Quality of life studied among prostate cancer survivors

Research carried out at the Beth Israel Deaconess Medical Centre, Boston, US, published this month in the New England Journal of Medicine, has identified several factors affecting quality of life in prostate cancer patients after their treatment.

These include detrimental affects on both urinary and sexual function. Researchers sought to identify determinants of health-related quality of life after primary treatment of prostate cancer and to measure the effects of such determinants on satisfaction with the outcome of treatment in patients and their spouses or partners.

They surveyed 1201 patients and 625 spouses or partners at multiple centres before and after radical prostatectomy, brachytherapy, or external-beam radiotherapy, evaluating factors that were associated with changes in quality of life within study groups and determined the effects on satisfaction with the treatment outcome.

Adjuvant hormone therapy for prostate cancer was associated with the worse affects across many quality of life areas patients receiving brachytherapy or radiotherapy. Patients in the brachytherapy group reported having long-lasting urinary irritation, bowel and sexual symptoms, and transient problems with vitality or hormonal function. Adverse side effects of the surgical removal of the prostate on sexual function were often mitigated by nerve-sparing procedures, it was found.

In some cases, the researchers found that after prostatectomy, urinary incontinence was observed, but urinary irritation and obstruction improved, particularly in patients with large prostates. The researchers found no record of treatment-related deaths with serious adverse events rare. Treatment related symptoms were often made worse by obesity, larger prostate size, high prostate-specific antigen score, and older age. It was found that black patients reported lower satisfaction with the degree of overall treatment side effects. Changes in quality of life were significantly associated with the degree of outcome satisfaction among patients and their spouses or partners.

The researchers concluded that each prostate-cancer treatment was associated with a distinct pattern of change in quality-of-life related to urinary, sexual, bowel, and hormonal function. These changes influenced satisfaction with treatment outcomes among patients and their spouses or partners.

For the full paper visit the New England Journal of Medicine website.