Measuring patients' expectations regarding health-related quality-of-life outcomes associated with prostate cancer surgery or radiotherapy.
OBJECTIVE
Establishing realistic health-related quality-of-life (HRQOL) expectations before the choice of cancer treatment is made is an important goal of patient counseling. We prospectively studied the pretreatment expectations of prostate cancer-specific HRQOL with an adapted Expanded Prostate Cancer Index Composite instrument.


METHODS
Baseline pretreatment Expanded Prostate Cancer Index Composite scores, pretreatment expectation scores, and 1-year posttreatment scores were prospectively collected for 50 patients undergoing radical prostatectomy or external beam radiotherapy. The pretreatment expectations and observed HRQOL scores at 1 year after treatment were compared for the urinary incontinence, urinary irritation, bowel, sexual, and hormonal domains.


RESULTS
The expectation scores did not differ from the HRQOL scores at 1 year for urinary irritation, bowel function, and the hormonal domain. However, the sexual domain expectations were 22.5% greater than observed sexual domain scores 1 year after treatment (P <0.0001, 99% confidence interval 11 to 34) for both surgery and radiotherapy subjects. Anxiety, depression, education level, and income did not correlate with the expectations for HRQOL outcomes. A modest correlation was found between optimism and greater expectations for the sexual domain (Pearson correlation coefficient 0.38, P <0.001).


CONCLUSIONS
Measuring HRQOL expectations before treatment may elucidate discrepancies between patient expectations and observed outcomes. This pilot study found that patients' expectations regarding urinary and bowel outcomes more closely reflected their eventual observed outcome than did their expectations regarding sexual outcome.
Symon
Zvi
Z
Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan, USA. symonz@sheba.health.gov.il
Daignault
Stephanie
S
Symon
Rachel
R
Dunn
Rodney L
RL
Sanda
Martin G
MG
Sandler
Howard M
HM
D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000523:psychology / Q000532:radiotherapy / Q000601:surgery; D011788:Quality of Life; D012725:Sexual Behavior / Q000523:psychology; D016896:Treatment Outcome