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A 3-y prospective study of health-related and disease-specific quality of life in patients with nonmetastatic prostate cancer treated with radical prostatectomy or external beam radiotherapy

Prostate Cancer and Prostatic Diseases volume 7, pages 144–151 (2004)Cite this article

Abstract

We assessed the longitudinal alteration of the quality of life (QOL) of patients with localized prostate cancer after radical prostatectomy or hormonoradiotherapy during 3-y follow-up. In addition, we examined the impact on QOL of initiation of second treatment after failure of primary treatment. In all, 135 patients with localized prostate cancer who underwent radical retropubic prostatectomy (RP) (N=84) or external beam radiotherapy with neoadjuvant hormone (XRT) (N=51) at our institute and who had a minimum follow-up of 3 y were included in this study. Data were collected prospectively, at baseline, at 3 months after treatment, at 1 y, and annually thereafter. QOL, generic and disease-targeted was evaluated using the European Organization for Research and Treatment of Cancer Prostate Cancer QOL Questionnaire, the Sapporo Medical University Sexual Function Questionnaire, the International Prostate Symptom Index Quality of Life Score and similar questions regarding bowel function. Repeated-measures ANOVA revealed significantly different patterns of alteration in the domains of QOL, with the exception of several domains, between the RP and XRT groups. Rapid decline of sexual function and increase in sexual bothersomeness were followed by slight amelioration throughout follow-up in the RP group, and did not change thereafter in the XRT group. Overall satisfaction with urinary condition significantly improved after treatment and that with bowel condition was stable during follow-up in both of the groups. Failure of primary treatment and initiation of salvage treatment had no impact on QOL. This prospective study revealed longitudinal alteration of QOL status of patients undergoing treatment for localized prostate cancer, but did not yield any conclusions regarding effect of treatment failure and second treatment on QOL due to small sample size. It should be noted that different instruments for assessment of QOL can generate different outcomes.

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Acknowledgements

We thank Drs Hiroshi Maeda, Takashi Okada, Kazutoshi Okubo, Yoshitaka Aoki, Shinnya Maekawa, Yosuke Matsuta, Nobufumi Ueda, Naoki Terada, Hiroki Ohara, Noriaki Utsunomiya, and associated nurses for their assistance. This study was supported in part by a Grant-in-Aid for Cancer Research from the Ministry of Health and Welfare of Japan.

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Authors and Affiliations

  1. Department of Urology, Kurashiki Central Hospital, Sendai, Japan

    K Yoshimura, K Ichioka, Y Matsui & A Terai

  2. Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan

    Y Arai

  3. Department of Urology, Otsu Red Cross Hospital, Sendai, Japan

    K Ogura

Authors
  1. K Yoshimura
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  2. Y Arai
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  3. K Ichioka
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  4. Y Matsui
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  6. A Terai
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Corresponding author

Correspondence to Y Arai.

Appendix A: Questions regarding urinary and bowel symptoms

Appendix A: Questions regarding urinary and bowel symptoms

Urinary function

  • Does coughing and/or sneezing induce leakage of urine? 0: Not at all, 1: Rarely, 2: Sometimes, 3: Frequently, 4: Always

  • How many pairs of underwear or pads do you need to use because of leakage of urine? 0: Not at all, 1: One or less per day, 2: Two to four per day, 3: Five or more per day, 4: Large size diaper, always

  • If you were to spend the rest of your life with your urinary symptoms just as they are now, how would you feel about that? 0: Delighted, 1: Pleased, 2: Mostly satisfied, 3: Mixed, 4: Mostly dissatisfied, 5: Unhappy, 6: Terrible

Bowel function

  • Do you have bowel or intestinal bleeding? 1: Not at all, 2: A little, 3: Quite a bit, 4: Very much

  • Do you need to empty your bowel more than once a day? 1: Not at all, 2: A little, 3: Quite a bit, 4: Very much

  • Do you have pains in or around your anus? 1: Not at all, 2: A little, 3: Quite a bit, 4: Very much

  • If you were to spend the rest of your life with your bowel symptoms just as they are now, how would you feel about that? 0: Delighted, 1: Pleased, 2: Mostly satisfied, 3: Mixed, 4: Mostly dissatisfied, 5: Unhappy, 6: Terrible

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Yoshimura, K., Arai, Y., Ichioka, K. et al. A 3-y prospective study of health-related and disease-specific quality of life in patients with nonmetastatic prostate cancer treated with radical prostatectomy or external beam radiotherapy. Prostate Cancer Prostatic Dis 7, 144–151 (2004). https://doi.org/10.1038/sj.pcan.4500714

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