Quality of Life Among Men With Prostate Cancer in Rural Georgia

Abstract

To perform a population-based study on the quality of life (QOL) after prostate cancer treatment in a rural and disadvantaged population, because these have been sparse. We conducted a follow-up study of 260 men with incident prostate cancer in a largely rural area of Southwest Georgia. The subjects underwent interviews at baseline and 6 and 12 months after the diagnosis. The analyses compared the 6- and 12-month QOL to that at baseline using linear and Poisson regression analyses for longitudinal data. Across all treatment groups, the self-reported physical and emotional QOL declined significantly after treatment, with little difference between that at 6 and that at 12 months. The decline in physical/emotional QOL did not differ by age, race, education, or Gleason score but was more pronounced among those with no comorbidities. Patients treated with hormones showed the worst deterioration in physical and emotional QOL, with the watchful waiting and external beam radiotherapy groups were the least affected. After 12 months, the percentage of men reporting that sexual, urinary, and bowel function was a large or very large problem was 53%, 22%, and 9% compared with 27%, 25%, and 4% at baseline, respectively. Worse bowel and urinary function played a stronger role than sexual function in predicting the overall physical and emotional QOL. Urinary obstruction improved but incontinence worsened. The doctors' and patients' assessment of the QOL showed only a low correlation, with patients reporting worse post-treatment QOL than the doctors. The general and most prostate-specific QOL measures (except for urinary function) in this previously understudied population declined after 6 months and remained about the same at 12 months after treatment of prostate cancer.