Dt. Eton et al., Early quality of life in patients with localized prostate carcinoma - An examination of treatment-related, demographic, and psychosocial factors, CANCER, 92(6), 2001, pp. 1451-1459
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.