Living With Prostate Cancer: Patients' And Spouses' Psychosocial Status And Quality Of Life

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Men's health
Article Date: 30 Dec 2007 - 1:00 PDT

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UroToday.com- In the September issue of the Journal of Clinical Oncology, Dr. Northouse and researchers report on the psychosocial effects of prostate cancer (CaP) across the spectrum of the illness.

The study evaluated quality of life (QoL), appraisal of illness (threat, uncertainty, hopelessness), resources (self-efficacy, communication, social support), symptoms, and risk for distress of men with CaP and their spouses across 3 phases of illness; newly diagnosed, biochemical recurrence, and advanced disease. Patients were from three large Midwest cancer centers. During the 3 years of study, 429 patient/spouse "dyads" were referred and 263 enrolled and completed assessments. Among the phases of illness, 170 (65%) were newly diagnosed, 33 (12%) had biochemical recurrence, and 60 (23%) had advanced disease. A total of 67% of patients had other health problems and 25% of spouses reported health problems. A variety of assessment tools were used to evaluate the endpoints.

Regarding QoL, the advanced disease dyad had poorer physical, emotional, functional, and total QoL. For appraisal variables, biochemical recurrence, and advanced disease dyads reported more negative appraisal of illness, negative appraisal of caregiving, uncertainty, and hopelessness. Spouses had significantly more uncertainty about the illness that did patients. Newly diagnosed dyads reported more self-efficacy than did the other dyads. This was more self-efficacy and social support as reported by patients as compared to spouses. Advanced dyads reported more general symptom distress than others, and patients reported more than spouses. There was a significant phase effect for risk for distress, with advanced dyads having higher risk compared with the other dyads. Lower social well-being was found for newly diagnosed dyads following prostatectomy compared to radiotherapy for patients and spouses.

These observations support a need for phase-specific programs of care for both prostate cancer patients and their spouses.

Northouse LL, Mood DW, Montie JE, Sandler HM, Forman JD, Hussain M, Pienta KJ, Smith DC, Sanda MG, and Kershaw T

J Clin Oncol. 25(27):4171-77, September 2007
DOI: 10.1200/JCO.2006.10.4067

Reported by UroToday.com Contributing Editor Christopher P. Evans, M.D

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