Living with Bladder Cancer: Self-reported Changes in Patients' Functional and Overall Health Status Following Diagnosis

Abstract

Background: Bladder cancer affects life quality, overall health, and mortality negatively. The effect of bladder cancer on activities of daily living (ADLs) is not well established.

Objective: To examine the effect of bladder cancer diagnosis on ADLs, in addition to physical, mental, and overall health measures.

Design setting and participants: Using data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare Health Outcomes Survey (MHOS) registry, responses regarding ADLs and overall health were evaluated in bladder cancer patients over time. The Short Form 12 health survey responses were analyzed to determine the change in physical and mental health scores following bladder cancer diagnosis.

Outcome measurements and statistical analysis: Changes in self-reported ability to perform ADLs and health outcomes following bladder cancer diagnosis were evaluated. Chi-square statistics were used to determine whether the baseline and follow-up surveys were statistically independent for each ADL. Composites scores for physical health (PCS12) and mental health (MCS12) were compared with two-sample t test.

Results and limitations: A total of 498 patients with surveys before and after bladder cancer diagnosis were identified. An increased percentage of patients reported difficulty in all ADL tasks following bladder cancer diagnosis; this increase was statistically significant for bathing (p = 0.02) and using the toilet (p = 0.03). These patients also reported a significant decline in overall health status (p = 0.0002). A significant reduction in the mean PCS12 and mean MCS12 composite scores was observed (p < 0.0001 and p = 0.0003, respectively).

Conclusions: Patients with bladder cancer report a significant decline in functional status and overall health, including both physical and mental well-being after diagnosis. Further study is needed for factors that may be most predictive of the decline in functional independence for this population.

Patient summary: There is a decreased ability to perform daily activities following bladder cancer diagnosis, and patients report a decrease in their physical and mental health. This information can help patients and their caregivers anticipate patient needs following bladder cancer diagnosis, in addition to helping manage their expectations when making decisions regarding treatment options.

Keywords: Activities of daily living; Bladder cancer; General health; Patient-reported outcomes.

Fig. 1

Percentages of patients reporting general health as poor in baseline and follow-up surveys. BC = bladder cancer. * = Denotes statistical significance.