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M S Litwin

Publications and source records attributed to M S Litwin.

At least 55 records · Page 3Linked to original sources
PubMed1999

Health related quality of life in older men without prostate cancer.

PURPOSE: We measured health related quality of life in a population of normal older men for use as controls in studies of older men treated for prostate cancer. MATERIALS AND METHODS: A statistically valid, population based sample of older men without prostate cancer completed a validated quality of life questionnaire that addressed impairment in the physical, mental, urinary, bowel and sexual domains. General and disease targeted health related quality of life was measured by the RAND 36-Item Health Survey and University of California, Los Angeles Prostate Cancer Index, respectively. RESULTS: Overall approximately a third of normal older men reported some degree of urinary leakage, while a third claimed some degree of rectal dysfunction and almost two-thirds acknowledged significant difficulty with erection. CONCLUSIONS: Older men in a randomly selected, population based sample do not have perfectly normal urinary continence, bowel function or sexual potency. By collecting data before treatment and following subjects longitudinally investigators may ensure that health related quality of life changes are analyzed in the context of any impairment that may have been present at baseline. If a longitudinal study is not feasible, a control group of men who are similar in age and other demographic variables must be used.

Age Factors↗
PubMed1999

Quality of life after salvage cryotherapy: the impact of treatment parameters.

PURPOSE: Cryotherapy has emerged as a promising salvage therapy option for treatment of locally recurrent prostate cancer after initial therapy. In this retrospective study we evaluate patient quality of life after salvage cryotherapy and correlate complications impairing quality of life with specific cryotherapy treatment parameters. MATERIALS AND METHODS: A modified UCLA Prostate Cancer Index measuring health related quality of life was sent to 150 patients who underwent salvage cryotherapy between July 1992 and April 1995. We evaluated the relationships among incontinence, pain, impotence, sloughing of tissue and problematic voiding symptoms, and cryotherapy treatment parameters, including use of a urethral warming catheter, number of cryotherapy probes and number of freeze-thaw cycles. We also evaluated patient overall degree of satisfaction with the procedure. RESULTS: Of 150 surveys 112 (74%) were returned. Mean followup was 16.7 months (range 0.5 to 31.5). Treatment without an effective urethral warming catheter was highly associated with urinary incontinence (p<0.003), perineal pain (p<0.001), tissue sloughing (p<0.003) and American Urological Association symptom score greater than 20 (p<0.004). Impotence was higher in the double freeze-thaw cycle group (p<0.05). Overall satisfaction with cryotherapy was 33%. CONCLUSIONS: Quality of life may be compromised by urinary incontinence, impotence, tissue sloughing, problematic voiding symptoms and/or perineal pain in a substantial number of patients following salvage cryotherapy. Effective urethral warming is essential in reducing complications and maximizing quality of life. Salvage cryotherapy does not appear to offer any quality of life advantages compared to salvage prostatectomy.

Adenocarcinoma↗
PubMed1999

Recovery of health related quality of life in the year after radical prostatectomy: early experience.

PURPOSE: We determined the temporal course of patient return to baseline quality of life after treatment with radical prostatectomy for early stage prostate cancer. MATERIALS AND METHODS: After establishing a longitudinal observational database of men undergoing radical retropubic prostatectomy we used established, validated quality of life questionnaires (RAND 36-Item Health Survey and University of California, Los Angeles Prostate Cancer Index) to document changes in general and disease specific health related quality of life (HRQOL). We assessed 90 patients at baseline before surgery and then at 3-month intervals for 1 year postoperatively. Logistic regression was used to explore predictors of the return to baseline. RESULTS: After prostatectomy patients had a significant decrease in all domains of HRQOL. Return to baseline was rapid in the general and bowel domains with at least two-thirds to three-fourths of patients reaching pretreatment levels within 6 months of surgery. Return to baseline was slower in the urinary and sexual function domains with 61 and 31% of the men, respectively, reaching pretreatment levels by 1 year after surgery. Of those who reached baseline the average intervals for the bowel, sexual and urinary domains were 5, 6 and 7 months, respectively. Married and white patients were more likely to achieve a return to baseline HRQOL during year 1 postoperatively. However, education level was inversely associated with the likelihood of returning to baseline. CONCLUSIONS: During the year after radical prostatectomy for early stage prostate cancer patient quality of life steadily improved. By 3 months postoperatively 30 to 40% of the patients had already recovered baseline levels of physical, mental and social functioning, and by 6 months more than 70% had reached baseline in the general HRQOL domains. By 12 months after surgery 86 to 97% of the patients had returned to baseline levels in each domain. Each domain continued to improve throughout the year. For the patients who reached baseline general HRQOL during followup average recovery time was 5 to 6 months.

Aged↗
PubMed1998

Dimensions of quality of life in prostate cancer.

PURPOSE: Quality of life research in prostate cancer involves the use of many questionnaires and specific items that may be partly redundant. We examine dimensions of quality of life in prostate cancer in the hope of somewhat simplifying communication of basic information. MATERIALS AND METHODS: We analyzed cross-sectional survey data on quality of life in patients with prostate cancer belonging to a Southern California HMO. Quality of life was assessed with the University of California, Los Angeles prostate cancer index. Scree plot and parallel analysis were used to identify factors for extraction and orthogonal (varimax) rotation to examine scale loadings. RESULTS: Four extracted factors explained a cumulative variance of 86%. The 8 physical and emotional scales loaded on 1 general factor explained 41% of the cumulative variance. Urinary function and bother, sexual function and bother, and bowel function and bother scales loaded on factors explained 16, 15 and 14% of the cumulative variance, respectively. CONCLUSIONS: The observation of only 1 general quality of life factor diverges from consistent previous observations of distinct physical and emotional factors in other types of patients, and the tight interaction of emotional and physical scales supports the vulnerability hypothesis, "with age the increasing interactions across dimensions of health leave a patient vulnerable in all when any is affected." The tight interaction of physical and emotional scales in these but not other patients opens the door theoretically to better evaluation of and targeting of health services for patients with prostate cancer.

Aged↗
PubMed1998

Differences in urologist and patient assessments of health related quality of life in men with prostate cancer: results of the CaPSURE database.

PURPOSE: We determine whether urologists caring for men with prostate cancer accurately captured the nuances of quality of life, as disclosed by patients in validated, self-administered health related quality of life instruments. MATERIALS AND METHODS: We analyzed information on 2,252 patients 42 to 95 years old enrolled in CaPSURE, a large, observational cancer of the prostate strategic urological research endeavor database, in which men with all stages of prostate cancer are followed quarterly with standardized validated written surveys to assess clinical parameters, symptoms and health related quality of life. At each visit urologists recorded Karnofsky performance status rating and the presence or absence of various symptoms, such as fatigue, pain and dysfunction in the sexual, urinary and bowel domains. Within 30 days of the visit patients independently completed self-administered health related quality of life instruments, including the RAND 36-Item Health Survey and University of California, Los Angeles Prostate Cancer Index, in which scores of 80 to 100 and 0 to 79 were interpreted as absence of impairment and moderate to severe impairment, respectively. Using chi-square analysis we compared symptoms, as recorded by the urologist, with health related quality of life impairment in relevant domains, as reported by the patient. RESULTS: Significant differences (p < or = 0.002) were noted between physician and patient assessment of clinical domains, such as physical, sexual, urinary and bowel function, fatigue and bone pain. In all domains urologists underestimated patient symptoms, causing health related quality of life impairment. CONCLUSIONS: In men with early stage and advanced prostate cancer physician ratings of patient symptoms do not correlate well with patient self-assessments of health related quality of life. Hence, urologists should attempt to elucidate more completely the components of patient quality of life after the diagnosis and treatment of prostate cancer.

Health Status Indicators↗
PubMed1998

Subspecialization, recruitment and retirement trends of American urologists.

PURPOSE: Trends of urology workforce, subspecialization, recruitment practices, retirement planning, practice characteristics and managed care impacts in the United States were assessed. MATERIALS AND METHODS: In February 1996 the executive interviewing branch of The Gallup Organization selected randomly and interviewed by telephone 507 practicing urologists in the United States who had provided urological patient care for more than 20 hours per week, practiced in 1995 and completed a urological residency program. RESULTS: Several important issues emerged. Urologists think we may be training too many urologists, subspecialty board certification would be a divisive issue to urology as a whole and 90% of urologists have an active retirement plan, although 23% are not funding the plan fully. CONCLUSIONS: The American Urological Association Gallup Poll, as refined by the Health Policy Survey and Research Committee, continues to be a unique and valuable tool in assessing practice patterns, gathering demographic data and measuring opinions of the American urologist. This information will help us chart our way to the twenty-first century.

Adult↗
PubMed1998

Transitions in health-related quality of life during the first nine months after diagnosis with prostate cancer.

Health-Related Quality of Life (HRQOL) is an important outcome measure in the study of prostate cancer. There are few data regarding the effect of sociodemographic variables, such as insurance status, educational level, marital status or income, on HRQOL. We examined whether these or other sociodemographic and clinical variables are predictive of HRQOL outcomes using an observational database of prostate cancer patients accrued from a wide array of clinical practice settings. We studied 131 patients with newly-diagnosed prostate cancer who had been followed for at least nine months. Patients were enrolled in CaPSURE(TM), a large, observational database of patients with prostate cancer. General and disease-specific HRQOL were measured with established, validated instruments at diagnosis and nine months later. Sociodemographic data and co-morbidity counts were recorded at baseline. Multivariate regression analysis was used to determine whether sociodemographic or clinical variables were predictive of baseline HRQOL or HRQOL changes during the study period. Several sociodemographic and clinical variables demonstrated significant associations with HRQOL. We found improvements in general and disease-specific domains of HRQOL during the nine months after diagnosis. For married patients, Emotional Well-Being and Family Functioning scores were better at baseline (+11.8, P<0.02), but Family Functioning declined over the nine month study period (-18.5, P=0.0006). Older patients had slightly better baseline performance in several domains of HRQOL, but experienced greater HRQOL decrements over time than did younger patients. Increasing comorbidity was associated with worse baseline general HRQOL. Early tumor stage was predictive of better scores in general HRQOL domains at baseline. Limited palpable disease stage (T2A/T2B) was predictive of worse Sexual Function and Sexual Bother at nine months (-8.6, P=0.04; -24, P=0.008). After initial decreases, patients appear to experience an improvement in general and disease-specific HRQOL within nine months of initial diagnosis with prostate cancer. Marital status is associated with better HRQOL, while advancing age is associated with more significant HRQOL declines over time. Patients with lower stage disease were noted to have better general HRQOL at baseline, although decreases in the physical domains were noted at nine months. These data shed new light on patients' experience with prostate cancer and suggest that HRQOL outcomes over time may occur in a predictable manner.

Journal Article↗
PubMed1998

Health-related quality of life in men with erectile dysfunction.

OBJECTIVE: To assess health-related quality of life (HRQOL) in men with erectile dysfunction. DESIGN: Descriptive survey with general and disease-specific measures. The instrument contained three established, validated HRQOL measures, a validated comorbidity checklist, and sociodemographics. The RAND 36-Item Health Survey 1.0 (SF-36) was used to assess general HRQOL. Sexual function and sexual bother were assessed using the UCLA Prostate Cancer Index. The marital interaction scale from the Cancer Rehabilitation Evaluation System Short Form (CARES-SF) was used to assess each patient's relationship with his sexual partner. SETTING: Urology clinics at a university medical center and the affiliated Veterans Affairs (VA) Medical Center. PARTICIPANTS: Thirty-five (67%) of 54 consecutive university patients presenting for erectile dysfunction and 22 (42%) of 52 VA patients who were awaiting a previously prescribed vacuum erection device participated. MAIN RESULTS: The university respondents scored slightly lower than population normals in social function, role limitations due to emotional problems, and emotional well-being. The VA respondents scored lower than expected in all eight domains. Scores for the VA population were significantly lower than those for the university population in physical function, role limitations due to physical problems, bodily pain, and social function. A significant correlation was seen between marital interaction and sexual function (r = -.33, p = .01) but not between marital interaction and sexual bother (r = -.15, p = .26) in the total sample. Sexual function also correlated significantly with general health perceptions (r = .34, p = .01), role limitations due to physical problems (r = .29, p = .03), and role limitations due to emotional problems (r = .30, p = .03). Sexual bother did not correlate with any of the general HRQOL domains. Affluent men reported better sexual function (p = .03). CONCLUSIONS: The emotional domains of the SF-36 are associated with more profound impairment than are the physical domains in men with erectile dysfunction. Erectile dysfunction and the bother it causes are discrete domains of HRQOL and distinct from each other in these patients. With increased attention to patient-centered medical outcomes, greater emphasis has been placed on such variables as HRQOL. This should be particularly true for a patient-driven symptom, such as erectile dysfunction.

Comorbidity↗
PubMed1998

Quality-of-life outcomes in long-term survivors of advanced prostate cancer.

The authors evaluate the temporal progression of health-related quality of life (HRQOL) in men treated hormonally with surgical or medical castration, as well as to see if either treatment would be associated with a greater impact on patients' quality of life. The authors assessed general and prostate-targeted HRQOL with two self-administered, validated instruments (the RAND 36-Item Health Survey and the UCLA Prostate Cancer Index) in a longitudinal, observational study of 63 men newly diagnosed with metastatic prostate cancer and treated with bilateral orchiectomy or combined androgen blockade with leuprolide and flutamide. Patients completed the two HRQOL instruments by mail at baseline and at 3- and 6-month intervals after initiation of treatment. Significant improvements were demonstrated in 10 of 14 HRQOL domains for all men during the first 12 months. These include all eight of the general HRQOL domains and the disease-specific domains that address bowel function. The authors identified no differences in any of the general or prostate-targeted HRQOL domains when comparing men who underwent orchiectomy versus combined androgen blockade. Patients with metastatic prostate cancer can be informed that general and prostate-specific HRQOL will be similar, regardless of whether they choose medical or surgical castration, and that health status will likely remain stable or improve during the initial months of treatment. Physicians must make patients aware of both the quantity and quality of life they can expect with advanced prostate cancer, and must actively involve them in their treatment decisions.

Aged↗
PubMed1998

The UCLA Prostate Cancer Index: development, reliability, and validity of a health-related quality of life measure.

OBJECTIVES: The need for accurate measures of health-related quality of life (HRQOL) in men treated for prostate cancer is of paramount importance because patients may survive for many years after their diagnosis. Hence, interest has increased in choosing treatments that optimize both the quality and quantity of life in patients with this disease. This study sought to develop and evaluate a self-administered, multiitem, disease-specific instrument to capture the health concerns central to the quality of life of men treated for early stage prostate cancer. METHODS: After focus group analysis and pilot testing, the instrument was tested with a large retrospective, cross-sectional survey. Exploratory factor analysis and multitrait scaling analysis were used to facilitate the formation of six scales containing 20 disease-targeted items that address impairment in the urinary, bowel, and sexual domains. The psychometric properties of the new scales were assessed by measuring test-retest reliability, internal consistency reliability, and construct validity. Performance on the new scales was compared with scores on other established cancer-related health-related quality of life instruments. Two hundred fifty-five long-term survivors of prostate cancer treatment and 273 age-matched and ZIP code-matched comparison subjects without prostate cancer from a large managed care population in California were studied. Mean age was 72.7 years. In addition to the new scales, the RAND 36-Item Health Survey (SF-36) was used as a generic core measure, and a cancer-related health-related quality of life instrument (the Cancer Rehabilitation System-Short Form) was used to provide construct validity. RESULTS: For the new scales, test-retest reliability ranged from 0.66 to 0.93, and internal consistency ranged from 0.65 to 0.93. Disease-targeted measures of function and bother in the three domains correlated substantially with one another. Scale scores correlated well with related, established scales. Men undergoing prostatectomy or pelvic irradiation demonstrated the expected differences in performance on the disease-specific health-related quality of life scales when compared with each other or with comparison subjects. Age was inversely related to sexual and bowel function. CONCLUSIONS: The UCLA Prostate Cancer Index performed well in this population of older men with and without prostate cancer. It demonstrated good psychometric properties and appeared to be well understood and easily completed. The high response among patients suggests that these men especially are interested in addressing both the general and disease-specific concerns that impact their daily quality of life.

Aged↗
PubMed1998

Epidemiological trends and financial outcomes in radical prostatectomy among Medicare beneficiaries, 1991 to 1993.

PURPOSE: We define epidemiological trends in radical prostatectomy among Medicare beneficiaries in the United States, describe related financial reimbursement to hospitals and physicians, and determine how many men received adjuvant therapy with androgen ablation or pelvic irradiation from 1991 to 1993. MATERIALS AND METHODS: We examined radical prostatectomy claims from a national 5% simple random sample (688,000 men) of 1991, 1992 and 1993 data on Medicare beneficiaries from the Health Care Financing Administration. We determined rates of radical prostatectomies among patients stratified by age, race and geographical region, and measured the fraction of men who had claims submitted for postoperative therapies for prostate cancer. We also collected financial information for Medicare parts A and B to estimate federal government economic burden from radical prostatectomy in this population. RESULTS: Among the 5,016 patients identified with Medicare claims for radical prostatectomy during 1991 to 1993 the rate peaked at 284/100,000 men in 1992 before declining the next year. For the youngest Medicare beneficiaries the rate increased 233% from 1991 to 1992 and 156% from 1992 to 1993. White men had a higher rate than nonwhite men in all 3 years but only in nonwhite men did the rate continue to rise during the study period. Geographical variations greater than 2-fold were noted. Total Medicare expenditures for radical prostatectomy were $194.2 million in 1991, $277.8 million in 1992 and $230.8 million in 1993. During 1991 to 1993 hospitals received more than three-fourths of total Medicare payments for radical prostatectomy, while physicians received less than one-fourth. More than 23% of men undergoing radical prostatectomy received subsequent therapy with gonadotropin releasing hormone agonists, bilateral orchiectomy and/or pelvic irradiation within 3 years of radical prostatectomy. CONCLUSIONS: Radical prostatectomy represents a significant burden on the federal health care dollar and does not appear to be as definitively curative as expected.

Age Factors↗
PubMed1997

Patient satisfaction with short stays for radical prostatectomy.

OBJECTIVES: We evaluated the effects on patient satisfaction of shortened postoperative hospital stays after radical retropubic prostatectomy (RRP). METHODS: A previously validated, self-administered instrument was used to assess satisfaction with care in a retrospective, cross-sectional study of 129 men who had undergone RRP after implementation of a short-stay clinical care pathway. Health-related quality of life outcomes, comorbidity, and sociodemographic data were also measured with established instruments. RESULTS: Satisfaction with care was uniformly high and did not vary with length of stay (LOS), time since surgery, or health-related quality of life. CONCLUSIONS: Decreased LOS mandated by the need for a cost-efficiency path does not adversely affect patient satisfaction.

Aged↗
PubMed1997

Measurement of health-related quality of life in men with prostate cancer: the CaPSURE database.

This paper reviews the reliability and validity of an instrument for assessing health-related quality of life (HRQOL) in CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor), an observational database of men with biopsy-confirmed prostate cancer. The questionnaire includes the RAND 36 item Health Survey 1.0, the UCLA Prostate Cancer Index and items measuring self-esteem and the impact of prostate cancer in general and on the family. The reliability and validity of this instrument are reported for a group of 2,382 men enrolled in CaPSURE. Individuals complete HRQOL questionnaires at enrollment and quarterly thereafter. The subscales of the instrument resulted in a high internal-consistency reliability across all subscales (range = 0.75-0.94). The test-retest reliability was good with the exception of the comparative health item (intraclass correlation coefficient (ICC) = 0.55). The concurrent validity data included moderately strong associations with subscales of similar concepts and the ability to distinguish between patients who are known to be different--newly diagnosed (within 6 months) and patients diagnosed and treated an average of 3 years ago. Overall, this instrument demonstrated good reliability and validity and supported the need for incorporating HRQOL as a component of outcomes assessment in the management of patients with prostate cancer.

Adult↗
PubMed1997

Health related quality of life outcomes in patients treated for metastatic kidney cancer: a pilot study.

PURPOSE: We assessed health related quality of life in patients with advanced renal cell carcinoma treated with nephrectomy and tumor infiltrating lymphocyte therapy in combination with interleukin-2. MATERIALS AND METHODS: A total of 20 patients with advanced renal cell carcinoma who underwent nephrectomy and combination immunotherapy with tumor infiltrating lymphocytes and interleukin-2 completed a retrospective, cross-sectional health related quality of life instrument. Established reference populations with other chronic medical conditions, or breast, prostate or other cancers were used for comparison of health related quality of life scores. General health related quality of life was measured with a RAND 36-Item Health Survey 1.0. Cancer targeted quality of life was measured with the Cancer Rehabilitation Evaluation System-Short Form. Sociodemographic and co-morbidity variables were also collected. RESULTS: General health related quality of life in patients treated with tumor infiltrating lymphocytes and interleukin-2 was significantly better than that in heart failure patients on 1 of 8 scales but significantly worse than in the general population on 6 of 8 scales. General health related quality of life in the former patients was also significantly worse than in those with hypertension on 5 of 8 scales and significantly worse than in diabetics on 2 scales. Cancer targeted health related quality of life in patients given immunotherapy was significantly better than in men with prostate cancer on 1 of 5 scales, significantly better than in women with breast cancer on 2 of 5 scales and significantly better than patients with other cancers (nonbreast and nonprostate) on 3 of 5 scales. CONCLUSIONS: Patients undergoing nephrectomy and adjuvant tumor infiltrating lymphocytes plus interleukin-2 therapy for advanced renal cell carcinoma report better health related quality of life than those with other malignancies and better physical function than patients with congestive heart failure. However, health related quality of life is worse than in the general population and similar or worse than in patients with hypertension or type II diabetes. This surveyed population is selective and may represent the best responders among survivors of a highly toxic therapy. Nevertheless, quality and quantity of life should be addressed with patients when considering immunotherapy for metastatic kidney cancer.

Carcinoma, Renal Cell↗
PubMed1996

Chronic expression of P-selectin on endothelial cells stimulated by the T-cell cytokine, interleukin-3.

P-selectin expressed on the surface of endothelium mediates leukocyte adhesion in vitro and rolling in vivo. Several inducers of cell-surface P-selectin expression on endothelial cells (EC) have previously been identified, all of which yield transient cell-surface expression of P-selectin lasting minutes to a few hours. We now show that a T-lymphocyte product, interleukin-3 (IL-3), stimulates the long-term endothelial cells (HUVEC). IL-3 induced cell-surface P-selectin expression in two phases. An initial peak at 10 minutes was followed by a prolonged upregulation beginning 16 hours after IL-3 addition and lasting at least 4 days. The level of P-selectin expression induced by IL-3 added for 48 hours was similar to that induced by treatment of HUVEC for 10 minutes with thrombin, and the effect of adding IL-3 for 48 hours followed by thrombin for 10 minutes was additive. Induction of cell-surface P-selectin expression by IL-3 was blocked by pretreatment of EC with a blocking monoclonal antibody against the IL-3 receptor alpha-chain. Lipopolysaccharide (LPS), tumor necrosis factor alpha (TNF alpha) and a mutant form of IL-3 with decreased potency did not induce cell-surface P-selectin expression after 48 hours' incubation with HUVEC, suggesting that the effect was specific to IL-3. The increase in cell-surface P-selectin expression occurring after 16 hours of incubation with IL-3 was accompanied by a similar prolonged increase in the steady-state mRNA level that was not observed at 10 minutes after IL-3 addition. As T-lymphocyte infiltration is a hallmark of chronic inflammation, our observations suggest that the secretion of IL-3 by T lymphocytes may serve to maintain the inflammatory state during chronic inflammation.

Cells, Cultured↗
PubMed1996

The CaPSURE database: a methodology for clinical practice and research in prostate cancer. CaPSURE Research Panel. Cancer of the Prostate Strategic Urologic Research Endeavor.

OBJECTIVES: Implicit in the modern concept of patient outcome assessment is a shift from primary reliance on clinical indicators to a broader definition that includes physical, psychological, and social well-being. This is especially true of prostate cancer, where treatment can profoundly alter patient well-being. We have initiated a longitudinal observational database, CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor) to document the impact of prostate cancer on resource utilization, clinical outcomes, health-related quality of life and survival in typical practice settings. METHODS: Observational databases have been used in the treatment of other conditions. We have incorporated many well-tested elements in our study. Data are collected from two sources: the physician and the patient. The urologist enrolls eligible patients into the study, completes a medical history, and records current status, treatment, and laboratory results at each office visit. Patients complete quarterly questionnaires on health-related quality of life, resource utilization, work loss, and satisfaction with care. RESULTS: Currently 21 sites participate in CaPSURE with 1419 patients enrolled by April 1996. Twenty percent of patients are newly diagnosed with prostate cancer. Time since diagnosis averages 3.0 years (SD = 3.1); mean age at diagnosis is 68.9 years (SD = 7.9, range = 39.6 to 90.7). The majority of patients (72%) are diagnosed with Stage B cancer. Patients receive a variety of treatments including surgery, irradiation, hormonal therapy, and watchful waiting. CONCLUSIONS: Information available from CaPSURE will assist practicing urologists who must make clinical decisions on the basis of data such as the results of treatment in typical care settings, the effect of prostate cancer and its treatment methods on patient quality of life, and the effect on health care costs of the early detection of prostate cancer.

Adult↗