Author(s)

Carmel Nirupa Anandadas, Susan Elizabeth Davidson, Noel William Clarke, Stephen Charles William Brown, John Paul Logue, Lynne Gilmore, Richard Swindell, Gerald Nicholas Collins, Patrick Henry O’Reilly, Guy David Wemyss-Holden, Maurice Waiming Lau, Pradip Madhukar Javle, Vijay Alini Chandi Ramani, Richard James Brough, James Pinson Wylie, Richard Andrew Cowan

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Objectives: In 1997, a study was launched to investigate the treatment of early prostate cancer. Using a patient preference design, health-related quality-of-life (HRQOL) and disease specific HRQOL was assessed prospectively to compare men undergoing radical prostatectomy (RP), hypo-fractionated conformal radiotherapy (CRT) or brachytherapy (BT). Methods: Patients with localised prostate cancer were counselled by a urological surgeon, clinical oncologist and specialist uro-oncology nurse. Patients received treatment according to individual preference. 430 men chose and received RP (n = 217), CRT (n = 161) and BT (n = 52). 354 (82%) completed pre-treatment RAND 36-Item Short-Form Health survey version-2 (SF36v2) and University of California, Los Angeles Prostate cancer index (UCLA-PCI) questionnaires. HRQOL score changes from baseline to 24 months were compared using Kruskall-Wallis test. Results: Pre-treatment, the CRT cohort scored lower for physical function (p = 0.0029) and general health perception (p = 0.0021). The BT cohort reported better baseline scores for urinary function (p = 0.0291), urinary bother (p = 0.0030), sexual function (p = 0.0009) and bowel bother (p = 0.0063). At 24 months, bowel function was similar for CRT and BT but both modalities were worse than RP (p = 0.0010). Urinary continence deteriorated most following RP (p < 0.0001) but BT had worse urinary bother (p = 0.0153). Sexual function deteriorated most following RP and BT (p < 0.0005). Percentages of patients achieving erections adequate for sexual activity (from baseline to 24 months) were 66% to 29% for RP, 62% to 49% for CRT and 88% to 65% for BT. Conclusion: This data demonstrates significant differences in disease specific quality-of-life between RP, CRT and BT and should be available for men with early prostate cancer making treatment decisions.

Early Prostate Cancer, Quality of Life, Patient Preference, Prostatectomy, Hypo-Fractionated Radiotherapy, Brachytherapy

C. Anandadas, S. Davidson, N. Clarke, S. Brown, J. Logue, L. Gilmore, R. Swindell, G. Collins, P. O’Reilly, G. Wemyss-Holden, M. Lau, P. Javle, V. Ramani, R. Brough, J. Wylie and R. Cowan, "Quality of Life in Men Treated for Early Prostate Cancer: A Prospective Patient Preference Cohort Study," Journal of Cancer Therapy, Vol. 2 No. 4, 2011, pp. 448-457. doi: 10.4236/jct.2011.24060.