Patient and spouse health related quality of life after radical retropublic prostatectomy

Abstract

The purpose of this study was to describe longitudinally, the health-related and disease-specific quality of life of patients who underwent a radical retropubic prostatectomy as treatment for localized prostate cancer and to describe the health-related quality of life of the wife of the radical retropubic prostatectomy patient. Pre-operatively, and at 6-weeks and 3-months post-operatively, 67 married couples completed and returned the SF-12, the Quality of Life Index - Cancer Version, and the Cantril Self-Anchoring Scale. The UCLA - Prostate Cancer Index (disease-specific instrument) was completed by the patient, pre-operatively and at 3-months post-operatively. Another instrument entitled Shared Visions, developed by the investigator, was administered at both post-op data points to assess the couples' recuperative concerns and suggested strategies for recovery. Repeated measures analysis of variance was performed to determine the differences in the patients' health-related quality of life and disease-specific quality of life, as well as the wives' health-related quality of life. Patient age and pathological stage of the prostate cancer were investigated to assess their impact on the patients' disease-specific quality of life. Finally, the relationship between the scores of the Quality of Life Index - Cancer Version and the scores on the SF-12 were investigated using the Pearson Product Moment Correlation. The patients' scores yielded significant (p < .05) main effects for the physical component summary of the SF-12 and for all of the scores for the Quality of Life Index - Cancer Version. The wives' scores yielded only one significant (p < .05) main effect---the health and functioning subscale of the Quality of Life Index. Significant (p < .001) main effects were noted for all areas of the patients' disease-specific quality of life. No significant interactions were noted between either patient age or pathological stage of the prostate cancer and disease-specific quality of life. The mental component summary score of the SF-12 demonstrated significant (p < .05 to p < .01) correlations with most of the Quality of Life Index. The most frequently mentioned recuperative concerns of the radical retropubic couples were sexual dysfunction, family stress and concerns about prognosis. The most frequently mentioned suggested strategies for recovery included: educating oneself about prostate cancer and its treatment to make an informed decision about care, mutual support between the patient and wife, and networking/support groups. For this sample of highly educated, affluent patients from one academic institution, these data indicate that patients experience changes in their health-related quality of life that begins to return to baseline by 3-months post-op. However, at 3-months post-op the patients are still experiencing poor disease-specific quality of life. The wives experienced good to very good health-related quality of life throughout the pre- and post-op periods. Data were collected too soon after surgery to determine the impact of the patient's age and pathological stage of prostate cancer on disease-specific quality of life.