The impact of cancer treatment on quality of life outcomes for patients with localized prostate cancer

Purpose: We evaluated the impact of localized prostate cancer treatment on general, cancer specific and symptom domains of quality of life for up to 5 years after diagnosis. Materials and Methods: A total of 842 men from the Health Professionals Fol lowup Study, diagnosed between 1993 and 1998, were included in cross-sectio nal analyses of quality of life associated with prostate cancer treatment. A subset of 146 men diagnosed after 1995 were followed prospectively. Quali ty of life was assessed with the Medical Outcomes Study Short-Form 36 Healt h Status Survey, Cancer Rehabilitation Evaluation System Short Form and Uni versity of California Los Angeles Prostate Cancer Index by mailed questionn aires. Primary treatment modality was taken from medical records and patien t self-report. Results: Significant treatment differences were observed in all quality of life measures, with the largest occurring in sexual, urinary and bowel symp toms. Bowel function was significantly worse in patients who received exter nal radiation and brachytherapy compared with prostatectomy (p <0.05). Alth ough they had better or equivalent urinary and sexual function (p <0.05), p atients treated with external radiation, hormones or watchful waiting had l ower generic quality of life scores in multiple domains compared with those who underwent prostatectomy. Patients who had brachytherapy had similar ge neric quality of life outcomes compared with prostatectomy in all domains. Conclusions: Our findings suggest that important differences in quality of life go beyond known physical symptoms associated with various prostate can cer treatment options, many of which involve making a trade-off. It is impo rtant for patients with prostate cancer and health care providers to consid er these differences while making treatment decisions.