Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Karin Ahlberg, University of Gothenburg, Sweden
- Second opponent: Senior Consultant Karin Agnethe Semb, Vestfold Hospital Trust, Tønsberg
- Third member and chair of the evaluation committee: Associate Professor Stig Müller, University of Oslo
Chair of the Defence
Professor II Viktor Berge, University of Oslo
Principal Supervisor
Chief Medical Officer, MD, PhD, Andreas Stensvold, Østfold Hospital Trust
Summary
Adverse effects, quality of life and satisfaction after curative treatment for prostate cancer – a Norwegian experience
The standard curative treatment options in Norway for prostate cancer are radical prostatectomy (RP) with or without post-operative pelvic radiotherapy (post-RP RT) or primary radiotherapy (prRT) with or without additional hormonal treatment.
The survival benefit of post-RP RT is unclear. Potential survival benefits must therefore be weighed against possible radiotherapy-induced adverse effects (AEs), which may impact negatively on patients’ health-related quality of life.
The aims of this thesis were to describe the use of post-RP RT in Norway and identify ‘risk factors’ for this additional treatment to RP (Paper I). The longitudinal study (Paper II) aimed to assess ‘real’ long-term AEs, using the EPIC-26 questionnaire, and explore the impact on health-related quality of life, using the SF-12 questionnaire. The third study of this thesis (Paper III) aimed to evaluate long-term satisfaction among prostate cancer survivors.
Of 6840 prostatectomized men, 17% had undergone post-RP RT during the nine-year observation period (January 2004 - December 2012). The majority received post-RP RT as a salvage strategy. Based on data routinely available at time of diagnosis (PSA, Gleason score and clinical risk group), the use of post-RP RT varied from 14% to 73%, the latter observed in a subgroup with clinical non organ-confined prostate cancer. Men who in addition to RP had undergone post-RP RT reported increased frequency and severity of long-term AEs compared to men receiving surgery alone, with negative - though limited - impact on their health-related quality of life. The majority of the long-term survivors reported satisfaction with the treatment (RP or prRT), most often followed up by their general practitioner. The factors most strongly associated with long-term satisfaction were sufficient information and good cooperation between the hospitals and general practitioners.
Additional information
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