Quality of Life, Health Outcomes, and Identity for Patients With Prostate Cancer in Five Different Treatment Groups

Purpose/Objectives: To describe how different treatments for prostate cancer affect health-related quality of life (QOL), health status, and  masculinity.

Design: Longitudinal survey design with descriptive, correlational, and comparative elements.

Setting: A tertiary medical center and associated clinics in a suburban community in the Southwestern United States.

Sample: 185 men with localized prostate cancer were enrolled from five treatment groups: watchful waiting (n = 30), surgery (n = 59), conventional radiation (n = 25), proton-beam radiation (n = 24), and a combination of conventional radiation and proton-beam radiation or mixedbeam radiation (n = 47). At six months, 163 remained on the study; at 12 months, 154 remained; and at 18 months, 153 remained. The average age was 68 years, and 82% of the men were white.

Methods: Men were enrolled at treatment and given a questionnaire with a self-addressed, stamped envelope for return. Questionnaires were mailed again at 6, 12, and 18 months.

Main Research Variables: Health-related QOL, health status, prostate treatment-specific symptoms, and sex-role identity.

Findings: No overall difference in health-related QOL or health status was found, but post-hoc analysis revealed specific differences. The differences existed in sexual functioning and gastrointestinal treatment-specific symptoms. No relationship existed between masculinity and health-related QOL.

Conclusions: Health-related QOL and health status are similar regardless of type of treatment. Radiation tends to produce more gastrointestinal symptoms, and surgery tends to produce more sexual functioning symptoms. Watchful waiting is associated with poorer general health.

Implications for Nursing Practice: Nurses can provide specific treatment-related information to men who are faced with making treatment decisions for prostate cancer and, in consultation with the healthcare team, can select a treatment best suited to them.