Quality of life and treatment outcomes: prostate carcinoma patients' perspectives after prostatectomy or radiation therapy.
BACKGROUND
Of the estimated 317,000 men in the United States diagnosed with prostate carcinoma in 1996, 57% will have localized disease, and their 5-year relative survival rate will be 98%. Limited information exists on patient-reported quality of life (QOL) and the incidence and severity of treatment-related side effects. The purpose of this study was to identify and compare patients' self-reported QOL and treatment side effects 1-5 years after radical prostatectomy or radiotherapy.


METHODS
Data collection for this cross-sectional study included a mailed, self-administered survey with three parts: a demographic survey, the Functional Assessment of Cancer Therapy-General (FACT-G), and a newly developed Prostate Cancer Treatment Outcome Questionnaire (PCTO-Q). The FACT-G measured the effect of prostate carcinoma on overall QOL in the two treatment groups. The PCTO-Q assessed the patients' perceptions of the incidence and severity of specific changes in bowel, urinary, and sexual functions. The test-retest reliability of the PCTO-Q in a pilot study was 91.2%.


RESULTS
Two hundred seventy-four eligible men completed the questionnaires; 132 (48%) reported having undergone prostatectomy and 142 (52%) reported having undergone radiotherapy. After age adjustment, the radiotherapy group reported more bowel dysfunction (P = 0.001), whereas the prostatectomy group reported more urinary problems (P = 0.03) and more sexual dysfunction (P = 0.001). Scores for the FACT-G were similar in the two treatment groups.


CONCLUSIONS
Men undergoing treatment for clinically localized prostate carcinoma continue to experience difficulty long after treatment. In this study, the prostatectomy group fared worse in regard to sexual and urinary functions, whereas the radiotherapy group experienced more bowel dysfunction. Survivor-reported QOL and treatment outcomes can assist physicians in counseling patients in the selection of the preferred course of treatment.
Shrader-Bogen
C L
CL
Institute for Research and Education, Methodist Hospital Cancer Center, HealthSystem Minnesota, Minneapolis 55416, USA.
Kjellberg
J L
JL
McPherson
C P
CP
Murray
C L
CL
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000523:psychology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D003376:Counseling; D003430:Cross-Sectional Studies; D003672:Defecation; D003710:Demography; D006801:Humans; D015994:Incidence; D007410:Intestinal Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011468:Prostatectomy / Q000009:adverse effects / Q000523:psychology; D011471:Prostatic Neoplasms / Q000523:psychology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects / Q000523:psychology; D015203:Reproducibility of Results; D012647:Self-Assessment; D012723:Sex; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D015996:Survival Rate; D016896:Treatment Outcome; D014554:Urination; D014570:Urologic Diseases / Q000209:etiology