title: General quality of life 2 years following treatment for prostate cancer: what influences outcomes? Results from the prostate cancer outcomes study.
abstract: OBJECTIVE
  The goal of this study was to determine the relationship between primary treatment, urinary dysfunction, sexual dysfunction, and general health-related quality of life (HRQOL) in prostate cancer.
  
  
  METHODS
  A sample of men with newly diagnosed prostate cancer between 1994 and 1995 was randomly selected from six population-based Surveillance, Epidemiology, and End Results registries. A baseline survey was completed by 2,306 men within 6 to 12 months of diagnosis, and these men also completed a follow-up HRQOL survey 2 years after diagnosis. Logistic regression models were used to determine whether primary treatment, urinary dysfunction, and sexual dysfunction were independently associated with general HRQOL outcomes approximately 2 years after diagnosis as measured by the Medical Outcomes Study 36-item Short Form Health Survey. The magnitude of this effect was estimated using least square means models.
  
  
  RESULTS
  After adjustment for potential confounders, primary treatment was not associated with 2-year general HRQOL outcomes in men with prostate cancer. Urinary function and bother were independently associated with worse general HRQOL in all domains. Sexual function and bother were also independently associated with worse general HRQOL, although the relationship was not as strong as in the urinary domains.
  
  
  CONCLUSIONS
  Primary treatment is not associated with 2-year general HRQOL outcomes in prostate cancer. Although both sexual and urinary function and bother are associated with quality of life, men who are more bothered by their urination or impotence are more likely to report worse quality of life. This implies that future research should be directed toward finding ways to improve treatment-related outcomes or help patients better cope with their posttreatment urinary or sexual dysfunction.
authors.affiliation: Section of Urology, VA Puget Sound Health Care System and the Department of Urology, University of Washington, Seattle, WA 98108, USA. penson@u.washington.edu
authors.forename: David F
authors.initials: DF
authors.lastname: Penson
authors.forename: Ziding
authors.initials: Z
authors.lastname: Feng
authors.forename: Alan
authors.initials: A
authors.lastname: Kuniyuki
authors.forename: Dale
authors.initials: D
authors.lastname: McClerran
authors.forename: Peter C
authors.initials: PC
authors.lastname: Albertsen
authors.forename: Dennis
authors.initials: D
authors.lastname: Deapen
authors.forename: Frank
authors.initials: F
authors.lastname: Gilliland
authors.forename: Richard
authors.initials: R
authors.lastname: Hoffman
authors.forename: Robert A
authors.initials: RA
authors.lastname: Stephenson
authors.forename: Arnold L
authors.initials: AL
authors.lastname: Potosky
authors.forename: Janet L
authors.initials: JL
authors.lastname: Stanford
mesh_terms: D000368:Aged; D003672:Defecation; D007172:Erectile Dysfunction / Q000209:etiology; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D011788:Quality of Life; D016896:Treatment Outcome; D014554:Urination; D014555:Urination Disorders / Q000209:etiology