New research has underlined the importance of considering how comorbidities can influence the treatment and survival of patients with prostate cancer.
The most common type of cancer affecting Australian men, the risk of developing prostate cancer increases with age. Because of this, the likelihood that patients already live with another medical condition is also high.
Dr Tenaw Tiruye from the University of South Australia used data from more than 15,000 men to gain new insights into how comorbidities (living with more than one condition) can impact prostate cancer patients.
He analysed prescription data (using a measure known as Rx-Risk) rather than hospital admissions to get a fuller picture of how comorbidities can impact patients, ensuring that less serious conditions that might not cause hospitalisations were captured.
“A lot of the previous research has been based on hospital admission data, so we tried to use Pharmaceutical Benefits Scheme data to measure comorbidities,” Dr Tiruye said.
“We used the Rx-Risk index, which captures 46 chronic conditions, to measure what the impact of comorbidities would be on treatment selection and mortality.”
Patients with an Rx-Risk of three or higher, meaning they were on three or more types of medications for different health issues, were more likely to undergo radiotherapy or hormone therapy than surgery to remove the prostate.
These men were also more likely to die from prostate cancer.
Specific conditions like cardiac and respiratory disorders, diabetes and chronic pain were also likely to influence the treatment choice due to potential side-effects with existing medications.
The research also found pre-existing conditions like cardiac disorders, chronic airway disease and thrombosis can have an increased risk of prostate cancer mortality, while diabetes and chronic pain were low risk.
However, Dr Tiruye also found that the age of the patient can have a greater influence on treatment selection than the level of comorbidity.
“We compared older men with low comorbidity versus younger men with high comorbidity and found that older men with low comorbidity were less likely to have surgery while younger men with high comorbidity were more likely to have surgery. This implies some older ‘healthy’ men may be missing out on certain treatments,” he said.
“The findings underscore the importance of living a healthy lifestyle to reduce the burden of other chronic conditions and have better outcomes if diagnosed with prostate cancer,” he added.
These studies were made possible through the South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC), which is supported by Australian Prostate Cancer (APC).
Established in 1998, it is the longest running prostate cancer registry in Australia and contributes to a national database collected through the Prostate Cancer Outcomes Registry Australia & NZ.
To date more than 21,000 men from across the State have been added to the registry.
APC and The Hospital Research Foundation are a proud sponsor of the SA PCCOC registry.