Burden of Illness in Prostate Cancer Patients with a Low-to-Moderate Risk of Progression: A One-Year, Pan-European Observational Study

Abstract

Objective. To assess the impact of low-to-moderate risk prostate cancer on patients' quality of life (QoL) at diagnosis and within the first year of treatment. Subjects and Methods. Men (n = 672) aged 50–75 years with prostate cancer (Gleason score ≤7, PSA ≤20 ng/mL and clinical staging T1c–T2b) were enrolled in five European countries. Patients completed five questionnaires, including EORTC Quality of Life Questionnaire—Prostate Cancer 25 (QLQ-PR25) and EORTC Quality of Life Questionnaire—Cancer 30 (QLQ-C30). Questionnaires were completed at baseline, at 3 months and 12 months after starting treatment. The primary endpoint was the change in QLQ-PR25 urinary symptoms subscale score from baseline to the assessment at 3 months. Results. Mean (SD) age was 65.0 (5.7) years and 400 (66%) men had Gleason score ≤6 prostate cancer. The most frequently used initial treatment was radical prostatectomy (71% of patients). QLQ-PR25 urinary symptoms subscale score was significantly increased at 3 months (P < 0.001), indicating that urinary symptoms worsened after treatment. The score was lower at 12 months than at 3 months, but it was still significantly higher than at baseline (P < 0.001). Hormonal treatment-related symptoms, sexual functioning, and sexual activity scores significantly worsened at 3 and 12 months (all P < 0.001). For the QLQ-C30 questionnaire, global health status/QoL score significantly decreased at month 3 but was not different from baseline by month 12. Scales for physical, role, and social functioning, and fatigue, showed significant deterioration at 3 and 12 months. Conclusions. Low-to-moderate risk prostate cancer may have a substantial effect on patients' QoL within one year following treatment.

Patients are dissatisfied with information provision: perceived information provision and quality of life in prostate cancer patients

“…The negative impact of prostate cancer and treatment‐related symptoms as urinary symptoms, bowel symptoms and sexual dysfunction on HRQoL is well described . In our study, we found a significant but weak correlation between global health and sexual activity, sexual functioning, urinary symptoms and incontinence ( r = −0.22, P < 0.002), confirming the earlier described findings.…”

“…For urinary symptoms and sexual function scales internal consistency is good (α = 0.70-0.86) [21]. The use of these questionnaires to assess the HRQoL in prostate cancer patients is internationally validated and well accepted in Europe as well in the Netherlands [22][23][24][25]. Internal consistency based on the current data was good for EORTC QLQ-C30 (α = 0.65-0.92).…”

Investigating the psychological impact of active surveillance or active treatment in newly diagnosed favorable‐risk prostate cancer patients: A 9‐month longitudinal study

“…The increase in AS patients' generalized anxiety symptoms over time contradicts previous research that reported declining anxiety in this group . Much of international AS research has been conducted on men being managed in centers with a strong focus on AS who have been refining and perfecting the diagnosis experience for almost two decades, and therefore AS is more widely accepted by clinicians and patients .…”

Including Health Economic Analysis in Pilot Studies: Lessons Learned from a Cost-Utility Analysis within the PROSPECTIV Pilot Study

“…This could suggest that the intervention is acting as a support, diminishing some of the overall impact of treatment and side effects on HRQoL. There is also evidence building across the literature, which suggests the EQ-5D instrument may not be sensitive enough to pick up changes in HRQoL for men with prostate cancer given the average age range of diagnosis (26,27). Hence the EQ-5D VAS scores may be more applicable to this analysis, which, when utilised, highlighted cost effectiveness.…”