Long-term health related quality of life of prostate cancer survivors varies by primary treatment: results from the PiCTure study

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The National Cancer Registry, in conjunction with the Northern Ireland Cancer Registry has published a new paper from the PiCTure (Prostate Cancer Treatment, your experience) study. Prostate cancer is the most frequently diagnosed cancer among men in Ireland and there are more men living with prostate cancer than any other cancer. One of the aims of the PiCTure study was to investigate the long term health related quality of life (HRQoL) of prostate cancer survivors. The PiCTure study is one of the largest population-based studies of prostate cancer survivors internationally. 

The researchers found that after controlling for socio-demographic and clinical factors, overall or global HRQoL (GHRQoL) varied significantly by primary treatment received. Compared to radical prostatectomy (RP), survivors who received androgen deprivation therapy alone (ADT) or external beam radiotherapy (EBRT) without concurrent ADT had significantly lower GHRQoL. The GHRQoL of men who received brachytherapy, EBRT with concurrent ADT or active surveillance/watchful waiting was not significantly different from men treated with RP. Some of the differences in GHRQoL can be explained by differences in symptoms experienced by prostate cancer survivors who received different primary prostate cancer treatment(s). There were statistically and clinically significant differences in general - (fatigue, pain, dyspnoea, appetite loss, constipation, diarrhoea and financial difficulties) and disease-specific symptoms (sexual, urinary, bowel, ADT) by primary treatment.  However, men in all treatment groups experienced fatigue and insomnia.

Based on their findings, the authors concluded that population-based information regarding statistically and clinically significant treatment effects on long-term global HRQoL, symptom burden and functionality should be provided to men during treatment decision-making. The authors also suggest that screening for symptoms and utilising interventions during long-term follow-up may improve survivors’ HRQoL.

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