Health Services ResearchThe Association of Long-term Treatment-related Side Effects With Cancer-specific and General Quality of Life Among Prostate Cancer Survivors
Section snippets
Overview of the PLCO Trial
From 1993 to 2001, the PLCO trial22, 23 enrolled 76,705 men aged 55-74 years at 10 screening sites in the United States. PLCO exclusion criteria for male participants were: (1) history of prostate, lung, or colorectal cancer, (2) current cancer treatment, (3) prior surgical removal of the prostate, lung, colon, or rectum, (4) current finasteride use, (5) ≥1 prostate-specific antigen (PSA) test ≤3 years ago, (6) colon cancer screening ≤3 years ago, (7) enrollment in another cancer screening or
Demographic and Clinical Information
Demographic and clinical characteristics are presented in Table 1. Participants had a mean age of 74.6 years and their average time since initial PCa diagnosis was 7.4 years (with a range from 5.0 to 9.9 years since diagnosis). Participants were mostly White (88.4%), married (81.7%), retired (77.1%), and had at least some college education (71.9%). Regarding clinical information, at diagnosis most men had stage-II disease (87.8%), a Gleason score of 3-6 (68.0%), and a PSA level ≤10 (82.2%).
Associations Between Treatment-related Side Effects and QOL
Comment
While most studies on QOL and PCa have focused on the short-term influence of treatment-related side effects, this study examined the long-term (5-10 years after diagnosis) association between PCa-related treatment side effects and cancer-specific and general QOL. The relationships between cancer-specific and general QOL measures and the EPIC domains were similar to those found by Wei et al.20
After adjusting for demographic and clinical variables, our results suggest that the urinary, sexual,
Conclusion
In summary, treatment-related side effects persisted up to 10-years after diagnosis and were associated with both cancer-specific and general QOL. These associations were particularly strong for the cancer-specific QOL measure, as evidenced by the larger point estimates and statistical significance of the treatment side effects. The 3 EPIC domains were all independently associated with cancer-specific QOL, with bowel side effects exhibiting the strongest association of the 3 domains. These
Acknowledgments
The authors appreciate the time and effort of the participants, the interviewers who conducted the interviews, and Susan Marx for administrative support.
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Financial Disclosure: The authors declare that they have no relevant financial interests.
Funding Support: This work was supported by the Midwest Division of the American Cancer Society, (grant number 113173-RSGPB-07-099-01-CPPB to Kathryn L.Taylor). This project was supported in part by the Biostatistics and Bioinformatics Shared Resource at the Lombardi Comprehensive Cancer Center by Award Number P30CA051008 from the National Cancer Institute.