What contributes more strongly to predicting QOL during 1-year recovery from treatment for clinically localized prostate cancer: 4-weeks-post-treatment depressive symptoms or type of treatment?
OBJECTIVE
Research on prostate cancer and quality of life (QOL) has focused on the effects of treatment type on subsequent QOL, without considering effects of depressive symptoms. The present purpose is to test the independent contribution of depressive symptoms (measured within 4 weeks after treatment) and treatment type in predicting QOL measured 4, 7, and 12 months following treatment for clinically localized prostate cancer.


METHODS
The 105 patients (all Stage I-II) were newly treated with radical prostatectomy, external beam radiation (EBR) or brachytherapy. Age ranged from 42 to 80 (mean = 64); 88% Caucasian and 9% African American. Repeated measures mixed linear models were adjusted for age, race, education, and marital status.


RESULTS
Depressive symptoms significantly (p < 0.01) predicted 8 of 10 disease-specific and 7 of 7 generic QOL outcomes. Treatment type significantly (p < 0.01) predicted urinary function and bowel bother but no generic QOL outcomes.


CONCLUSIONS
Depressive symptoms appears to predict a wider range of QOL outcomes (measured 4-12 months after treatment) than treatment type; however, when treatment is significant its effect sizes are slightly larger than depressive symptoms. Health care providers should (1) assess depressive symptoms in prostate cancer patients before and after treatment, and (2) provide psychosocial (e.g., counseling, support groups) and pharmacologic treatment options for improving depressive symptoms.
Monahan
Patrick O
PO
Department of Medicine, Indiana University School of Medicine, 1050 Wishard Blvd, RG 4101, Indianapolis, IN 46202-2872, USA. pmonahan@iupui.edu
Champion
Victoria
V
Rawl
Susan
S
Giesler
R Brian
RB
Given
Barbara
B
Given
Charles W
CW
Burns
Debra
D
Bigatti
Silvia
S
Reuille
Kristina M
KM
Azzouz
Faouzi
F
Wu
Jingwei
J
Koch
Michael
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D003863:Depression / Q000209:etiology* / Q000523:psychology; D003866:Depressive Disorder / Q000209:etiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery; D011788:Quality of Life; D012307:Risk Factors; D018434:Sickness Impact Profile; D013997:Time Factors; D016896:Treatment Outcome