MP28-10: 10-year outcomes in work loss, physical function, and mental health of 6,693 men undergoing primary treatment for prostate cancer

Samuel Washington*, San Francisco, CA, Peter Lonergan, Dublin, Ireland, Janet Cowan, Shoujun Zhao, Scott Greenberg, Jenny Broering, Nynikka Palmer, Robert Parker, Alexander Bell, Matthew Cooperberg, Peter Carroll, San Francisco, CA

Introduction: Men with prostate cancer (PCa) often consider their work (time off) and health when choosing between management options. Using the CaPSURE database, we examine associations between PCa treatment and work loss, physical function, and mental health within ten years of initial management.

Methods: We identified men with PCa managed with radical prostatectomy (RP), external beam radiation therapy (EBRT), brachytherapy (BT), or active surveillance/watchful waiting (AS/WW), in a longitudinal study of 43 primarily community-based US urology practices. Data on work type [full-time, part-time, or retired/unemployed/disabled)], physical labor (PL, y/n), weeks of work missed, number of clinic visits annually, physical function (PF) and mental health (MH) were collected prior to treatment and 1,3,5 and 10 years after treatment. We examined associations between treatment and work weeks missed, PF, and MH using repeated measures GEE and generalized linear mixed modeling adjusted for clinical, health behaviors, and demographics. Estimates were reported as relative risk (RR) and 95% confidence intervals or slope and standard error (SE). A p<0.05 was significant.

Results: We identified 6,673 men, with mean age at diagnosis of 64.4 years (SD 8.3). Most were insured (54% private, 43% Medicare), white (90%, 7% Black, 1% Latino) with low- (60%) or intermediate-risk (32%) disease by CAPRA score. Most had paid work (44%) or were retired (45%) and underwent RP (62%, 14% BT, 14% EBRT, 10% AS/WW). Men missed median 5.3 weeks in first year (IQR 1.6-12.2) with up to 2.1 weeks missed at all other time points. Full-time work (RR 1.5, 95% 1.34-1.64), part time work (RR 1.19, CI 1.03-1.38), and PL (RR 1.17, 95% CI 1.05-1.30) conferred greater risk of long-term work loss. Full time (slope +17.7, SE 0.7) and part time work (slope +8.9, SE 0.9) maintained long-term PF. Treatment was not associated with long term work loss or changes in PF. MH was maintained with full time (slope +1.7, SE 0.5) and part time work (slope +2.3, SE 0.6). AS/WW (slope +1.5, SE 0.7) maintained MH while declining with BT (slope -0.8, SE 0.6) and EBRT (slope -0.9, SE 0.6).

Conclusions: Most men undergoing PCa treatment for PCa continued to miss work due to cancer care for years after treatment. Employment maintained MH and PF over time. Compared to RP, AS/WW maintained long-term MH scores while BT and RT noted declines over time. When counseling men, long-term impact of PCa treatment on work and health should be carefully discussed thoroughly.

Source of Funding: UCSF Goldberg-Benioff Program in Translational Cancer Biology