Examining relationships between age at diagnosis and health-related quality of life outcomes in prostate cancer survivors

Abstract

BackgroundPatient reports of health related quality of life can provide important information about the long-term impact of prostate cancer. Because patient symptoms and function can differ by age of the survivor, the aim of our study was to examine patient-reported quality of life and prostate symptoms by age at diagnosis among a registry of Dutch prostate cancer survivors.MethodsA population of 617 individuals from the Patient Reported Outcomes Following Initial Treatment and Long-Term Evaluation of Survivorship (PROFILES) database was surveyed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) and prostate symptom (EORTC QLQ-PR25) scales. Age at diagnosis was the main independent variable, with three age categories: 60 years and younger, 61–70 years, and 71 years and older. Dependent variables were the EORTC-QLQ-C30 and EORTC QLQ-PR25 scales, divided into positive and negative outcomes. Positive measures of health-related quality of life included global health, physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning. Negative outcomes included fatigue, nausea, pain, dyspnea, insomnia, appetite, constipation, and diarrhea. We also assessed sexual activity, and urinary, bowel and hormonal symptoms. Descriptive analyses included frequencies with chi-square tests and medians with Kruskal-Wallis tests. Multivariable adjusted analyses were conducted by median regression modeling.ResultsAmong the numerous scales showing some unadjusted association with age group, only two scales demonstrated significant differences between prostate cancer patients age 71+ compared to the youngest group (age < 61) after multivariable adjustment. On average, the oldest patients experienced an 8.3-point lower median physical functioning score (β = − 8.3; 95% CI = − 13.9, − 2.8; p = 0.003) and a 16.7-point lower median sexual activity score (β = − 16.7; 95% CI = − 24.7, − 8.6; p < 0.001) while controlling for BMI, marital status, time since diagnosis, comorbidities (heart condition), Gleason score, and treatment (prostatectomy).ConclusionsResults suggest that patient age at diagnosis should be considered among factors that contribute to health-related quality of life outcomes for prostate cancer survivors. Implications for Cancer Survivors: A possible reevaluation of screening recommendations may be appropriate to acknowledge age as a factor contributing to health-related quality of life outcomes for prostate cancer survivors.

Preliminary exploration of clinical factors affecting acute toxicity and quality of life after carbon ion therapy for prostate cancer

“…A previous review by Blank and Bellizzi observed that older cancer survivors when diagnosed had a higher QOL, given that earlier cancer detection can lead to increased stress and an overall negative psychological perception [31]. Nevertheless, many studies have come to the opposite conclusion that age predicted a decline QOL, due to aging-related fatigue, constipation and poorer appetite [22, 32]. This could also be the reason why, in our study, bowel QOL gradually declined as time progressed.…”

Examining the influence of illness perception and financial toxicity on the quality of life of prostate cancer patients

“…Age has been described as the most important factor influencing health-related QoL in patients with CaP [19]. Though older men with prostate cancer have been shown to not be different significantly from their younger counterparts in quality of life following treatment [20], other studies have reported that prostate cancer patients who were diagnosed at a younger age had the better health-related quality of life specifically in relation to higher levels of physical functioning and sexual activity [21,22]. While some studies reported that education did not have significant influence on quality of life of cancer patients [23][24][25], an older study among men with prostate cancer reported that patients with lower education levels had worse physical, social and role functions and experienced more side-effects [26].…”

Molecular Expression of Some Oncogenes and Predisposing Behaviors Contributing to the Aggressiveness of Prostate Cancer

“…Studies on the relationship between age and prostate cancer have shown that there is a significant relationship between age and the incidence of this cancer, however, the average age of patients with prostate cancer varies from study to study. Different factors, such as changes in diet and lifestyle, enhanced life expectancy, more access to screening and diagnosis of prostate cancer, occupational risk factors, the improvement in cancer registry completeness, and more exposure to the environment, can affect patients at different ages (20,23,24). In this study, only 20% of patients had a family history of prostate cancer.…”