Handbook of Disease Burdens and Quality of Life Measures pp 2875-2885 | Cite as
Quality of Life in Men Undergoing Radical Prostatectomy for Prostate Cancer
Prostate cancer is the most common noncutaneous cancer in men and the second-leading cause of death from cancer in men in the United States. Approximately one in six men will be diagnosed with the disease during his lifetime. When a man is diagnosed with clinically localized prostate cancer, he is immediately faced with a number of complex issues regarding the management of the disease. Options available to him include surgical management in the form of radical prostatectomy, radiotherapy including external beam radiation therapy and brachytherapy, hormone ablation, and expectant management or active surveillance (i.e., “watchful waiting”).
Key facts about radical prostatectomy
Involves the surgical treatment for prostate cancer with curative intent
Estimated that over 100,000 procedures performed each year in the United States
Involves removal of entire prostate and seminal vesicles. On occasion, may include removal of pelvic lymph nodes
Common surgical techniques include retropubic, perineal, laparoscopic, and robotic-assisted laparoscopic approaches
Most common side effects which may impact quality of life include urinary leakage (< 10%) and erectile dysfunction (15–40%)
Commonly-used and validated measures of QOL after radical prostatectomy
1. The UCLA Prostate Cancer Index (UCLA PCI): 20-item instrument that is prostate-specific in nature. Does not contain questions regarding general HRQOL, and therefore commonly administered along with general health instrument (e.g., RAND SF-36).
2. The Expanded Prostate Cancer Index-Composite (EPIC): Expanded version of the UCLA PCI with 30 additional disease-specific items to more comprehensively define QOL outcomes following prostate cancer treatment. The EPIC includes additional 8 disease specific domains.
3. The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire with its prostate cancer specific module (EORTC QLQ-C30): Broad-based questionnaire was originally designed to measure cancer-specific QOL outcomes with various types of malignancies. Includes five general scales, a global health scale, three symptom scales, and 6 additional items. A prostate cancer module of 20 additional questions regarding bowel, urinary, and sexual function was added.
4. The Functional Assessment of Cancer Therapy-Prostate Instrument (FACT-P): Questionnaire containing 38 items; 26 measure five general QOL domains with the remaining 12 measuring disease-specific issues. Perhaps better suited to assessing men with metastatic disease.
Improved understanding of the side effects of interventions and their impact of health-related quality of life (HRQOL) is an important part of understanding of the impact of the cancer as well as the modalities to treat the malignancy. To this end, HRQOL assessments have become and important area of interest with respect to radical prostatectomy. Researchers have evaluated many different aspects of this topic, including the impact of comorbidities, socioeconomic status, type of prostatectomy, as well as comparisons to other treatments for prostate cancer. However, despite the potential for side effects, overall satisfaction with the surgery remains high, and patients report little decrease in their overall quality of life. A thorough understanding of these issues is essential for clinicians who must assist their patients through complicated decision processes once they are diagnosed with localized prostate cancer.
KeywordsProstate Cancer Urinary Incontinence Erectile Dysfunction Radical Prostatectomy Erectile Function
List of Abbreviations:
external beam radiation therapy
- EORTC QLQ-C30
the European organization for research and treatment of cancer core quality of life questionnaire with its prostate cancer specific module
the expanded prostate cancer index-composite
The functional assessment of cancer therapy-prostate instrument
health-related quality of life
robotic-assisted laparoscopic radical prostatectomy
- UCLA PCI
The UCLA prostate cancer index
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