Abstract 1819: Quality of life among prostate cancer survivors in the Physicians’ Health Study
Authors: Hannah L. Mandel, Julie L. Kasperzyk, Howard Sesso, Jing Ma, Meir Stampfer, Martin Sanda, Lorelei Mucci
Journal: Cancer Research (2010)

Abstract Background: Quality of life (QOL) outcomes are an important issue among men with prostate cancer (PCa), and are a function of their advancing age, disease, and treatment status. We sought to characterize the frequency of moderate-to-severe impairment across a broad range of QOL domains in a large cohort of PCa survivors, and to assess effects of pre- and post-treatment patient and clinical factors on QOL outcomes. Methods: The study included 1,482 men enrolled in the Physicians’ Health Study who were diagnosed with PCa from 1982-2005 and responded to a follow-up questionnaire in 2005-2006. Median time from diagnosis to questionnaire response was 5.7 years. QOL in the previous year was assessed by self-reported occurrence of 13 conditions or symptoms related to urinary, bowel, and sexual function. We compared the frequency of moderate/severe symptoms (vs. never/mild) by age at questionnaire (&amp;lt;70, 70-79, ≥80 years), tumor stage (T3+, T1/T2), and first treatment (prostatectomy, radiation) using chi-square tests. We used logistic regression to evaluate the association of age, stage, and treatment with moderate/severe symptoms, mutually adjusting for these factors and time since diagnosis. Results: Among all PCa patients, the most commonly reported QOL symptoms were impotence (77.1%), reduced sexual desire (49.4%), and nocturia (22.6%). Urinary symptoms (nocturia, decreased force of stream), sexual symptoms (impotence, reduced desire), hot flashes, and fatigue were more common with increasing age, regardless of treatment, stage, or time since diagnosis. Compared to stage T1/T2, men with stage T3+ PCa were more likely (p&amp;lt;0.05) to report nocturia (32% vs. 22%), urinary frequency (26% vs. 15%), abdominal pain (4% vs. 1%), hot flashes (14% vs. 7%), impotence (92% vs. 77%), reduced sexual desire (69% vs. 48%), and fatigue (20% vs. 9%) even after a median of 6 years since diagnosis. Differences by stage remained statistically significant, except for nocturia and hot flashes, after adjusting for age, treatment, and time since diagnosis. Men who had a prostatectomy (n = 764) were more likely to report moderate/severe incontinence (14% vs. 5%, p&amp;lt;0.0001) and impotence (80% vs. 74%, p=0.02) than those who had radiation (n = 511). However, men who had a prostatectomy vs. radiation were less likely (p&amp;lt;0.01) to report nocturia (14% vs. 33%), urinary frequency (10% vs. 21%), decreased force of urinary stream (7% vs. 23%), hematuria (1% vs. 3%), rectal urgency (5% vs. 13%), diarrhea (2% vs. 5%), hot flashes (5% vs. 11%), reduced sexual desire (42% vs. 54%), and fatigue (7% vs. 13%); these associations were independent of age, stage, and time since diagnosis. Conclusions: PCa survivors in this US-based cohort experienced a variety of post-diagnostic symptoms, even after an average of 6 years, relating to urinary, bowel, and sexual function. These symptoms increased with age, varied by treatment type, and were more severe among men with advanced PCa. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1819.