We investigated if a cancer patient's unrelieved symptoms during the last 3 months of life increase the risk of long-term psychological morbidity of the surviving partner. All women (n=506) living in Sweden under 80 years of age, who lost their husband/partner owing to cancer of the prostate in 1996 or of the urinary bladder in 1995 or 1996 were asked to answer an anonymous postal questionnaire, 2 -4 years after their loss. The widows' psychological morbidity was associated with the patient's unrelieved mental symptoms. When the patient was perceived to have been very anxious during last three months of life (compared to no observed symptoms) the relative risks for the widows' psychological morbidity were: 2.5 (1.4 -4.3) for depression and 3.4 (1.4 -8.2) for anxiety. When comparing reports of the patient's pain (much vs no), the relative risks were 0.8 (0.5 -1.2) for widowhood depression, and 0.8 (0.4 -1.7) for widowhood anxiety. The patients were found to have had adequate access to physical pain control but poor access to psychological symptom control. Efficiency in diagnosing and treating psychological complications of terminally ill cancer patients may not only improve their quality of life but possibly also prevent long-term psychological morbidity of their surviving partners.

Based on traditional quality of life scales, it has been suggested that known sideeffects of prostate cancer treatment do not in¯uence the quality of life. The present authors have developed an alternative approach to quality of life assessment applying epidemiological methods.Using a self administered questionnaire, we investigated 431 prostate cancer patients and an age strati®ed sample of 435 randomly selected men.Patients reporting any level of distress due to waning sexual functions (66%) or urine or bowel symptoms (38%), reported a lower psychological well-being compared to patients not reporting these symptoms or patients not distressed by their symptoms.Our results stress that an intact sexual and urinary and bowel functions are important for the quality of life among elderly men with or without prostate cancer.