Patients' perceptions of quality of life after treatment for early prostate cancer

Jack A. Clark, Thomas Inui, Rebecca A. Silliman, Barbara G. Bokhour, Steven H. Krasnow, Richard A. Robinson, Monica Spaulding, James A. Talcott

Research output: Contribution to journalArticle

144 Citations (Scopus)

Abstract

Purpose: Treatment for early prostate cancer produces problematic physical side effects, but prior studies have found little influence on patients' perceived health status. We examined psychosocial outcomes of treatment for early prostate cancer. Patients and Methods: Patients with previously treated prostate cancer and a reference group of men with a normal prostate-specific antigen (PSA) level and no history of prostate cancer completed questionnaires. Innovative scales assessed behavioral consequences of urinary dysfunction, sexuality, health worry, PSA concern, perceived cancer control, treatment decision making, decision regret, and cancer-related outlook. Urinary, bowel, and sexual dysfunction were assessed with symptom indexes; health status was assessed by the Physical and Mental Summaries of the Short Form (SF-12) Health Survey. Results: Compared with men without prostate cancer, prostate cancer patients reported greater urinary, bowel, and sexual dysfunction, but similar health status. They reported worse problems of urinary control, sexual intimacy and confidence, and masculinity, and greater PSA concern. Perceptions of cancer control and treatment decisions were positive, but varied by treatment: prostatectomy patients indicated the highest and observation patients indicated the lowest cancer control. Bowel and sexual dysfunction were associated with poorer sexual intimacy, masculinity, and perceived cancer control; masculinity and PSA concern were associated with greater confidence in treatment choice; and diminished sexual intimacy and less interest in PSA were associated with greater regret. Conclusion: The lack of change in global measures of health status after treatment for early prostate cancer obscures important influences in men's lives; cancer diagnosis and treatment complications may result in complex outcomes. Aggressive treatment may confer confidence in cancer control, yet be countered by diminished intimate relationships and masculinity, which accompany sexual dysfunction.

Original languageEnglish (US)
Pages (from-to)3777-3784
Number of pages8
JournalJournal of Clinical Oncology
Volume21
Issue number20
DOIs
StatePublished - Oct 15 2003
Externally publishedYes

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Prostatic Neoplasms
Quality of Life
Prostate-Specific Antigen
Masculinity
Health Status
Neoplasms
Therapeutics
Emotions
Sexuality
Prostatectomy
Health Surveys
Decision Making
Observation
Health

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Clark, J. A., Inui, T., Silliman, R. A., Bokhour, B. G., Krasnow, S. H., Robinson, R. A., ... Talcott, J. A. (2003). Patients' perceptions of quality of life after treatment for early prostate cancer. Journal of Clinical Oncology, 21(20), 3777-3784. https://doi.org/10.1200/JCO.2003.02.115

Patients' perceptions of quality of life after treatment for early prostate cancer. / Clark, Jack A.; Inui, Thomas; Silliman, Rebecca A.; Bokhour, Barbara G.; Krasnow, Steven H.; Robinson, Richard A.; Spaulding, Monica; Talcott, James A.

In: Journal of Clinical Oncology, Vol. 21, No. 20, 15.10.2003, p. 3777-3784.

Research output: Contribution to journalArticle

Clark, JA, Inui, T, Silliman, RA, Bokhour, BG, Krasnow, SH, Robinson, RA, Spaulding, M & Talcott, JA 2003, 'Patients' perceptions of quality of life after treatment for early prostate cancer', Journal of Clinical Oncology, vol. 21, no. 20, pp. 3777-3784. https://doi.org/10.1200/JCO.2003.02.115
Clark, Jack A. ; Inui, Thomas ; Silliman, Rebecca A. ; Bokhour, Barbara G. ; Krasnow, Steven H. ; Robinson, Richard A. ; Spaulding, Monica ; Talcott, James A. / Patients' perceptions of quality of life after treatment for early prostate cancer. In: Journal of Clinical Oncology. 2003 ; Vol. 21, No. 20. pp. 3777-3784.
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N2 - Purpose: Treatment for early prostate cancer produces problematic physical side effects, but prior studies have found little influence on patients' perceived health status. We examined psychosocial outcomes of treatment for early prostate cancer. Patients and Methods: Patients with previously treated prostate cancer and a reference group of men with a normal prostate-specific antigen (PSA) level and no history of prostate cancer completed questionnaires. Innovative scales assessed behavioral consequences of urinary dysfunction, sexuality, health worry, PSA concern, perceived cancer control, treatment decision making, decision regret, and cancer-related outlook. Urinary, bowel, and sexual dysfunction were assessed with symptom indexes; health status was assessed by the Physical and Mental Summaries of the Short Form (SF-12) Health Survey. Results: Compared with men without prostate cancer, prostate cancer patients reported greater urinary, bowel, and sexual dysfunction, but similar health status. They reported worse problems of urinary control, sexual intimacy and confidence, and masculinity, and greater PSA concern. Perceptions of cancer control and treatment decisions were positive, but varied by treatment: prostatectomy patients indicated the highest and observation patients indicated the lowest cancer control. Bowel and sexual dysfunction were associated with poorer sexual intimacy, masculinity, and perceived cancer control; masculinity and PSA concern were associated with greater confidence in treatment choice; and diminished sexual intimacy and less interest in PSA were associated with greater regret. Conclusion: The lack of change in global measures of health status after treatment for early prostate cancer obscures important influences in men's lives; cancer diagnosis and treatment complications may result in complex outcomes. Aggressive treatment may confer confidence in cancer control, yet be countered by diminished intimate relationships and masculinity, which accompany sexual dysfunction.

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