Early quality of life in patients with localized prostate carcinoma - An examination of treatment-related, demographic, and psychosocial factors

BACKGROUND. Men with localized prostate carcinoma are faced with important treatment decisions, and quality of life (QoL) information has become a cru cial element of decision making. The first objective of this study was to c ompare the early, health-related QoL (HRQoL) of men with localized prostate carcinoma who were treated with radical prostatectomy, external beam radio therapy, or brachytherapy. A second objective was to identify demographic a nd psychosocial variables that predict HRQoL. METHODS. Two-hundred fifty-six men with localized prostate carcinoma were i nterviewed within 7 weeks of treatment initiation. The interview included m easures of prostate-specific HRQoL (the University of California-Los Angele s Prostate Cancer Index), general HRQoL (the SF-36), and psychosocial varia bles. RESULTS. After adjusting for covariates, treatment group differences were f ound for both prostate specific HRQoL and general HRQoL. Men who underwent prostatectomy reported more urinary and sexual problems and more general ph ysical dysfunction compared with men who were treated with either form of r adiation therapy. Men who were treated with brachytherapy reported the fewe st problems in sexual function and the least general physical dysfunction. Few treatment group differences were found in mental functioning. Both demo graphic factors and psychosocial factors predicted HRQoL. Older men and Afr ican-American men reported more physical problems than younger men and Cauc asian men, respectively. A supportive social environment, high self-efficac y, and high self-esteem were predictive of better HRQoL. CONCLUSIONS. Shortly after undergoing treatment for localized prostate carc inoma, men who underwent radical prostatectomy, older men, and African-Amer ican men are at heightened risk for experiencing prostate-specific and gene ral deficits in HRQoL. Having psychosocial resources from which to draw may enhance HRQoL. (C) 2001 American Cancer Society.