Side-effects of treatment for localized prostate cancer: are they valued differently by patients and healthy controls?
OBJECTIVE
To determine how men treated for localized prostate cancer and who had permanent side-effects, and healthy controls, would value five descriptions of health states associated with side-effects of treatment for localized prostate cancer, hypothesising that patients would value the health states as less detrimental than men with no prostate cancer.


METHODS
In previous research, patients with prostate cancer reported high generic quality-of-life scores after primary treatment, despite side-effects; it was suggested that these patients accepted the side-effects, i.e. urinary, bowel and sexual dysfunction, as 'part of the bargain' because they felt they were saved from a life-threatening disease. Thus, we asked 54 men who had been treated for localized prostate cancer and had permanent side-effects, and 53 healthy controls, to value five descriptions of health states. All respondents valued all descriptions using two valuation methods, a visual analogue scale (VAS, range 0-100) and time trade-off (TTO, range 0-1). The respondent functioning was assessed using the EuroQol-5D, completed with items on urinary, bowel and sexual function.


RESULTS
Patients and healthy controls had similar valuations for nine of the 10 comparisons (five health states by two methods). Valuations in both groups resulted in the same ranking order of states on the TTO and one exchange in rank order on the VAS.


CONCLUSIONS
When asked to value five health states associated with side-effects of treatment for localized prostate cancer, there was no difference in the valuation of erectile, urinary and bowel dysfunction between patients with permanent side-effects after treatment and healthy controls. More likely explanations for the high generic quality-of-life scores after primary treatment for prostate cancer are a response shift and insensitivity of generic health-related quality-of-life measures.
Korfage
Ida J
IJ
Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
de Koning
Harry J
HJ
Habbema
J Dik F
JD
Schröder
Fritz H
FH
Essink-Bot
Marie-Louise
ML
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D001294:Attitude to Health; D006304:Health Status; D006801:Humans; D008297:Male; D010147:Pain Measurement; D011468:Prostatectomy / Q000009:adverse effects / Q000523:psychology; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life / Q000523:psychology*; D011878:Radiotherapy / Q000009:adverse effects / Q000523:psychology; D012002:Rectal Diseases / Q000209:etiology / Q000523:psychology; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology / Q000523:psychology
D000970:Antineoplastic Agents