Health-related quality of life after the diagnosis of locally advanced or advanced prostate cancer: a longitudinal study

Document Type

Journal Article

Publication Title

Cancer Nursing


Lippincott Williams and Wilkins


School of Medical and Health Sciences




Zajdlewicz, L., Hyde, M. K., Lepore, S. J., Gardiner, R. A., & Chambers, S. K. (2017). Health-related quality of life after the diagnosis of locally advanced or advanced prostate cancer: A longitudinal study. Cancer Nursing, 40(5), 412-419.


Background: Approximately 20% of men with a diagnosis of prostate cancer present with locally advanced or advanced disease. Few studies consider longer-term impact of disease progression and treatment adverse effects on health-related quality of life (QoL) of these men.

Objective: Describe changes in health-related QoL over 5 years for men with newly diagnosed locally advanced or advanced prostate cancer.

Interventions/Methods: Eighty-one men with locally advanced or advanced prostate cancer referred to the study by their treating urologist completed a self-administered questionnaire assessing distress, cancer-specific distress, decision regret, satisfaction with life, and global and disease-specific health-related QoL. Questionnaires were administered close to diagnosis (baseline), 2, 6, 12, 24, 36, 48, and 60 months’ follow-up.

Results: Men were of mean age 68.3 (SD, 7.9) years and at mean of 31.9 (SD, 50.5) days postdiagnosis. The most common treatment received was androgen deprivation therapy (95.1%) or radiation therapy (79%). The proportion of men classified as distressed (Distress Thermometer) ranged from 46.3% (baseline) to 32.6% (60 months). Decrements in physical QoL were found at 2, 6, 12, 24, 36, and 48 months compared with baseline. Life satisfaction ratings were lower at 6 months compared with baseline. Sexual concerns were consistently high across the 5 years (Expanded Prostate Cancer Index Composite <30).

Conclusions: In the context of advanced disease, results indicate that health-related QoL fluctuates from diagnosis to 5 years later. A substantial proportion remained distressed at 5-year follow-up.

Implications for Practice: Care frameworks supporting ongoing assessment of health-related QoL concerns of men with advanced prostate cancer are needed with a particular focus on sexual adjustment.



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