Information and Resources from the U-M Comprehensive Cancer Center

Research Roundup

Men have overly optimistic expectations about recovery from prostate cancer surgery, U-M study finds

Nearly half of men undergoing surgery for prostate cancer expect better recovery from the side effects of the surgery than they actually attain one year after the operation, a University of Michigan Comprehensive Cancer Center study finds.

In addition, prior to surgery, a small proportion of men had expected to have better urinary continence and sexual function a year after the surgery than they had before it -- the opposite of what typically happens.

"This is a belief that does not reflect preoperative counseling, which, on the contrary, alerts men to urinary and sexual problems after surgery," says study author Daniela Wittmann, M.S.W, sexual health coordinator at the U-M Prostate Cancer Survivorship Program.

The study, published in a recent issue of the Journal of Urology, surveyed 152 men undergoing radical prostatectomy, an operation to remove the prostate. All of the men filled out questionnaires before surgery, after receiving preoperative counseling.

The study showed that for the most part, men's expectations of hormonal and bowel function matched what happened one year after surgery. But, when it came to urinary incontinence only 36% of the men's expectations corresponded to what happened one year post-surgery.

In addition, only 40% of men found what they expected for sexual function to be true one year post-surgery.

"When we provide preoperative education, we can only inform men in terms of overall statistics. We can't predict for the individual," Wittmann said. "This may mean that, if in doubt, people tend toward being hopeful and optimistic; perhaps overly optimistic."

The researchers suggest that it is important to provide men with tools for urinary and sexual recovery after surgery and with support that will lead to the best possible outcome. Patients who undergo surgery for prostate cancer at U-M participate in the Prostate Cancer Survivorship Program. The program includes partners as well. It is designed to provide men with excellent surgical care along with tailored, couples-oriented support both before and after surgery to help ease recovery from the side effects of surgery.

 

Thyroid cancer treatment varies by hospital, U-M study finds

Where thyroid cancer patients go for care plays a large role in whether they receive radioactive iodine treatment, a new study from the University of Michigan Comprehensive Cancer Center finds.

"What hospital you go to makes a difference in the use of radioactive iodine. It doesn't just matter what the tumor looks like, but where you go for care," says lead study author Megan Haymart, M.D., assistant professor of internal medicine at the U-M Medical School.

Results of the study appear in a recent issue of the Journal of the American Medical Association. Thyroid cancer is one of the 10 most common cancers in the United States and is expected to become even more common in the next decade as more early stage cancers are uncovered.

Radioactive iodine following surgery to remove the thyroid is known to be an effective treatment for advanced or high-risk thyroid cancer that is very likely to return. But patients with small, low-risk disease often have an excellent prognosis without radioactive iodine treatment.

Researchers looked at data from 189,219 patients diagnosed with thyroid cancer between 1990 and 2008, as reported to the National Cancer Database.

Researchers found that radioactive iodine treatment is being used more frequently overall -- 56% of patients in 2008, compared to 40% of patients in 1990. Size and severity of the tumor did impact a patient's likelihood to have radioactive iodine, accounting for about 21 percent of the variation in care.

In addition, factors such as whether the hospital saw a high volume of thyroid cancer patients played a role. But 29% of the variation between whether patients received radioactive iodine was attributable to hospital factors that could not be explained.

"Even among people who are high-risk -- and the guidelines are clear that these patients should receive radioactive iodine -- there is still variation," Haymart says. This suggests doctors are unclear about the indications for radioactive iodine. We need randomized clinical trials that look at radioactive iodine in low-risk patients so that we can set better guidelines for its use."

Radioactive iodine treatment can have long-term side effects, including risk of a second cancer or damage to nearby tissue such as salivary glands.

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