4.6 Article

Stability of health-related quality of life and morbidity burden from 18 months after diagnosis of prostate cancer: results of a UK-wide population-based outcome cohort

Journal

SUPPORTIVE CARE IN CANCER
Volume 30, Issue 4, Pages 3151-3164

Publisher

SPRINGER
DOI: 10.1007/s00520-021-06650-7

Keywords

Prostate cancer; Patient-reported outcomes; Survivorship; Health-related quality of life; Health status; Functional outcomes

Funding

  1. Movember Foundation
  2. Prostate Cancer UK, Prostate Cancer Outcomes programme [BO26/MO]

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A study on men diagnosed with prostate cancer found that the majority of those who did not receive further treatment within 12 months after diagnosis experienced stable health-related quality of life and specific morbidity outcomes over time. Those who reported receiving their first active treatment between surveys showed the largest declines in quality of life and functional outcomes.
Objective To evaluate the dynamic nature of self-reported health-related quality of life (HRQL) and morbidity burden in men diagnosed with prostate cancer, we performed a follow-up study of the Life After Prostate Cancer Diagnosis (LAPCD) study cohort 12 months after initial survey. Methods The LAPCD study collected information from 35,823 men across the UK who were 18-42 months post-diagnosis of prostate cancer. Men who were still alive 12 months later were resurveyed. Generic HRQL (EQ-5D-5L plus self-assessed health rating) and prostate cancer-specific outcomes (EPIC-26) were assessed. Treatment(s) received was self-reported. Previously defined clinically meaningful differences were used to evaluate changes in outcomes over time. Results A total of 28,450 men across all disease stages completed follow-up surveys (85.8% response). Of the 21,700 included in this study, 89.7% reported no additional treatments since the first survey. This group experienced stable urinary and bowel outcomes, with good function for most men at both time points. On-going poor (but stable) urinary issues were associated with previous surgery. Sexual function scores remained low (mean: 26.8/100). Self-assessed health ratings were stable over time. The largest declines in HRQL and functional outcomes were experienced by men reporting their first active treatment between surveys. Discussion The results suggest stability of HRQL and most specific morbidities by 18-42 months for men who report no further treatment in the subsequent 12 months. This is reassuring for those with good function and HRQL but re-enforces the need for early intervention and support for men who experience poor outcomes.

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