Stability of health-related quality of life and morbidity burden from 18\xa0months after diagnosis of prostate cancer: results of a UK-wide population-based outcome cohort

Samantha J Mason,Richard Wagland,Paul Kind,Penny Wright,Sarah Wilding,Amy Downing,Luke Hounsome,Eila Watson,Peter Selby,Anna Gavin,Hugh Butcher,Adam W Glaser

doi:10.1007/s00520-021-06650-7

Abstract

ObjectiveTo evaluate the dynamic nature of self-reported health-related quality of life (HRQL) and morbidity burden in men diagnosed with prostate cancer, we performed a follow-up study of the Life After Prostate Cancer Diagnosis (LAPCD) study cohort 12 months after initial survey.MethodsThe LAPCD study collected information from 35,823 men across the UK who were 18–42 months post-diagnosis of prostate cancer. Men who were still alive 12 months later were resurveyed. Generic HRQL (EQ-5D-5L plus self-assessed health rating) and prostate cancer-specific outcomes (EPIC-26) were assessed. Treatment(s) received was self-reported. Previously defined clinically meaningful differences were used to evaluate changes in outcomes over time.ResultsA total of 28,450 men across all disease stages completed follow-up surveys (85.8% response). Of the 21,700 included in this study, 89.7% reported no additional treatments since the first survey. This group experienced stable urinary and bowel outcomes, with good function for most men at both time points. On-going poor (but stable) urinary issues were associated with previous surgery. Sexual function scores remained low (mean: 26.8/100). Self-assessed health ratings were stable over time. The largest declines in HRQL and functional outcomes were experienced by men reporting their first active treatment between surveys.DiscussionThe results suggest stability of HRQL and most specific morbidities by 18–42 months for men who report no further treatment in the subsequent 12 months. This is reassuring for those with good function and HRQL but re-enforces the need for early intervention and support for men who experience poor outcomes.

Highlights

Men are living for increasing periods with and beyond a diagnosis of prostate cancer (PCa) [1]
We report on a follow-up of the largest PCa patientreported outcome study in the world to date, evaluating the on-going health-related quality of life (HRQL) of the Life After Prostate Cancer Diagnosis (LAPCD) cohort
Of the 588 men who reported being on monitoring at initial survey and active treatment at follow-up, 39.8% reported subsequent surgery and 29.3% reported moving to androgen deprivation therapy (ADT)

Summary

Introduction

Men are living for increasing periods with and beyond a diagnosis of prostate cancer (PCa) [1]. Focus has shifted to understanding the needs of men surviving PCa and their health-related quality of life (HRQL) in the years following diagnosis and treatment [2]. It is believed that the most severe treatment side effects occur in the first year following treatment for PCa, with some improvement thereafter [3,4,5,6]. Many HRQL studies focus on the impact of specific primary treatments, typically in men with localised PCa [3, 4, 7, 10]. Few studies have addressed longer-term outcomes [7, 11], in patients treated with a range of regimens and those with advanced disease

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Discussion

Conclusion