Endocrine Abstracts

Introduction: Metastatic or locally advanced prostate cancer is treated with surgical or medical hormone therapy. Preservation of the patient’s quality of life is a major parameter that influences the management at this stage. Comparative studies between both types of hormone therapy that consider the patient’s quality of life are almost nonexistent. The objective of our study is to evaluate the impact of medical and surgical castration on the quality of life in patients with locally advanced or metastatic prostate cancer.

Methods: A retrospective and comparative study including 200 patients with locally advanced or metastatic prostate cancer. 90 patients had medical castration and 110 patients underwent surgical castration. They were questioned about their quality of life using the â€oeexpanded prostate cancer index composits which includes urinary, digestive, sexual and hormonal evaluation.

Results: The two groups were comparable about age, clinical examination, tumor staging, histological results and initial rate of PSA. The difference between the two groups was statistically significant concerning digestive and hormonal evaluation. Indeed, strangury was more frequently found in patients having medical castration (P=0.03). Intestinal transit disorders were also more frequently found in patients who had medical castration (P=0.03). Hot flashes were more frequent and embarrassing in patients having medical castration than patients having surgical castration (P=0.1 and 0.008 respectively). Nipple pain was more frequently found in patients with medical castration (P=0.02). The two groups were similar about sexual and urinary evaluation.

Conclusions: Surgical castration is as effective as medical castration and has the advantage of better preservation of the patient’s quality of life.