Quality of Life in Men Diagnosed with Prostate Cancer and in a Healthy Cohort
We will quantify the complications of the disease, treatments, and aging, including the extent of physical symptoms and general and disease-specific HRQL. Participants with PCa, diagnosed 5-10 years previously, will include men with PCa from the screening arm (Group 1; N = 250) and men diagnosed with PCa from the usual care arm (Group 2; N = 250). We will compare the PCa patients to randomly selected sub-samples of PLCO participants with no cancer diagnosis from the screening arm (Group 3; N = 250) and from the usual care arm (Group 4; N = 250). We will accrue participants from 5 of the 10 PLCO Screening Centers and will assess current symptomatology and HRQL via telephone interview. The specific aims are: 1) To document the extent of urinary, sexual, and bowel dysfunction and cancer-specific HRQL in a sample of PCa survivors who are 5 to 10 years post-diagnosis, compared to a sample of men who have not been diagnosed with cancer. These analyses will include Groups 1 and 2 vs. 3 and 4. H.1.1: PCa survivors will report overall poorer physical functioning (i.e., urinary, sexual, bowel) relative to the participants without PCa, adjusting for age, race, comorbidities, screening center, trial arm, and time since trial enrollment. H.1.2: Time since trial enrollment will moderate the differences between PCa survivors and men without PCa, such that the two groups will be more similar on the outcomes as time since enrollment increases. H.1.3. We will explore the interaction between trial arm (screening/UC) and PCa status (present/absent) to determine whether HRQL following a PCa diagnosis is differentially affected by receipt of regular screening. We hypothesize that men diagnosed in the screening arm will report relatively fewer or less severe symptoms and better cancer-specific HRQL compared to men diagnosed in the usual care arm (Groups 1 vs. 2), whereas we do not expect to find a difference between the trial arms among men without cancer (Groups 3 vs. 4). 2) Within the PCa survivor cohorts, we will assess treatment-related symptoms and cancer-specific HRQL. We will adjust for demographic and trial-related confounding variables (e.g., race, age, disease stage at diagnosis, comorbidities, time since diagnosis, and screening center). H.2: We hypothesize that surgery will result in the poorest sexual and urinary functioning outcomes, while radiation and radiation plus hormone therapy will result in the poorest bowel functioning outcomes. This analysis will combine Groups 1 and 2 and adjust for trial arm and the other potential confounders. 3) Based on the previous literature, we expect to find no difference on general HRQL between a) men with PCa (Groups 1 and 2) vs. the healthy comparison groups (Groups 3 and 4), or b) between different treatment modalities (Groups 1 and 2 combined). We will test this hypothesis using a standard equivalence approach.
Long-term disease-specific functioning among prostate cancer survivors and noncancer controls in the prostate, lung, colorectal, and ovarian cancer screening trial.
Taylor KL, Luta G, Miller AB, Church TR, Kelly SP, Muenz LR, Davis KM, Dawson DL, Edmond S, Reding D, Mabie JE, Riley TL
J. Clin. Oncol. 2012 Aug; Volume 30 (Issue 22): Pages 2768-75 PUBMED