Quality of Life in Men Undergoing Radical Prostatectomy for Prostate Cancer

  • M. Pearson
  • E. M. Wallen
  • R. S. Pruthi
Reference work entry


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”).

Radical prostatectomy remains one of the most important tools for localized disease – a “gold-standard” for definitive treatment to which novel therapies are compared (Table 167-1 ). It is estimated that in the United States that approximately 77,000 of the procedures are performed annually. To assist clinicians along these lines, several validated questionnaires have been developed and are commonly used to monitor quality of life changes in patients as they relate to treatment of localized prostate cancer. Providers who treat localized prostate cancer should be familiar with and utilize these instruments as part of their routine post-treatment evaluation of patients over time (Table 167-2 ).
Table 167-1

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%)

Table 167-2

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.


Prostate Cancer Urinary Incontinence Erectile Dysfunction Radical Prostatectomy Erectile Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:


external beam radiation therapy


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


socioeconomic status


The UCLA prostate cancer index


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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • M. Pearson
    • 1
  • E. M. Wallen
    • 1
  • R. S. Pruthi
    • 1
  1. 1.Division of Urologic SurgeryThe University of North Carolina at Chapel HillChapel HillUSA

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