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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

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Abstract

Purpose

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.

Implications of Cancer Survivors

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.

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Acknowledgments

The authors would like to thank all the healthcare professionals who helped to screen the survivors for eligibility and those who cooperated with us in obtaining ethical approval. We would like to thank Dr. David Donnelly for the statistical analysis performed during the course of this study, Dr. Sandra Deady (NCRI) and Colin Fox (NICR) for data extraction and Joanne Clooney (NCRI), Claire O’Callaghan (NCRI) and Audrey Craven-Lynn (NICR) for their work in survey administration and data entry. Data entry was also undertaken by Patricia McDowell and Jonathan Mitchell in the NICR. We would like to thank the members of the Prostate Cancer Steering Committee and the Men Against Cancer (MAC) support group, all those who commented on the survey during development and those who pre-tested it. Finally, we would like to thank the men who completed the survey.

Conflict of interest

LS previously received an unrestricted project grant from Sanofi-Aventis to investigate treatment patterns in prostate cancer.

Author information

Authors and Affiliations

  1. National Cancer Registry, Cork, Ireland

    Frances Josephine Drummond, Eamonn O’Leary & Linda Sharp

  2. Northern Ireland Cancer Registry, Belfast, Northern Ireland

    Heather Kinnear,  Donnelly & Anna Gavin

Authors
  1. Frances Josephine Drummond
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  2. Heather Kinnear
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  3. Eamonn O’Leary
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  4. Donnelly
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  5. Anna Gavin
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Corresponding author

Correspondence to Frances Josephine Drummond.

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Drummond, F.J., Kinnear, H., O’Leary, E. et al. 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. J Cancer Surviv 9, 361–372 (2015). https://doi.org/10.1007/s11764-014-0419-6

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  • DOI: https://doi.org/10.1007/s11764-014-0419-6

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