The burden of prostate cancer from diagnosis until death

To quantify the need for treatment and care in patients with conservatively treated prostate cancer.

All men who had been diagnosed with prostate cancer in a defined geographical area and who died within the period 1987-91 were identified. Patients treated with curative intent were excluded. Medical records from hospitals, nursing homes and community nurses for the period from diagnosis until death were scrutinized for the remaining 174 patients.

Of the 174 patients, 95% were symptomatic at diagnosis and 62% died from prostate cancer. All but two patients were hospitalized for prostate cancer, for a mean of 1 month. Thirty-six per cent needed regular nursing in nursing homes or by community nurses at home. Complications requiring hospitalization or long-term catheterization occurred in 49%. Prostatic surgery was performed in 66% and androgen ablation in 76% of the patients; palliative irradiation was given to 16% and 50% received analgesics regularly, including opiates or equivalents in 37%. Prednisone was given to 29%, after the failure of androgen ablation.

Our findings demonstrate the considerable burden imposed both on patients and health-care resources by symptomatic prostate cancer, conservatively treated. There are few data available for comparison.