title: Health-Related Quality of Life After the Diagnosis of Locally Advanced or Advanced Prostate Cancer: A Longitudinal Study.
abstract: Approximately 20% of men with a diagnosis of prostate cancer present with locally advanced or advanced disease. Few studies consider longer-term impact of disease progression and treatment adverse effects on health-related quality of life (QoL) of these men.
  
  
  
  Describe changes in health-related QoL over 5 years for men with newly diagnosed locally advanced or advanced prostate cancer.
  
  
  
  Eighty-one men with locally advanced or advanced prostate cancer referred to the study by their treating urologist completed a self-administered questionnaire assessing distress, cancer-specific distress, decision regret, satisfaction with life, and global and disease-specific health-related QoL. Questionnaires were administered close to diagnosis (baseline), 2, 6, 12, 24, 36, 48, and 60 months' follow-up.
  
  
  
  Men were of mean age 68.3 (SD, 7.9) years and at mean of 31.9 (SD, 50.5) days postdiagnosis. The most common treatment received was androgen deprivation therapy (95.1%) or radiation therapy (79%). The proportion of men classified as distressed (Distress Thermometer) ranged from 46.3% (baseline) to 32.6% (60 months). Decrements in physical QoL were found at 2, 6, 12, 24, 36, and 48 months compared with baseline. Life satisfaction ratings were lower at 6 months compared with baseline. Sexual concerns were consistently high across the 5 years (Expanded Prostate Cancer Index Composite <30).
  
  
  
  In the context of advanced disease, results indicate that health-related QoL fluctuates from diagnosis to 5 years later. A substantial proportion remained distressed at 5-year follow-up.
  
  
  
  Care frameworks supporting ongoing assessment of health-related QoL concerns of men with advanced prostate cancer are needed with a particular focus on sexual adjustment.
authors.affiliation: Author Affiliations: Cancer Council Queensland, Brisbane, and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia (Ms Zajdlewicz and Dr Hyde and Prof Chambers); Department of Social and Behavioral Sciences, Temple University, Philadelphia, Pennsylvania (Prof Lepore); University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane (Prof Gardiner); and Prostate Cancer Foundation of Australia, Sydney, and Exercise Medicine Research Institute, Edith Cowan University, Perth (Prof Chambers), Australia.
authors.forename: Leah
authors.initials: L
authors.lastname: Zajdlewicz
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Hyde
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Lepore
authors.forename: Robert A
authors.initials: RA
authors.lastname: Gardiner
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Chambers
mesh_terms: D000368:Aged; D018450:Disease Progression; D000066498:Emotional Adjustment; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life / Q000523:psychology; D012725:Sexual Behavior / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome