QUALITY-OF-LIFE OUTCOMES IN LONG-TERM SURVIVORS OF ADVANCED PROSTATE-CANCER

The authors evaluate the temporal progression of health-related qualit y of life (HRQOL) in men treated hormonally with surgical or medical c astration, as well as to see if either treatment would be associated w ith a greater impact on patients' quality of life. The authors assesse d general and prostate-targeted HRQOL with two self-administered, vali dated instruments (the RAND 36-Item Health Survey and the UCLA Prostat e Cancer Index) in a longitudinal, observational study of 63 men newly diagnosed with metastatic prostate cancer and treated with bilateral orchiectomy or combined androgen blockade with leuprolide and flutamid e. Patients completed the two HRQOL instruments by mail at baseline an d at 3- and 6-month intervals after initiation of treatment. Significa nt improvements were demonstrated in 10 of 14 HRQOL domains for all me n during the first 12 months. These include all eight of the general H RQOL domains and the disease-specific domains that address bowel funct ion. The authors identified no differences in any of the general or pr ostate-targeted HRQOL domains when comparing men who underwent orchiec tomy versus combined androgen blockade. Patients with metastatic prost ate cancer can be informed that general and prostate-specific HRQOL wi ll be similar, regardless of whether they choose medical or surgical c astration, and that health status will likely remain stable or improve during the initial months of treatment. Physicians must make patients aware of both the quantity and quality of life they can expect with a dvanced prostate cancer, and must actively involve them in their treat ment decisions.