Prostate and ovarian cancers are among the leading causes of death in Western countries. Applied preventive health strategies, including screening and early medical treatments either with prophylactic or curative intention, may substantially affect patients’ quality of life (QOL). This thesis focuses on the psychosocial and QOL issues involved in the evaluation of early-detected and treated prostate cancer among men in the general population, and in the evaluation of preventive health strategies for ovarian cancer among women at increased hereditary risk of developing the disease. The main objectives of this thesis are to determine the QOL effects of primary treatment for localized prostate cancer detected by screening or in a regular clinical setting, and to determine the QOL effects of prophylactic salpingo-oophorectomy (surgery) versus gynecological screening among high-risk women. Early-stage prostate cancer can be detected by means of prostate-specific antigen (PSA) testing, which potentially may lead to overdiagnosis and overtreatment, i.e. diagnosis and treatment of indolent tumors that might not ever become of clinical significance during the patient’s life. Two primary treatment modalities commonly applied for localized prostate cancer: radical prostatectomy and external beam radiotherapy are potentially curative, however, they may result in side-effects and impairment of QOL. The increased number of men with early diagnosis due to PSA testing may face these less favorable effects. Side-effects mainly concern erectile and urinary problems after prostatectomy, and bowel and erectile problems after irradiation. Decreased levels of urinary, bowel and sexual functioning after treatment are not related to the method of cancer detection (screen-detected vs. clinically diagnosed cancer). Women from hereditary breast/ovarian cancer families may opt either for periodic gynecological screening or prophylactic ovarian surgery to manage their cancer risk. In the face of uncertain efficacy of the currently available screening techniques and the established risk-reducing benefit of prophylactic oophorectomy for ovarian/breast cancer, carriers of BRCA1/BRCA2 gene mutations are usually advised to undergo prophylactic oophorectomy. Surgery does not appear to have any significant impact on generic QOL; it is associated with reduced cancer-specific distress and lower perceived risk of cancer. Unfavorable effects include a significant increase in endocrine and sexual symptoms. Although hormone replacement therapy has a positive impact on surgically-induced vasomotor symptoms, it may be less effective than is often assumed.

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Aaronson, Prof. Dr. N.K. (promotor), Dutch Cancer Society, Maas, Prof. Dr. P.J. van der (promotor)
N.K. Aaronson (Neil) , P.J. van der Maas (Paul)
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam

Madalinska, J. B. (2007, January 24). Psychosocial and Quality of Life Issues in Prostate and Ovarian Cancer. Retrieved from