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Multicenter Study
. 2018 Apr;26(4):1297-1304.
doi: 10.1007/s00520-017-3953-8. Epub 2017 Nov 10.

The impact of prostate cancer diagnosis and treatment decision-making on health-related quality of life before treatment onset

Maarten Cuypers  1 , Romy E D Lamers  2 , Erik B Cornel  3 , Lonneke V van de Poll-Franse  4   5   6 , Marieke de Vries  7 , Paul J M Kil  2
Affiliations
Multicenter Study

The impact of prostate cancer diagnosis and treatment decision-making on health-related quality of life before treatment onset

Maarten Cuypers et al. Support Care Cancer. 2018 Apr.

Abstract

Objective: The objective of this study is to test if patients' health-related quality of life (HRQoL) declines after prostate biopsy to detect Pca, and after subsequent treatment decision-making in case Pca is confirmed, and to test whether personality state and traits are associated with these potential changes in HRQoL.

Methods: Patients who were scheduled for prostate biopsy to detect Pca (N = 377) filled out a baseline questionnaire about HRQoL (EORTC QLQ-C30 and PR25), "big five" personality traits (BFI-10), optimism (LOT-r), and self-efficacy (Decision Self-efficacy Scale) (t0). Patients with confirmed Pca (N = 126) filled out a follow-up questionnaire on HRQoL within 2 weeks after treatment was chosen but had not yet started (t1).

Results: HRQoL declined between t0 and t1, reflected in impaired role and cognitive functioning, and elevated fatigue, constipation, and prostate-specific symptoms. Sexual activity and functioning improved. Baseline HRQoL scores were unrelated to the selection of a particular treatment, but for patients who chose a curative treatment, post-decision HRQoL showed a greater decline compared to patients who chose active surveillance. Optimism was associated with HRQoL at baseline; decisional self-efficacy was positively associated with HRQoL at follow-up. No associations between HRQoL and the "big five" personality traits were found.

Conclusion: Patients who have undergone prostate biopsy and treatment decision-making for Pca experience a decline in HRQoL. Choosing treatment with a curative intent was associated with greater decline in HRQoL. Interventions aimed at optimism and decision self-efficacy could be helpful to reduce HRQoL impairment around the time of prostate biopsy and treatment decision-making.

Keywords: Cancer; Decision-making; Decisional self-efficacy; Diagnosis; HRQoL; Oncology; Optimism; Prostate cancer.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Patient flow
See this image and copyright information in PMC

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