Long-Term Health-Related Quality of Life in Patients with Prostate Cancer after Treatment

Choe, Jin Ho; Lee, Hyun Moo; Chai, Soo Eung; Choi, Han Yong

Abstract

PURPOSE: The study of quality of life issues has been gaining importance because treatment significantly impacts on the ability of a patient to continue social and occupational activities. The impact of treatment modalities for localized or locally advanced prostate cancer on the quality of life of patients was compared.
MATERIALS AND METHODS
186 eligible patients with localized or locally advanced prostate cancer were enrolled from four treatment groups: radical prostatectomy (RP), external beam radiotherapy (EBRT), hormonal therapy (HT) and watchful waiting (WW). To compare changes in the Health Related Quality of Life (HRQoL) after treatment by these modalities, the patients were given questionnaires, with self-addressed, stamped envelopes, for completion and return both before and after treatment. The questionnaire was mailed to the patients that were followed up for more than 12 months after treatment. Finally, 98 patients (RP 36, EBRT 31, HT 13, and WW 18) remained on the study. The sexual, urinary and bowel functions, and certain aspects of the HRQoL of these treatment groups were examined. The general HRQoL was evaluated with the EORTC QLQ-C30 (version 3.0), and the prostate cancer-specific QoL measured using EORTC QLQ-PR25.
RESULTS
On global health status and functional scales, the RP group showed the worst progression in their mean scores between baseline and treatment, and had the worst urinary incontinence, erection and ejaculation problems of the groups. EBRT was associated with adverse bowel function, HT tended to produce more sexual functioning symptoms and WW had the least erection and ejaculation problems.
CONCLUSIONS
The assignment of patients to several treatment modalities entails different risks of erectile dysfunction, urinary leakage, and bowel dysfunction. These findings will help facilitate patient counseling with regard to the HRQoL expectations of patients.