Health related quality of life (HRQOL) and supportive care needs of men after treatment for early stage prostate cancer
Objective
To describe the medium and long-term outcomes of treatment of prostate cancer in men less than 70 years of age
Prostate cancer is second only to lung cancer as the most common cancer in men.
The NSW Prostate Cancer Care and Outcomes Study (PCOS) is following a group of men with prostate cancer from diagnosis for up to five years. The original cohort contained 2021 cases recruited via the NSW Central Cancer Registry and 495 age and postcode matched controls. HRQOL is the main outcome of interest, but supportive care needs and coping styles have also been surveyed. HRQOL data are being collected using a telephone administered questionnaire. The University of California LA Prostate Cancer Index (UCLA PCI) and the hormonal domain section of the Expanded Prostate Cancer Index (EPIC) are being used to measure HRQOL at baseline then at 1,2,3 and 5 years after diagnosis.
Five-year interviews were completed for all cases by December 2007. When we originally set up this cohort we estimated that approximately 67% of cases would likely be alive and available for their five-year interview, equating to approximately 1,355 interviews. Retention rates in the cohort exceeded our estimates by a considerable amount, to the extent where 80% of cases who were interviewed at baseline undertook a five-year interview (n=1,602). Five-year interviews for controls were completed in 2008 and 390 controls (80%) of the original cohort completed their 5th year interview. A paper describing the quality of life study was published in the British Medical Journal in 2009. The findings show that the various treatments for localised prostate cancer have a persistent effects on long term quality of life. Men with prostate cancer and the clinicians who treat them whould be aware of the effects of treatment on quality of life and weight them up against the patient's age and the risk of progression of prostate cancer if untreated, to make informed decisions about treatment.
A paper describing the unmet supportive care needs in the year following diagnosis was published in the Journal of Clinical Oncology in 2007. The findings show that attention should be given to sexual and psychological needs in the early months after diagnosis or treatment of prostate cancer, particularly in younger men, those with less education, and those having surgery.
A subsample of the cohort completed a discrete choice experiment of preferences for treatment outcomes. A final version of a manuscript will be shortly submitted to the BMJ.
Linked data have been obtained from Medicare and PBS for men who consented to these data being released. A costing study is currently underway.
A submission has been made to the NHMRC to obtain funding to complete 10 year quality of life measures in all men remaining in the cohort.
Funding source
NH&MRC Project Grant
CHERE staff
Paula Cronin, Bonny Parkinson, Jody Church
Collaborators
Madeleine King1 David Smith2, Rajah Supramaniam2, Jeanette Ward3, Martin Berry4, Bruce Armstrong5
1. University of Sydney
2. The Cancer Council New South Wales, Sydney
3. Institute of Population Health, Ottawa, Canada
4. Cancer Therapy Centre, Liverpool Health Service, Sydney
5. Sydney Cancer Centre and School of Public Health, USYD
