Symptom clusters related to treatment for prostate cancer

Purpose/Objectives: To identify symptom clusters that include urinary and erectile dysfunction among men treated for prostate cancer. Design: Secondary data analysis. Setting: University-affiliated urology clinic. Sample: Data collected on 402 men for a longitudinal prostate cancer quality-of-life study. Methods: Data were collected from an eight-month time point. Four analytic approaches were applied to determine whether consistent clusters of symptoms were identifiable. Main Research Variables: Pain, fatigue, emotional distress, and urinary, sexual, and bowel dysfunction. Findings: Thirty-three percent of patients reported scores on three or more quality-of-life measures falling in the lowest quartile for that measure. Although composition of the clusters was not consistent, poor mental health or poor energy was a component of any cluster made up of three or more symptoms. Conclusions: Using a four-way analytic approach enabled the authors to explore how symptom clusters measuring general and disease-specific quality of life occurred in patients who have been treated for prostate cancer. When clusters occur, fatigue and emotional distress often are included. Implications for Nursing: Fatigue and emotional distress may be seen together or in combination with prostate cancer-specific symptoms. Nurses should be more alert to the possibility of additional treatment-related symptoms when fatigue or emotional distress is present.