TY - JOUR
T1 - Quality of life and satisfaction with outcome among prostate-cancer survivors
AU - Sanda, Martin G.
AU - Dunn, Rodney L.
AU - Michalski, Jeff
AU - Sandler, Howard M.
AU - Northouse, Laurel
AU - Hembroff, Larry
AU - Lin, Xihong
AU - Greenfield, Thomas K.
AU - Litwin, Mark S.
AU - Saigal, Christopher S.
AU - Mahadevan, Arul
AU - Klein, Eric
AU - Kibel, Adam
AU - Pisters, Louis L.
AU - Kuban, Deborah
AU - Kaplan, Irving
AU - Wood, David
AU - Ciezki, Jay
AU - Shah, Nikhil
AU - Wei, John T.
PY - 2008/3/20
Y1 - 2008/3/20
N2 - Background: We sought to identify determinants of health-related quality of life after primary treatment of prostate cancer and to measure the effects of such determinants on satisfaction with the outcome of treatment in patients and their spouses or partners. Methods: We prospectively measured outcomes reported by 1201 patients and 625 spouses or partners at multiple centers before and after radical prostatectomy, brachytherapy, or external-beam radiotherapy. We evaluated factors that were associated with changes in quality of life within study groups and determined the effects on satisfaction with the treatment outcome. Results: Adjuvant hormone therapy was associated with worse outcomes across multiple quality-of-life domains among patients receiving brachytherapy or radiotherapy. Patients in the brachytherapy group reported having long-lasting urinary irritation, bowel and sexual symptoms, and transient problems with vitality or hormonal function. Adverse effects of prostatectomy on sexual function were mitigated by nerve-sparing procedures. After prostatectomy, urinary incontinence was observed, but urinary irritation and obstruction improved, particularly in patients with large prostates. No treatment-related deaths occurred; serious adverse events were rare. Treatment-related symptoms were exacerbated by obesity, a large prostate size, a high prostate-specific antigen score, and older age. Black patients reported lower satisfaction with the degree of overall treatment outcomes. Changes in quality of life were significantly associated with the degree of outcome satisfaction among patients and their spouses or partners. Conclusions: Each prostate-cancer treatment was associated with a distinct pattern of change in quality-of-life domains related to urinary, sexual, bowel, and hormonal function. These changes influenced satisfaction with treatment outcomes among patients and their spouses or partners.
AB - Background: We sought to identify determinants of health-related quality of life after primary treatment of prostate cancer and to measure the effects of such determinants on satisfaction with the outcome of treatment in patients and their spouses or partners. Methods: We prospectively measured outcomes reported by 1201 patients and 625 spouses or partners at multiple centers before and after radical prostatectomy, brachytherapy, or external-beam radiotherapy. We evaluated factors that were associated with changes in quality of life within study groups and determined the effects on satisfaction with the treatment outcome. Results: Adjuvant hormone therapy was associated with worse outcomes across multiple quality-of-life domains among patients receiving brachytherapy or radiotherapy. Patients in the brachytherapy group reported having long-lasting urinary irritation, bowel and sexual symptoms, and transient problems with vitality or hormonal function. Adverse effects of prostatectomy on sexual function were mitigated by nerve-sparing procedures. After prostatectomy, urinary incontinence was observed, but urinary irritation and obstruction improved, particularly in patients with large prostates. No treatment-related deaths occurred; serious adverse events were rare. Treatment-related symptoms were exacerbated by obesity, a large prostate size, a high prostate-specific antigen score, and older age. Black patients reported lower satisfaction with the degree of overall treatment outcomes. Changes in quality of life were significantly associated with the degree of outcome satisfaction among patients and their spouses or partners. Conclusions: Each prostate-cancer treatment was associated with a distinct pattern of change in quality-of-life domains related to urinary, sexual, bowel, and hormonal function. These changes influenced satisfaction with treatment outcomes among patients and their spouses or partners.
UR - http://www.scopus.com/inward/record.url?scp=40949147326&partnerID=8YFLogxK
U2 - 10.1056/NEJMoa074311
DO - 10.1056/NEJMoa074311
M3 - Article
C2 - 18354103
AN - SCOPUS:40949147326
SN - 0028-4793
VL - 358
SP - 1250
EP - 1261
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 12
ER -