QUALITY-OF-LIFE AND TREATMENT OUTCOMES - PROSTATE CARCINOMA PATIENTS PERSPECTIVES AFTER PROSTATECTOMY OR RADIATION-THERAPY

BACKGROUND. Of the estimated 317,000 men in the United States diagnose d with prostate carcinoma in 1996, 57% will have localized disease, an d their 5-year relative survival rate will be 98%. Limited information exists on patient-reported quality of life (QOL) and the incidence an d severity of treatment-related side effects. The purpose of this stud y was to identify and compare patients' self-reported QOL and treatmen t side effects 1-5 years after radical prostatectomy or radiotherapy. METHODS. Data collection for this cross-sectional study included a mai led, self-administered survey with three parts: a demographic survey, the Functional Assessment of Cancer Therapy-General (FACT-G), and a ne wly developed Prostate Cancer Treatment Outcome Questionnaire (PCTO-Q) . The FACT-G measured the effect of prostate carcinoma on overall QOL in the two treatment groups. The PCTO-Q assessed the patients' percept ions of the incidence and severity of specific changes in bowel, urina ry, and sexual functions. The test-retest reliability of the PCTO-Q in a pilot study was 91.2%. RESULTS. Two hundred seventy-four eligible m en completed the questionnaires; 132 (48%) reported having undergone p rostatectomy and 142 (52%) reported having undergone radiotherapy. Aft er age adjustment, the radiotherapy group reported more bowel dysfunct ion (P = 0.001), whereas the prostatectomy group reported more urinary problems (P = 0.03) and more sexual dysfunction (P = 0.001). Scores f or the FACT-G were similar in the two treatment groups. CONCLUSIONS. M en undergoing treatment for clinically localized prostate carcinoma co ntinue to experience difficulty long after treatment. In this study, t he prostatectomy group fared worse in regard to sexual and urinary fun ctions, whereas the radiotherapy group experienced more bowel dysfunct ion. Survivor-reported QOL and treatment outcomes can assist physician s in counseling patients in the selection of the preferred course of t reatment. (C) 1997 American Cancer Society.