Background:
Prostate cancer is the most commonly diagnosed cancer and second leading cause of cancer death among men in the US. Approximately three million prostate cancer survivors are living in the US according to 2014 estimate by American Cancer Society. Little is known about the risk factors and the causes of medical admissions associated with hospitalization of prostate cancer survivors. This study explores the pattern and prevalence of medical hospitalization among prostate cancer survivors especially evaluating them based on BMI and the influence of the modality of prostate cancer treatment on these hospitalizations.
Methods:
A retrospective review of medical records was performed at a single academic institute for all medical admissions for male patients aged 40 years and above who were diagnosed or treated for prostate cancer more than 2 years prior to the study enrollment and were admitted to the medicine services from January 1st 2008 to December 31st 2010. 461 admissions were eligible for study enrollment, of which 157 admissions were from patients with a single medical admission and 304 admissions were recurrent admissions from 88 patients. Therefore only the first medical admission for these 88 patients was accounted for the analysis, making 245 patients as the final study population. Unpaired t-test, ANOVA and Chi-square tests were used to compare characteristics, admission types, and medical comorbidities by BMI and prostate cancer treatment type.
Results:
The study population was stratified into two groups based on weight: non-obese with BMI less than 25 and overweight/obese with BMI ≥ 25. Most of the study population characteristics were similar except non-obese group had a higher frequency for history of hydronephrosis (p-value < 0.05) and obese group had higher frequency of incontinence (p-value < 0.05). Only 13% of the prostate cancer survivors were admitted for complaints related to genitourinary system. Overweight/obesity was not associated with the type of medical admissions including genitourinary system. Evaluation of the type of treatment for prostate cancer also showed no significant difference in the type of medical admissions, however patients who had received surgical treatment were younger (p-value <0.05) and had lower medical comorbidities burden (based on the Charlson Comorbidity Index) compared to the other groups.
Conclusions:
Although obesity is a risk factor for prostate cancer and can also influence the quality of life for prostate cancer survivors, our results show that overweight/obesity and type of treatment for prostate cancer were not associated with any specific pattern for systemic medical admissions, including the genitourinary system, among the prostate cancer survivors. Interestingly we noticed that hospital physicians infrequently documented prostate cancer in the assessment and plan of care for these encounters and rarely consulted oncology or urology services during these admissions.