In a nutshell
This study examined health-related quality of life (HRQL) in patients receiving degarelix (Firmagon) or leuprorelin (Eligard) for advanced prostate cancer.
Some background
In some cases prostate cancer has spread through the wall of the prostate (locally advanced) or has spread to distant organs (metastatic prostate cancer). Research suggests that patients with locally advanced or metastatic prostate cancer can have decreased HRQL. A number of factors could be responsible for this: disease progression, stress due to rising PSA (prostate specific antigen; rising levels of PSA indicate that the cancer has returned) or adverse events following treatment.
Certain prostate cancers require androgens (male sex hormones such as testosterone) to grow. The drugs degarelix and leuprorelin are useful against this type of cancer as they reduce the production of testosterone which slows the cancer growth. This increases survival time for patients but can be associated with decreased HRQL.
Methods & findings
HRQL was examined in 408 patients with advanced prostate cancer. Patients received either degarelix or leuprorelin for 12 months. The 207 patients who received degarelix got one large dose (240 mg) for the first month and then 80 mg each month for 11 months. The 201 patients in the leuprorelin group received 7.5 mg every month for 12 months. HRQL was measured using questionnaires.
Increased PSA levels was linked to poorer HRQL in patients. Patients who did not have increased PSA levels had similar HRQL compared to males of the same age from the general population. This suggests that advanced prostate cancer itself does not affect HRQL or that the patients included in the trial were healthier than would be expected.
A significant decrease in quality of life measurements was also found in patients suffering from adverse events. These adverse events included muscle, bone or joint symptoms and cardiovascular symptoms.
There was a trend towards better HRQL in patients receiving degarelix compared to patients receiving leuprorelin. However, the results were not statistically significant.
The bottom line
The authors concluded that patients with progressed PSA status have a significantly lower quality of life than patients without PSA progression. Treatment with degarelix could improve HRQL as it reduces PSA progression.
The fine print
The follow up time for this study may have been too short to see all the effects of advance prostate cancer on HRQL.
Published By :
Journal of Urology
Date :
Sep 25, 2014
