Prostate cancer and its treatment induce multiple symptoms that significantly impair function and distress patients. Although symptom burden associated with specific treatment pathways has been described, the severity of symptoms across the population and correlates of symptom severity are less well understood.
To describe the severity of symptoms and identify correlates of symptom severity among men treated for prostate cancer.
The severity of prostate cancer specific symptoms of 1127 men treated for prostate cancer from 12 Australian healthcare settings was assessed using Expended Prostate Cancer Index Composite short form, in which symptoms related to five domains (urinary incontinence, urinary irritative/obstructive, bowel, sexual and hormonal function) were measured on a 0-100 scale with higher scores indicating less severe symptoms. Information on overall health-related quality of life, socio-demographics and treatment were also collected. The mean score of each domain was calculated and its potential correlates were identified using bivariate analyses.
Symptom severity was highest for sexual function (mean 24.6, standard deviation [SD] 26.3), followed by urinary incontinence (mean 67.7, SD 31.65). The mean scores of symptoms of other domains ranged from 82.3 to 88.7. Across domains, symptom severity was positively (p<0.05) associated with quality of life. Sexual function severity was also significantly associated with age, education, work status, income, marital status, time since diagnosis. Receipt of surgery and radiotherapy was associated with severity of symptoms related to hormonal function, bowel function and urinary incontinence.
Overall, the severity of prostate cancer specific symptoms was positively associated with men’s overall health-related quality of life. Sexual function related symptom was the most concern for men treated for prostate cancer and must be addressed.