Hu, REVIEW: Utilization of Pharmacotherapy for Erectile Dysfunction Following Treatment for Prostate Cancer, The Journal of Sexual Medicine, 7, 3, (1062-1073), (2010).
Wiley Online Library
Shunichi Namiki and Yoichi Arai, Health‐related quality of life in men with localized prostate cancer, International Journal of Urology, 17, 2, (125-138), (2009).
Wiley Online Library
Jonathan Bergman, Christopher S. Saigal, Lorna Kwan and Mark S. Litwin, Responsiveness of the University of California-Los Angeles Prostate Cancer Index, Urology, 75, 6, (1418), (2010).
Crossref
Anurag K. Singh, Terry L. Mashtare, Susan A. McCloskey, Stefanie A. Seixas-Mikelus, Hyung L. Kim and Kilian Salerno May, Increasing Age and Treatment Modality Are Predictors for Subsequent Diagnosis of Bladder Cancer Following Prostate Cancer Diagnosis, International Journal of Radiation Oncology*Biology*Physics, 78, 4, (1086), (2010).
Crossref
John B. Malcolm, Michael D. Fabrizio, Bethany B. Barone, Robert W. Given, Raymond S. Lance, Donald F. Lynch, John W. Davis, Mark E. Shaves and Paul F. Schellhammer, Quality of Life After Open or Robotic Prostatectomy, Cryoablation or Brachytherapy for Localized Prostate Cancer, The Journal of Urology, 183, 5, (1822), (2010).
Crossref
Ellen M.A. Roeloffzen, Irene M. Lips, Marion P.R. van Gellekom, Joep van Roermund, Steven J. Frank, Jan J. Battermann and Marco van Vulpen, Health-Related Quality of Life up to Six Years After 125I Brachytherapy for Early-Stage Prostate Cancer, International Journal of Radiation Oncology*Biology*Physics, 76, 4, (1054), (2010).
Crossref
Kristie Howlett, Theresa Koetters, Janet Edrington, Claudia West, Steven Paul, Kathryn Lee, Bradley E. Aouizerat, William Wara, Patrick Swift and Christine Miaskowski, Changes in Sexual Function on Mood and Quality of Life in Patients Undergoing Radiation Therapy for Prostate Cancer, Oncology Nursing Forum, 37, 1, (E58), (2010).
Crossref
O. Simonin, P.-H. Savoie, G. Serment, F. Bladou and G. Karsenty, Incontinence urinaire après prostatectomie ouverte ou laparoscopique pour cancer prostatique localisé. Une revue de la littérature, Progrès en Urologie, 20, 4, (239), (2010).
Crossref
Mark S. Litwin, Editorial Comment, Urology, 75, 2, (437), (2010).
Crossref
Alex Shteynshlyuger and Gerald L. Andriole, Prostate Cancer: To Screen or Not to Screen?, Urologic Clinics of North America, 37, 1, (1), (2010).
Crossref
Svetomir Dragićević, Tamara Naumović, Ivan Soldatović, Sava Mićić, Cane Tulić and Tatjana Pekmezović, Evaluation of Health-Related Quality of Life in Patients with Prostate Cancer after Treatment with Radical Retropubic Prostatectomy and Permanent Prostate Brachytherapy, Urologia Internationalis, 85, 2, (173), (2010).
Crossref
Jesse D. Le, Matthew R. Cooperberg, Natalia Sadetsky, Adam B. Hittelman, Maxwell V. Meng, Janet E. Cowan, David M. Latini and Peter R. Carroll, Changes in specific domains of sexual function and sexual bother after radical prostatectomy, BJU International, 106, 7, (1022-1029), (2010).
Wiley Online Library
Yong Li, Paul J. Cozzi and Pamela J. Russell, Promising tumor‐associated antigens for future prostate cancer therapy, Medicinal Research Reviews, 30, 1, (67-101), (2009).
Wiley Online Library
J. Kellogg Parsons, Lorna Kwan, Sarah E. Connor, David C. Miller and Mark S. Litwin, Prostate cancer treatment for economically disadvantaged men, Cancer, 116, 5, (1378-1384), (2010).
Wiley Online Library
F. Joly, A.-C. Degrendel and A.-V. Guizard, Qualité de vie après radiothérapie pour un cancer localisé de la prostate, Cancer/Radiothérapie, 14, 6-7, (519), (2010).
Crossref
George J. Huang, Natalia Sadetsky and David F. Penson, Health Related Quality of Life for Men Treated for Localized Prostate Cancer With Long-Term Followup, The Journal of Urology, 183, 6, (2206), (2010).
Crossref
Kathryn L. Taylor, Kimberly M. Davis, Tara Lamond, Randi M. Williams, Marc D. Schwartz, William Lawrence, Shibao Feng, Susan Brink, Amy Birney, John Lynch, James Regan and Anatoly Dritschilo, Use and Evaluation of a CD-ROM-Based Decision Aid for Prostate Cancer Treatment Decisions, Behavioral Medicine, 36, 4, (130), (2010).
Crossref
Nobumichi Tanaka, Kiyohide Fujimoto, Isao Asakawa, Akihide Hirayama, Tatsuo Yoneda, Katsunori Yoshida, Yoshihiko Hirao, Masatoshi Hasegawa and Noboru Konishi, Variations in health-related quality of life in Japanese men who underwent iodine-125 permanent brachytherapy for localized prostate cancer, Brachytherapy, 9, 4, (300), (2010).
Crossref
Peter C. Albertsen, The Unintended Burden of Increased Prostate Cancer Detection Associated With Prostate Cancer Screening and Diagnosis, Urology, 75, 2, (399), (2010).
Crossref
Martin G. Sanda, Urinary Obstructive Problems Exposed But Hormonal Health-Related Quality-of-Life Concerns Eschewed in Prostate Cancer Quality-of-Life Study, Journal of Clinical Oncology, 28, 31, (4667), (2010).
Crossref
John L. Gore, Kiran Gollapudi, Jonathan Bergman, Lorna Kwan, Tracey L. Krupski and Mark S. Litwin, Correlates of Bother Following Treatment for Clinically Localized Prostate Cancer, The Journal of Urology, 184, 4, (1309), (2010).
Crossref
Yolanda Pardo, Ferran Guedea, Ferrán Aguiló, Pablo Fernández, Víctor Macías, Alfonso Mariño, Asunción Hervás, Ismael Herruzo, María José Ortiz, Javier Ponce de León, Jordi Craven-Bratle, José Francisco Suárez, Ana Boladeras, Àngels Pont, Adriana Ayala, Gemma Sancho, Evelyn Martínez, Jordi Alonso and Montserrat Ferrer, Quality-of-Life Impact of Primary Treatments for Localized Prostate Cancer in Patients Without Hormonal Treatment, Journal of Clinical Oncology, 28, 31, (4687), (2010).
Crossref
Shunichi Namiki, Shigeto Ishidoya, Sadafumu Kawamura, Tatsuo Tochigi and Yoichi Arai, Quality of life among elderly men treated for prostate cancer with either radical prostatectomy or external beam radiation therapy, Journal of Cancer Research and Clinical Oncology, 136, 3, (379), (2010).
Crossref
Scott D. Ramsey, Steven B. Zeliadt, Neeraj K. Arora, David K. Blough, David F. Penson, Ingrid Oakley-Girvan, Ann S. Hamilton, Stephen K. Van Den Eeden, Catherine R. Fedorenko and Arnold L. Potosky, Unanticipated and Underappreciated Outcomes During Management of Local Stage Prostate Cancer: A Prospective Survey, The Journal of Urology, 184, 1, (120), (2010).
Crossref
D. Palma, T. Pickles, M. Keyes and W.J. Morris, Reply, Urology, 73, 4, (866), (2009).
Crossref
Peter Branney, Alan White, Sunjay Jain, Chris Hiley and Paul Flowers, Choosing Health, Choosing Treatment: Patient Choice After Diagnosis of Localized Prostate Cancer, Urology, 74, 5, (968), (2009).
Crossref
Eric Meuleman, Editorial Comment on: Erectile Dysfunction After External Beam Radiotherapy for Prostate Cancer, European Urology, 55, 1, (234), (2009).
Crossref
Andrea Salonia, Re: Quality of Life and Satisfaction with Outcome among Prostate-Cancer Survivors, European Urology, 55, 2, (526), (2009).
Crossref
Michael Pinkawa, Karin Fischedick, Bernd Gagel, Marc D Piroth, Branka Asadpour, Jens Klotz, Holger Borchers, Gerhard Jakse and Michael J Eble, Impact of age and comorbidities on health-related quality of life for patients with prostate cancer: evaluation before a curative treatment, BMC Cancer, 9, 1, (2009).
Crossref
Patricia A. Parker, Curtis A. Pettaway, Richard J. Babaian, Louis L. Pisters, Brian Miles, Adoneca Fortier, Qi Wei, Danielle D. Carr and Lorenzo Cohen, The Effects of a Presurgical Stress Management Intervention for Men With Prostate Cancer Undergoing Radical Prostatectomy, Journal of Clinical Oncology, 27, 19, (3169), (2009).
Crossref
M D Krahn, K E Bremner, G Tomlinson and G Naglie, Utility and health-related quality of life in prostate cancer patients 12 months after radical prostatectomy or radiation therapy, Prostate Cancer and Prostatic Diseases, 12, 4, (361), (2009).
Crossref
C. Giberti, L. Chiono, Fabrizio Gallo, M. Schenone and E. Gastaldi, Radical retropubic prostatectomy versus brachytherapy for low-risk prostatic cancer: a prospective study, World Journal of Urology, 27, 5, (607), (2009).
Crossref
John L. Gore, Lorna Kwan, Steve P. Lee, Robert E. Reiter and Mark S. Litwin, Survivorship Beyond Convalescence: 48-Month Quality-of-Life Outcomes After Treatment for Localized Prostate Cancer, JNCI: Journal of the National Cancer Institute, 101, 12, (888), (2009).
Crossref
Eric M. Horwitz, Why External Beam Radiotherapy Is Treatment of Choice for Most Men With Early-stage Nonmetastatic Prostate Cancer, Urology, 73, 3, (470), (2009).
Crossref
L Fairley, M Baker, J Whiteway, W Cross and D Forman, Trends in non-metastatic prostate cancer management in the Northern and Yorkshire region of England, 2000–2006, British Journal of Cancer, 101, 11, (1839), (2009).
Crossref
Ronald C. Chen, Jack A. Clark and James A. Talcott, Individualizing Quality-of-Life Outcomes Reporting: How Localized Prostate Cancer Treatments Affect Patients With Different Levels of Baseline Urinary, Bowel, and Sexual Function, Journal of Clinical Oncology, 27, 24, (3916), (2009).
Crossref
Annika Waldmann, Volker Rohde, Karen Bremner, Murray Krahn, Thomas Kuechler and Alexander Katalinic, Measuring prostate-specific quality of life in prostate cancer patients scheduled for radiotherapy or radical prostatectomy and reference men in Germany and Canada using the Patient Oriented Prostate Utility Scale-Psychometric (PORPUS-P), BMC Cancer, 9, 1, (2009).
Crossref
William W. Wong, Sujay A. Vora, Steven E. Schild, Gary A. Ezzell, Paul E. Andrews, Robert G. Ferrigni and Scott K. Swanson, Radiation dose escalation for localized prostate cancer, Cancer, 115, 23, (5596-5606), (2009).
Wiley Online Library
Patrick Teloken, Guilherme Mesquita, Francesco Montorsi and John Mulhall, ORIGINAL RESEARCH—ED PHARMACOTHERAPY: Post‐Radical Prostatectomy Pharmacological Penile Rehabilitation: Practice Patterns Among the International Society for Sexual Medicine Practitioners, The Journal of Sexual Medicine, 6, 7, (2032-2038), (2009).
Wiley Online Library
K. Hashine, Y. Kusuhara, N. Miura, A. Shirato, Y. Sumiyoshi and M. Kataoka, Health-related Quality of Life using SF-8 and EPIC Questionnaires after Treatment with Radical Retropubic Prostatectomy and Permanent Prostate Brachytherapy, Japanese Journal of Clinical Oncology, 39, 8, (502), (2009).
Crossref
Soroush Rais-Bahrami, Manish A. Vira and Louis Potters, Radiation therapy approaches to the treatment of high-risk prostate cancer, Current Urology Reports, 10, 3, (187), (2009).
Crossref
Soroush Rais-Bahrami, Manish A. Vira and Louis Potters, Radiation therapy approaches to the treatment of high-risk prostate cancer, Current Prostate Reports, 7, 3, (95), (2009).
Crossref
G. Raynal, X. Tillou, F. Saint and J. Petit, La démarche de Santé publique en urologie, Progrès en Urologie, 19, 8, (538), (2009).
Crossref
Eddy Valgueblasse and Aurélien Descazeaud, Morbidité urinaire après radiothérapie externe et curiethérapie pour cancer de prostate cliniquement localisé, Progrès en Urologie - FMC, 19, 1, (F15), (2009).
Crossref
Ferran Guedea, Montserrat Ferrer, Joan Pera, Ferrán Aguiló, Anna Boladeras, José Francisco Suárez, Oriol Cunillera, Ferrán Ferrer, Yolanda Pardo, Evelyn Martínez and Montse Ventura, Quality of life two years after radical prostatectomy, prostate brachytherapy or external beam radiotherapy for clinically localised prostate cancer: the Catalan Institute of Oncology/Bellvitge Hospital experience, Clinical and Translational Oncology, 11, 7, (470), (2009).
Crossref
Mark S. Litwin, Improving the Utility of Quality-of-Life Data From Men With Prostate Cancer, Journal of Clinical Oncology, 27, 24, (3877), (2009).
Crossref
Itsuhiro Takizawa, Noboru Hara, Tsutomu Nishiyama, Masaaki Kaneko, Tatsuhiko Hoshii, Emiko Tsuchida and Kota Takahashi, Oncological results, functional outcomes and health-related quality-of-life in men who received a radical prostatectomy or external beam radiation therapy for localized prostate cancer: a study on long-term patient outcome with risk stratification, Asian Journal of Andrology, 11, 3, (283), (2009).
Crossref
Edan Y. Shapiro, Soroush Rais-Bahrami, Carol Morgenstern, Barbara Napolitano, Lee Richstone and Louis Potters, Long-Term Outcomes in Younger Men Following Permanent Prostate Brachytherapy, The Journal of Urology, 181, 4, (1665), (2009).
Crossref
Jonathan Bergman, John L. Gore, David F. Penson, Lorna Kwan and Mark S. Litwin, Erectile Aid Use by Men Treated for Localized Prostate Cancer, The Journal of Urology, 182, 2, (649), (2009).
Crossref
Ferran Guedea and Montse Ferrer, Spanish Researchers at the Forefront of Clinical Investigation: The case of quality of life in prostate cancer, Clinical and Translational Oncology, 11, 7, (403), (2009).
Crossref
Marc A. Dall’Era and Christopher J. Kane, Watchful waiting versus active surveillance: Appropriate patient selection, Current Prostate Reports, 7, 1, (5), (2009).
Crossref
William V. Shappley, Stacey A. Kenfield, Julie L. Kasperzyk, Weiliang Qiu, Meir J. Stampfer, Martin G. Sanda and June M. Chan, Prospective Study of Determinants and Outcomes of Deferred Treatment or Watchful Waiting Among Men With Prostate Cancer in a Nationwide Cohort, Journal of Clinical Oncology, 27, 30, (4980), (2009).
Crossref
Ryan T. Schulte, David P. Wood, Stephanie Daignault, Rajal B. Shah and John T. Wei, Utility of extended pattern prostate biopsies for tumor localization, Cancer, 113, 7, (1559-1565), (2008).
Wiley Online Library
Wesley M. White, Natalia Sadetsky, W. Bedford Waters, Peter R. Carroll and Mark S. Litwin, Quality of Life in Men With Locally Advanced Adenocarcinoma of the Prostate: An Exploratory Analysis Using Data From the CaPSURE Database, The Journal of Urology, 180, 6, (2409), (2008).
Crossref
Alan M. Nieder, Michael P. Porter and Mark S. Soloway, Radiation Therapy for Prostate Cancer Increases Subsequent Risk of Bladder and Rectal Cancer: A Population Based Cohort Study, The Journal of Urology, 180, 5, (2005), (2008).
Crossref
Naeem Bhojani, Paul Perrotte, Claudio Jeldres, Nazareno Suardi, Georg Hutterer, Shahrokh F. Shariat and Pierre I. Karakiewicz, ORIGINAL RESEARCH—MEN'S SEXUAL HEALTH: The Effect of Comorbidities and Socioeconomic Status on Sexual and Urinary Function in Men Undergoing Prostate Cancer Screening, The Journal of Sexual Medicine, 5, 3, (668-676), (2008).
Wiley Online Library
Marc A. Dall'Era, Badrinath R. Konety, Janet E. Cowan, Katsuto Shinohara, Frank Stauf, Matthew R. Cooperberg, Maxwell V. Meng, Christopher J. Kane, Nanette Perez, Viraj A. Master and Peter R. Carroll, Active surveillance for the management of prostate cancer in a contemporary cohort, Cancer, 112, 12, (2664-2670), (2008).
Wiley Online Library
Oren Cahlon, Margie Hunt and Michael J. Zelefsky, Intensity-Modulated Radiation Therapy: Supportive Data for Prostate Cancer, Seminars in Radiation Oncology, 10.1016/j.semradonc.2007.09.007, 18, 1, (48-57), (2008).
Crossref
E Ream, A Quennell, L Fincham, S Faithfull, V Khoo, J Wilson-Barnett and A Richardson, Supportive care needs of men living with prostate cancer in England: a survey, British Journal of Cancer, 98, 12, (1903), (2008).
Crossref
Marc A Dall'Era and Badrinath R Konety, Active surveillance for low-risk prostate cancer: selection of patients and predictors of progression, Nature Clinical Practice Urology, 5, 5, (277), (2008).
Crossref
Jodi Halpern and Robert M. Arnold, Affective Forecasting: An Unrecognized Challenge in Making Serious Health Decisions, Journal of General Internal Medicine, 23, 10, (1708), (2008).
Crossref
Marc A. Dall’Era and Christopher J. Kane, Watchful waiting versus active surveillance: Appropriate patient selection, Current Urology Reports, 9, 3, (211), (2008).
Crossref
K. Hashine, Y. Kusuhara, N. Miura, A. Shirato, Y. Sumiyoshi and M. Kataoka, A Prospective Longitudinal Study Comparing a Radical Retropubic Prostatectomy and Permanent Prostate Brachytherapy Regarding the Health-related Quality of Life for Localized Prostate Cancer, Japanese Journal of Clinical Oncology, 38, 7, (480), (2008).
Crossref
Lonneke V. van de Poll-Franse, Lorna Kwan, Robert E. Reiter, Steve P. Lee and Mark S. Litwin, The Influence of Cardiovascular Disease on Health Related Quality of Life in Men With Prostate Cancer: A 4-Year Followup Study, The Journal of Urology, 10.1016/j.juro.2007.11.086, 179, 4, (1362-1367), (2008).
Crossref
Kurt Fritzsche, Daniel Diederich and Wolfgang Schultze-Seemann, Psychoonkologie des Prostatakarzinoms, Zeitschrift für Psychosomatische Medizin und Psychotherapie, 54, 4, (329), (2008).
Crossref
Shunichi Namiki, Lorna Kwan, Marjorie Kagawa-Singer, Yoichi Arai and Mark S. Litwin, The Effect of Erectile Function on the Use of Phosphodiesterase-5 Inhibitors After Radical Prostatectomy in Japanese and U.S. Men, Urology, 71, 5, (901), (2008).
Crossref
Alon Z. Weizer and Maha H. Hussain, Prostate Cancer Prevention Trial, Wiley Encyclopedia of Clinical Trials, (1-7), (2008).
Wiley Online Library
David F. Penson, Quality of Life After Therapy for Localized Prostate Cancer, The Cancer Journal, 10.1097/PPO.0b013e3181570121, 13, 5, (318-326), (2007).
Crossref
Patrick C. Walsh, Theodore L. DeWeese and Mario A. Eisenberger, Localized Prostate Cancer, New England Journal of Medicine, 357, 26, (2696), (2007).
Crossref
Murielle Mimeault, Parmender P. Mehta, Ralph Hauke, Jean-Pierre Henichart, Patrick Depreux, Ming-Fong Lin and Surinder K. Batra, Improvement of cytotoxic effects induced by mitoxantrone on hormone-refractory metastatic prostate cancer cells by co-targeting epidermal growth factor receptor and hedgehog signaling cascades, Growth Factors, 25, 6, (400), (2007).
Crossref
, Quality of life after prostate cancer therapy is affected by the treatment method, Nature Clinical Practice Urology, 4, 8, (407), (2007).
Crossref
Frank Peinemann, Ulrich Grouven, Lars G Hemkens, Carmen Bartel, Holger Borchers, Michael Pinkawa, Axel Heidenreich, Stefan Sauerland and Frank Peinemann, Low-dose rate brachytherapy for men with localized prostate cancer, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD008871.pub2, (2011).
Crossref

Volume109, Issue11

1 June 2007

Pages 2239-2247

Cancer

Quality of life after surgery, external beam irradiation, or brachytherapy for early‐stage prostate cancer