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Quality of life for men receiving a second treatment for prostate cancer: data from CaPSURE.

Latini-D; Arredondo-S; Sadetsky-N; Kawakami-J; Carroll-P
Oncol Nurs Forum 2007 Jan; 34(1):210-211
We assessed the impact of second treatment on health-related quality of life (HRQOL) for men with prostate cancer. This is an important issue because second treatment resulting from PSA recurrence has the potential to further negatively impact HRQOL and affect the overall value of treatment. We build on the results of 2 small cross-sectional studies by examining HRQOL longitudinally for RP patients without recurrent disease compared with RP patients who received a second treatment for recurrent disease. This longitudinal approach allowed us to examine HRQOL before initial treatment for PCa as well as post-recurrence to understand whether men who will eventually recur and receive a second treatment present with poorer baseline HRQOL. We report descriptive results from a longitudinal, observational national registry of men with localized prostate cancer. We compared differences in HRQOL before and after second treatment for men who had asymptomatic PSA recurrence (N=175) with those who did not have biochemical failure (N=722). We examined HRQOL at baseline with a model adjusting for baseline clinical and sociodemographic characteristics. Longitudinal changes in HRQOL were evaluated using a repeated-measures approach for each HRQOL domain. Men in this analysis (N=897) had localized disease, initially underwent radical prostatectomy (RP) monotherapy, and completed at least one pre- and post-RP HRQOL questionnaire. The Medical Outcomes Survey Short Form-36 and UCLA Prostate Cancer Index were used to measure HRQOL. Associations between patient groups and time interval on HRQOL were analyzed using repeated measures. Men who received a second treatment presented with more severe disease before RP and had worse general HRQOL. Although HRQOL differed signifi cantly over time for the 2 groups, most domains for the second treatment group improved or remained stable until 15 months before second treatment, at which point they declined. Scores in the Sexual Functioning and Role-Physical domains showed both clinically and statistically signifi cant patterns of decline over time. HRQOL is affected following second treatment but starts to decline approximately 1 year before second treatment. Not all aspects of HRQOL declined at the same rate, so patients should be counseled that certain domains may be affected more by additional treatment.
Biological-effects; Mathematical-models; Medical-monitoring; Medical-surveys; Medical-treatment; Men; Physiological-effects; Physiological-measurements; Physiological-response; Prostate-cancer; Qualitative-analysis; Quality-standards; Questionnaires; Statistical-analysis; Surgery
David Latini, Baylor College of Medicine and MEDVAMC, Houston, TX 77030
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Oncology Nursing Forum
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University of California, Berkeley