The impact of androgen deprivation on quality of life after radical prostatectomy for prostate carcinoma.
BACKGROUND
Androgen deprivation is commonly prescribed for men with a rising prostate specific antigen level after radical prostatectomy, despite scant evidence regarding its efficacy and side effects. In the current study, the authors compared measures of health-related quality of life (HRQOL) in men who were treated with androgen deprivation after radical prostatectomy with those for men who underwent surgery but were not treated with androgen deprivation.


METHODS
Medicare Provider and Analysis and Review (MedPAR) files were used to identify men who had undergone radical prostatectomies between 1991-1992. Medicare Part B data then were used to select two samples: men who subsequently were androgen deprived and those who were not. In 1999, a mail survey was administered that addressed a range of disease-related and treatment-related issues, including HRQOL. Age-adjusted comparisons of responses to seven multiitem measures of HRQOL were performed.


RESULTS
The overall response rate was 82%. On all seven HRQOL measures (impact of cancer and treatment, concern regarding body image, mental health, general health, activity, worries about cancer and dying, and energy), there were statistically significant decrements associated with androgen deprivation.


CONCLUSIONS
Patients and physicians must weigh the price patients pay with regard to HRQOL against the uncertain benefits of early androgen deprivation.
Center for Survey Research, University of Massachusetts, Boston, Massachusetts, USA. mmcnaughtoncollins@partners.org
Floyd J
FJ
Fowler
Mary
M
McNaughton Collins
Elizabeth
E
Walker Corkery
Diana B
DB
Elliott
Michael J
MJ
Barry
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000009:adverse effects*; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D001294:Attitude to Health; D003131:Combined Modality Therapy; D003625:Data Collection; D006304:Health Status; D006801:Humans; D008297:Male; D009919:Orchiectomy / Q000009:adverse effects*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D017430:Prostate-Specific Antigen