Transitions in health-related quality of life during the first nine months after diagnosis with prostate cancer

Abstract

Health-Related Quality of Life (HRQOL) is an important outcome measure in the study of prostate cancer. There are few data regarding the effect of sociodemographic variables, such as insurance status, educational level, marital status or income, on HRQOL. We examined whether these or other sociodemographic and clinical variables are predictive of HRQOL outcomes using an observational database of prostate cancer patients accrued from a wide array of clinical practice settings.We studied 131 patients with newly-diagnosed prostate cancer who had been followed for at least nine months. Patients were enrolled in CaPSURE TM , a large, observational database of patients with prostate cancer. General and diseasespeci®c HRQOL were measured with established, validated instruments at diagnosis and nine months later. Sociodemographic data and co-morbidity counts were recorded at baseline. Multivariate regression analysis was used to determine whether sociodemographic or clinical variables were predictive of baseline HRQOL or HRQOL changes during the study period.Several sociodemographic and clinical variables demonstrated signi®cant associations with HRQOL. We found improvements in general and diseasespeci®c domains of HRQOL during the nine months after diagnosis. For married patients, Emotional Well-Being and Family Functioning scores were better at baseline ( 11.8, P`0.02), but Family Functioning declined over the nine month study period (À18.5, P 0.0006). Older patients had slightly better baseline performance in several domains of HRQOL, but experienced greater HRQOL decrements over time than did younger patients. Increasing comorbidity was associated with worse baseline general HRQOL. Early tumor stage was predictive of better scores in general HRQOL domains at baseline. Limited palpable disease stage (T2A/T2B) was predictive of worse Sexual Function and Sexual Bother at nine months (À8.6, P 0.04; À24, P 0.008).After initial decreases, patients appear to experience an improvement in general and disease-speci®c HRQOL within nine months of initial diagnosis with prostate cancer. Marital status is associated with better HRQOL, while advancing age is associated with more signi®cant HRQOL declines over time. Patients with lower stage disease were noted to have better general HRQOL at baseline, although decreases in the physical domains were noted at nine months. These data shed new light on patients' experience with prostate cancer and suggest that HRQOL outcomes over time may occur in a predictable manner.

Quality of life following prostate cancer treatments

“…They also found that men with higher education levels were less likely to have a return to baseline HRQOL. Penson et al [33] noted similar findings with regard to marital status. In addition, they found a relationship between income, insurance status, and certain HRQOL domains.…”

Racial Differences in Sexuality Profiles Among American, Japanese, and Japanese American Men with Localized Prostate Cancer

“…Partner characteristics might be considered a psychological factor. Prior reports from the Prostate Cancer Outcomes Study [33] and the CaPSURE data set [34] documented independent associations between sexuality and race/ethnicity and insurance status. Moreover, the age difference between patients and partners was a significant predictive factor of maintaining postoperative potency independent of the patient's age [35].…”

Social disparities and prostate cancer: mapping the gaps in our knowledge

“…Prostate cancer survival is clearly higher for married men [69] and, in the US, for men of higher SEP, but no association between survival and SEP was found in Canada [70]. Lower SEP is also associated with lower quality of life, both at diagnosis and following treatment [71], while being married is associated with a higher quality of life [72]. Prostate cancer mortality is also associated with lower family position [73].…”