Patients’ Perceptions of Quality of Life After Treatment for Early Prostate Cancer Jack A. Clark, Thomas S. Inui, Rebecca A. Silliman, Barbara G. Bokhour, Steven H. Krasnow, Richard A. Robinson, Monica Spaulding, James A. Talcott From the Boston University School of Public Health; Boston University Medical School; Harvard Vanguard Medical Associates; Center for Outcomes Research, Massachusetts General Hospital Cancer Center, Massachusetts General Hospital; Harvard Medical School, Boston; Center for Health Quality, Outcomes, and Economic Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA; Indiana University School of Medicine; Regenstrief Institute for Health Care, Indianapolis, IN; Veterans Affairs Medical Center, Washington, DC; Veterans Affairs Western New York Health Care System; and State University of New York at Buffalo Medical School, Buffalo, NY. Address reprint requests to Jack A. Clark, PhD, Department of Health Services, Boston University School of Public Health, 715 Albany St, T3-W, Boston, MA 02118; e-mail: jaclark@bu.edu. Purpose: Treatment for early prostate cancer produces problematic physical side effects, but prior studies have found little influence on patients’ perceived health status. We examined psychosocial outcomes of treatment for early prostate cancer. Patients and Methods: Patients with previously treated prostate cancer and a reference group of men with a normal prostate-specific antigen (PSA) level and no history of prostate cancer completed questionnaires. Innovative scales assessed behavioral consequences of urinary dysfunction, sexuality, health worry, PSA concern, perceived cancer control, treatment decision making, decision regret, and cancer-related outlook. Urinary, bowel, and sexual dysfunction were assessed with symptom indexes; health status was assessed by the Physical and Mental Summaries of the Short Form (SF-12) Health Survey. Results: Compared with men without prostate cancer, prostate cancer patients reported greater urinary, bowel, and sexual dysfunction, but similar health status. They reported worse problems of urinary control, sexual intimacy and confidence, and masculinity, and greater PSA concern. Perceptions of cancer control and treatment decisions were positive, but varied by treatment: prostatectomy patients indicated the highest and observation patients indicated the lowest cancer control. Bowel and sexual dysfunction were associated with poorer sexual intimacy, masculinity, and perceived cancer control; masculinity and PSA concern were associated with greater confidence in treatment choice; and diminished sexual intimacy and less interest in PSA were associated with greater regret. Conclusion: The lack of change in global measures of health status after treatment for early prostate cancer obscures important influences in men’s lives; cancer diagnosis and treatment complications may result in complex outcomes. Aggressive treatment may confer confidence in cancer control, yet be countered by diminished intimate relationships and masculinity, which accompany sexual dysfunction. Journal of Clinical Oncology, Vol 21, Issue 20 (October), 2003: 3777-3784 JAMA, 6/04 Ann Fonfa's Comments Interventions Over 15 Yrs Watchful Waiting Beneficial in Some Patients 5-Yr Outcomes After Prostatectomy/Radiotherapy Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.