Quality of Life Research

, Volume 23, Issue 5, pp 1557–1568 | Cite as

Quality of life in partners of patients with localised prostate cancer

  • Nora Eisemann
  • Annika Waldmann
  • Volker Rohde
  • Alexander Katalinic



The diagnosis of prostate cancer and the following treatment does not only affect the patient, but also his partner. Partners often suffer even more severely from psychological distress than the patients themselves. This analysis aims to describe the quality of life (QoL) after the cancer diagnosis over time and to identify the effects of possible predictors of partners’ quality of life in a German study population.

Data and methods

Patients with localised prostate cancer and their partners were recruited from a prospective multicenter study in Germany, the Prostate Cancer, Sexuality, and Partnership (ProCaSP) Study. At five observation times during the follow-up period of 2 years after diagnosis, QoL (EORTC QLQ-C30) and personal, social, and cancer-related health factors as well as adaptation and coping factors of 293 couples were observed and analysed with mixed effects analysis.


The men’s prostate cancer diagnosis had a small, but significant impact on their partner’s QoL. However, QoL of partners was most affected by the partners’ own physical health and psychological condition, time, and their relationship quality.


The finding that average QoL increased again 3 months after diagnosis and later should give partners faith and hope for the future. The identified most important predictors of partners’ QoL are potentially susceptible to intervention, and further research on target groups in special need of support and on adequate interventions is needed.


Quality of life Prostate cancer Partner Couple Mixed effects analysis 



We thank the reviewers for their helpful contributions to the revision of the manuscript.


  1. 1.
    Robert Koch Institute and the Association of Population-based Cancer Registries in Germany (2012). Cancer in Germany 2007/2008. Incidence and trends, 8 ed. Berlin.Google Scholar
  2. 2.
    Eton, D. T., Lepore, S. J., & Helgeson, V. S. (2005). Psychological distress in spouses of men treated for early-stage prostate carcinoma. Cancer, 103(11), 2412–2418.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Kornblith, A. B., et al. (1994). Quality of life of patients with prostate cancer and their spouses. The value of a data base in clinical care. Cancer, 73(11), 2791–2802.PubMedCrossRefGoogle Scholar
  4. 4.
    Cliff, A. M., & MacDonagh, R. P. (2000). Psychosocial morbidity in prostate cancer: II. A comparison of patients and partners. BJU Int, 86(7), 834–839.PubMedCrossRefGoogle Scholar
  5. 5.
    Tanner, T., Galbraith, M., & Hays, L. (2011). From a woman’s perspective: Life as a partner of a prostate cancer survivor. J Midwifery Womens Health, 56(2), 154–160.PubMedCrossRefGoogle Scholar
  6. 6.
    Kornblith, A. B., et al. (2001). The impact of docetaxel, estramustine, and low dose hydrocortisone on the quality of life of men with hormone refractory prostate cancer and their partners: A feasibility study. Annals of Oncology, 12(5), 633–641.PubMedCrossRefGoogle Scholar
  7. 7.
    The World Health Organization Quality of Life assessment. (1995). (WHOQOL): Position paper from the World Health Organization. Social Science and Medicine, 41(10), 1403–1409.CrossRefGoogle Scholar
  8. 8.
    Kershaw, T. S., et al. (2008). Longitudinal analysis of a model to predict quality of life in prostate cancer patients and their spouses. Annals of Behavioral Medicine, 36(2), 117–128.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Campbell, L. C., et al. (2004). Prostate cancer in African Americans: Relationship of patient and partner self-efficacy to quality of life. Journal of Pain and Symptom Management, 28(5), 433–444.PubMedCrossRefGoogle Scholar
  10. 10.
    Song, L., et al. (2011). Assessing longitudinal quality of life in prostate cancer patients and their spouses: A multilevel modeling approach. Quality of Life Research, 20(3), 371–381.PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Applebaum, A. J., et al. (2013). Preliminary study of themes of meaning and psychosocial service use among informal cancer caregivers. Palliative & Supportive Care, 1–10. doi: 10.1017/S1478951513000084.
  12. 12.
    Street, A. F., et al. (2010). Psychosocial adaptation in female partners of men with prostate cancer. Eur J Cancer Care (Engl), 19(2), 234–242.CrossRefGoogle Scholar
  13. 13.
    Germino, B. B., et al. (1998). Uncertainty in prostate cancer. Ethnic and family patterns. Cancer Pract, 6(2), 107–113.PubMedCrossRefGoogle Scholar
  14. 14.
    Northouse, L. L., Dorris, G., & Charron-Moore, C. (1995). Factors affecting couples’ adjustment to recurrent breast cancer. Social Science and Medicine, 41(1), 69–76.PubMedCrossRefGoogle Scholar
  15. 15.
    Mellon, S., Northouse, L. L., & Weiss, L. K. (2006). A population-based study of the quality of life of cancer survivors and their family caregivers. Cancer Nursing, 29(2), 120–131. quiz 132-3.PubMedCrossRefGoogle Scholar
  16. 16.
    Wadhwa, D., et al. (2013). Quality of life and mental health in caregivers of outpatients with advanced cancer. Psychooncology, 22(2), 403–410.PubMedGoogle Scholar
  17. 17.
    Lazarus, R. S. (2000). Toward better research on stress and coping. American Psychologist, 55(6), 665–673.PubMedCrossRefGoogle Scholar
  18. 18.
    Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Berlin: Springer Publishing Company.Google Scholar
  19. 19.
    Northouse, L., et al. (2005). Effects of a family intervention on the quality of life of women with recurrent breast cancer and their family caregivers. Psychooncology, 14(6), 478–491.PubMedCrossRefGoogle Scholar
  20. 20.
    Manne, S., et al. (2010). Cancer-related communication, relationship intimacy, and psychological distress among couples coping with localized prostate cancer. Journal of Cancer Survivorship, 4(1), 74–85.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Malcarne, V. L., et al. (2002). Problem-solving skills and emotional distress in spouses of men with prostate cancer. Journal of Cancer Education, 17(3), 150–154.PubMedGoogle Scholar
  22. 22.
    Wittekind, C., Meyer, H.-J., & Bootz, F. (Eds.). (2002). In UICC: TNM Klassifikation maligner Tumoren (6th ed). Berlin: Springer.Google Scholar
  23. 23.
    Aaronson, N. K., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85(5), 365–376.PubMedCrossRefGoogle Scholar
  24. 24.
    Fayers, P., et al. (2001). The EORTC QLQ-C30 scoring manual (3rd ed.). Brussels: European Organization for Research and Treatment of Cancer.Google Scholar
  25. 25.
    Osoba, D., et al. (1998). Interpreting the significance of changes in health-related quality-of-life scores. Journal of Clinical Oncology, 16(1), 139–144.PubMedGoogle Scholar
  26. 26.
    Gandek, B., et al. (1998). Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. Journal of Clinical Epidemiology, 51(11), 1171–1178.PubMedCrossRefGoogle Scholar
  27. 27.
    Krahn, M., et al. (2000). Construction of the Patient-Oriented Prostate Utility Scale (PORPUS): A multiattribute health state classification system for prostate cancer. Journal of Clinical Epidemiology, 53(9), 920–930.PubMedCrossRefGoogle Scholar
  28. 28.
    Goldzweig, G., et al. (2009). Gender and psychological distress among middle- and older-aged colorectal cancer patients and their spouses: an unexpected outcome. Critical Reviews in Oncology Hematology, 70(1), 71–82.CrossRefGoogle Scholar
  29. 29.
    Bestmann, B., et al. (2007). Prostate-specific symptoms of prostate cancer in a German general population. Prostate Cancer and Prostatic Disease, 10(1), 52–59.CrossRefGoogle Scholar
  30. 30.
    Rosen, R. C., et al. (1997). The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49(6), 822–830.PubMedCrossRefGoogle Scholar
  31. 31.
    Rabin, R. et al. (2011). EQ-5D-3L User Guide. Basic information on how to use the EQ-5D-3L instrument. Version 4.0, EuroQol Group: Rotterdam.Google Scholar
  32. 32.
    Waldmann, A., Schubert, D., & Katalinic, A. (2013). Normative data of the EORTC qlq-c30 for the german population: A population-based survey. PLoS ONE, 8(9), e74149.PubMedCentralPubMedCrossRefGoogle Scholar
  33. 33.
    R Development Core Team. (2013). R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing.Google Scholar
  34. 34.
    van Buuren, S., & Groothuis-Oudshoorn, K. (2011). MICE: Multivariate imputation by chained equations in R. Journal of Statistical Software, 45(3), 1–67.Google Scholar
  35. 35.
    Pinheiro, J., Bates, D., DebRoy, S., Sarkar, D., & R Development Core Team. (2013). nlme: Linear and Nonlinear Mixed Effects Models. R package version 3.1-113.Google Scholar
  36. 36.
    Bates, D., Maechler, M., & Bolker, B. (2013). lme4: Linear mixed-effects models using S4 classes. R package version 1.0-5.
  37. 37.
    Baayen, R. H. (2011). languageR: Data sets and functions withAnalyzing Linguistic Data: A practical introduction to statistics”. R package version 1.4.
  38. 38.
    Sterne, J. A., et al. (2009). Multiple imputation for missing data in epidemiological and clinical research: Potential and pitfalls. BMJ, 338, b2393.PubMedCentralPubMedCrossRefGoogle Scholar
  39. 39.
    Bartlett, J. W., Frost, C., & Carpenter, J. R. (2011). Multiple imputation models should incorporate the outcome in the model of interest. Brain, 134(Pt 11), 189. author reply e190.CrossRefGoogle Scholar
  40. 40.
    Schafer, J. (1997). Analysis of incomplete multivariate data. London: Chapman & Hall.CrossRefGoogle Scholar
  41. 41.
    Schwarz, R., & Hinz, A. (2001). Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. European Journal of Cancer, 37(11), 1345–1351.PubMedCrossRefGoogle Scholar
  42. 42.
    Badger, T. A., et al. (2011). Psychosocial interventions to improve quality of life in prostate cancer survivors and their intimate or family partners. Quality of Life Research, 20(6), 833–844.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Nora Eisemann
    • 1
  • Annika Waldmann
    • 2
  • Volker Rohde
    • 3
  • Alexander Katalinic
    • 1
    • 2
  1. 1.Institute of Cancer EpidemiologyUniversity of LuebeckLuebeckGermany
  2. 2.Institute of Social Medicine and EpidemiologyUniversity Hospital Schleswig–HolsteinLuebeckGermany
  3. 3.Praxis für UrologieBad SchwartauGermany

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