Health-related quality of life in prostate cancer

Abstract

Background. With new treatment options, the prognosis of prostate cancer (PCa) has improved in recent decades, and health-related quality of life (HRQoL) has become an important outcome of treatment. HRQoL scores are also essential for health economic analyses concerning treatment options for the disease. This study assesses HRQoL scores in different health states of PCa, compares the results obtained by different HRQoL instruments, compares the HRQoL of PCa patients with that of the general population, and explores factors associated with the resultant HRQoL scores. Material and methods. An observational cross-sectional study among PCa patients in the Helsinki and Uusimaa Hospital District between September 2009 and December 2010. A total of 630 PCa patients (aged 43–92) assessed their HRQoL with the generic 15D and EQ-5D, as well as the cancer-specific EORTC QLQ-C30 questionnaires. Patients were divided into five mutually exclusive groups based on disease state: Loc1 (local disease, first six months after diagnosis; n = 47), Loc2 (local disease, 0.5–1.5 years after diagnosis or recurrence; n = 158), Loc3 (local disease, more than 1.5 years after diagnosis; n = 317), Metastatic (after detection of metastases; n = 89) and Palliative care (n = 19). Multivariate analysis served to evaluate the factors associated with the HRQoL scores. Results. The utility scores were highest at baseline. Markedly impaired HRQoL was seen first at the more advanced states of the disease. All HRQoL instruments studied were consistent in all states of the disease, yet the HRQoL scores obtained varied widely. Symptoms of fatigue and pain, and background variables of financial difficulties and age were the most important factors associated with poor HRQoL. Conclusions. All instruments provided valuable insight into PCa patients’ overall HRQoL. Management of cancer-related symptoms is important in maintaining patients’ HRQoL, but more attention should also focus on financial difficulties.

View correction statement:

Corrigendum

Acknowledgement

We would like to thank Stephen Harris for linguistic assistance.

Declaration of interest: This work was supported by the Cancer Society of Finland and GlaxoSmithKline Oy, Finland. No study sponsors were involved in the study design or in the collection, analysis, or interpretation of data, nor were they involved in the writing of the manuscript or in the decision to submit the manuscript for publication. However, ST and NF are employees of GlaxoSmithKline. All authors have contributed to the study conception and design, the acquisition, analysis and interpretation of the data, and the writing the manuscript.