Living alone, obesity and smoking: Important factors for quality of life after radiotherapy and androgen deprivation therapy for prostate cancer

Abstract

Background. While effective treatment of prostate cancer with radiotherapy and hormones increase survival, adverse effects may reduce quality of life (QoL). The aim of this study was to investigate frequency and severity of self-assessed late adverse effects, and identify the patients most exposed. Material and methods. QoL of 317 cancer survivors with primary stage T1-T3 prostate cancer treated with conformal radiotherapy (70–78 Gy) and androgen deprivation therapy was analyzed by using SF-12 and EPIC-26 questionnaires. Patients were stratified into three groups, filling out the questionnaires 1–2, 2–3, and 3–4 years after radiotherapy. Differences between groups were tested with ANOVA and the χ² test. The influence of marital status, severe obesity, smoking, stage of disease, and applied dose of radiotherapy on QoL was evaluated with multiple linear and logistic regression analyses. Results. Of 337 patients, 317 (94%) answered the questionnaire. The sexual and hormonal summary scores in the EPIC significantly improved during time since radiotherapy (p < 0.001). Current smoking had a negative effect on SF-12 Physical Component Summary (PCS) and the Mental Component Summary (MCS) scores, on EPIC bowel overall bother (OR 7.8; p = 0.003), on EPIC mean urinary incontinence scores, and on the sexual domain. Severe obesity had a negative influence on SF-12 PCS and vitality. Severe obesity also was a negative predictor for moderate-to-severe problems in the EPIC urinary incontinence, and in the hormonal domain. Living alone was associated with lower SF-12 PCS, MCS scores, and SF-12 general health, social functioning, and the EPIC hormonal domain. The stage of disease or the radiation dose had no statistically significant impact on QoL. Conclusion. Results showed significant negative associations between smoking, severe obesity and living alone on self-assessed late adverse effects after radiotherapy for prostate cancer. This information may guide rehabilitation.

Acknowledgements

We especially wish to thank the cancer patients who participated in the study for their valuable contributions. This study was funded by Odense University Hospital (OUH) Research Foundation, the University of Southern Denmark, the Danish Cancer Society, CIRRO – The Lundbeck Foundation Center for Interventional Research in Radiation Oncology, the Department of Oncology, OUH, the Mette Hede Nielsen Foundation, the Scholarship Funds of the Physician Council, OUH, the Nurses Research Foundation, the Danish Nurses Organization Research Foundation, and the Propa Vita Foundation.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.