Advertisement
No AccessJournal of UrologyAdult Urology1 Oct 2010

Correlates of Bother Following Treatment for Clinically Localized Prostate Cancer

    View All Author Information

    Purpose:

    We determined factors associated with bother, the distress patients experience as a result of functional detriments after treatment for localized prostate cancer.

    Materials and Methods:

    A prospective cohort of men treated for clinically localized prostate cancer completed a questionnaire comprising the UCLA-PCI, Medical Outcomes Study Short Form-36, American Urological Association Symptom Index and Memorial Anxiety Scale for Prostate Cancer fear of recurrence subscale. We used nonlinear mixed models to identify factors associated with severe urinary, sexual and bowel bother.

    Results:

    Worse function scores were associated with severe urinary, sexual and bowel bother following treatment (OR 0.88–0.94, p <0.001). Worse American Urological Association Symptom Index score was associated with severe urinary bother (OR 1.22, 95% CI 1.16–1.28). Time since treatment was inversely associated with urinary (OR 0.68, 95% CI 0.54–0.83) and bowel bother (OR 0.63, 95% CI 0.47–0.80) early after treatment but not for the entire 48-month study period. Receipt of concomitant androgen deprivation therapy was not associated with bother 48 months after radiation.

    Conclusions:

    Addressing functional detriment may confer improvement in urinary, sexual and bowel bother. Patient distress related to dysfunction improves with time. Measuring health related quality of life after prostate cancer treatment should incorporate functional and bother assessments.

    References

    • 1 : Survivorship beyond convalescence: 48-month quality-of-life outcomes after treatment for localized prostate cancer. J Natl Cancer Inst2009; 101: 888. Google Scholar
    • 2 : Quality of life after surgery, external beam irradiation, or brachytherapy for early-stage prostate cancer. Cancer2007; 109: 2239. Google Scholar
    • 3 : Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med2008; 358: 1250. Google Scholar
    • 4 : Quality of life three years after diagnosis of localised prostate cancer: population based cohort study. BMJ2009; 339: b4817. Google Scholar
    • 5 : The UCLA Prostate Cancer Index: development, reliability, and validity of a health-related quality of life measure. Med Care1998; 36: 1002. Google Scholar
    • 6 : The memorial anxiety scale for prostate cancer: validation of a new scale to measure anxiety in men with prostate cancer. Cancer2003; 97: 2910. Google Scholar
    • 7 : SF-36 Health Survey: Manual and Interpretation Guide. Boston: The Health Institute, New England Medical Center1993. Google Scholar
    • 8 : Anatomic radical retropubic prostatectomy. In: Campbell's Urology. Edited by . Philadelphia: WB Saunders2002. Google Scholar
    • 9 : Results of 3D conformal radiotherapy in the treatment of localized prostate cancer. Int J Radiat Oncol Biol Phys1997; 38: 311. Google Scholar
    • 10 : Planning, delivery, and quality assurance of intensity-modulated radiotherapy using dynamic multileaf collimator: a strategy for large-scale implementation for the treatment of carcinoma of the prostate. Int J Radiat Oncol Biol Phys1997; 39: 863. Google Scholar
    • 11 : Urinary function and bother after radical prostatectomy or radiation for prostate cancer: a longitudinal, multivariate quality of life analysis from the Cancer of the Prostate Strategic Urologic Research Endeavor. J Urol2000; 164: 1973. LinkGoogle Scholar
    • 12 : Neoadjuvant hormonal therapy and older age are associated with adverse sexual health-related quality-of-life outcome after prostate brachytherapy. Urology2002; 59: 480. Google Scholar
    • 13 : Should function and bother be measured and reported separately for prostate cancer quality-of-life domains?. Urology2006; 68: 599. Google Scholar
    • 14 : Subjective and objective dimensions of quality of life in psychiatric patients: a factor analytical approach: The South Verona Outcome Project 4. Br J Psychiatry2001; 178: 268. Google Scholar
    • 15 : Longitudinal assessment of changes in sexual function and bother in patients treated with external beam radiotherapy or brachytherapy, with and without neoadjuvant androgen ablation: data from CaPSURE. Int J Radiat Oncol Biol Phys2004; 60: 1066. Google Scholar
    • 16 : Urinary and sexual outcomes in long-term (5+ years) prostate cancer disease free survivors after radical prostatectomy. Health Qual Life Outcomes2009; 7: 94. Google Scholar
    • 17 : Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA2000; 283: 354. Google Scholar
    • 18 : Time course and predictors of symptoms after primary prostate cancer therapy. J Clin Oncol2003; 21: 3979. Google Scholar
    • 19 : Assessing anxiety in men with prostate cancer: further data on the reliability and validity of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC). Psychosomatics2006; 47: 340. Google Scholar
    • 20 : Urinary morbidity and incontinence following transurethral resection of the prostate after brachytherapy. J Urol2005; 173: 808. LinkGoogle Scholar
    • 21 : Urinary incontinence in prostate cancer patients treated with external beam radiotherapy. Radiother Oncol2005; 74: 197. Google Scholar
    • 22 : Sildenafil preserves intracorporeal smooth muscle after radical retropubic prostatectomy. J Urol2004; 171: 771. LinkGoogle Scholar
    • 23 : Neoadjuvant hormonal therapy impairs sexual outcome among younger men who undergo external beam radiotherapy for localized prostate cancer. Urology2004; 63: 946. Google Scholar
    Advertisement