title: Long-term health-related quality of life of prostate cancer survivors varies by primary treatment. Results from the PiCTure (Prostate Cancer Treatment, your experience) study.
abstract: OBJECTIVE
  Men are living longer with prostate cancer. In a two-country study, we investigated the health-related quality of life (HRQoL) of prostate cancer survivors up to 18 years post-diagnosis.
  
  
  METHODS
  Postal questionnaires were administered in 2012 to 6559 prostate cancer (ICD10 C61) survivors 2-18 years post-diagnosis, identified through population-based cancer registries in Ireland. HRQoL was measured using QLQ-C30 and QLQ-PR25. HRQoL, functional and symptom scores were compared by primary treatment(s) using multiple linear regression.
  
  
  RESULTS
  Fifty-four percent responded (n = 3348). After controlling for socio-demographic and clinical factors, global HRQoL varied significantly by primary treatment (p < 0.001); compared to radical prostatectomy (RP), survivors who received androgen deprivation therapy alone (ADT; p < 0.001) or external beam radiotherapy (EBRT) without concurrent ADT (p = 0.001) had significantly lower global HRQoL. The global HRQoL of men who received brachytherapy (p = 0.157), EBRT with concurrent ADT (p = 0.940) or active surveillance/watchful waiting (p = 0.388) was not significantly different from men treated with RP. There were statistically and clinically significant differences in general (fatigue, pain, dyspnoea, appetite loss, constipation, diarrhoea, financial difficulties) and disease-specific symptoms (sexual, urinary, bowel, ADT) by primary treatment. Fatigue and insomnia scores were high for survivors in all treatment groups.
  
  
  CONCLUSIONS
  Prostate cancer survivors' long-term HRQoL varied with primary treatment.
  
  
  CONCLUSIONS
  Population-based information regarding statistically and clinically significant treatment effects on long-term global HRQoL, symptom burden and functionality should be provided during treatment decision-making. Screening for symptoms and utilising interventions during long-term follow-up may improve survivors' HRQoL.
authors.affiliation: National Cancer Registry, Cork, Ireland, f.drummond@ncri.ie.
authors.forename: Frances Josephine
authors.initials: FJ
authors.lastname: Drummond
authors.forename: Heather
authors.initials: H
authors.lastname: Kinnear
authors.forename: Eamonn
authors.initials: E
authors.lastname: O'Leary
authors.lastname: Donnelly
authors.forename: Anna
authors.initials: A
authors.lastname: Gavin
authors.forename: Linda
authors.initials: L
authors.lastname: Sharp
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods* / Q000706:statistics & numerical data*; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D011468:Prostatectomy / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*