Adult urologyQuality of life at the end of life: trends in patients with metastatic prostate cancer
Section snippets
Patients
Eighty-one men were diagnosed with metastatic prostate cancer at the University of California, Los Angeles, from November 1993 through June 1996, of whom 78 agreed to be included in a longitudinal, observational cohort. Metastasis was confirmed with whole-body nuclear bone scanning. Patients completed confidential HRQOL questionnaires at baseline (before beginning androgen ablation therapy), at 3-month intervals for the first year, and subsequently at 6-month intervals for up to 5 years. For
Results
Table I lists the clinical characteristics of our study sample. At baseline, the mean age was 73.8 ± 4.4 years (range 67 to 82), with 16 patients aged 70 years or older. Most patients were white (75%), married or living with a partner (73%), and unemployed or retired (80%). Only 35% had at least a college degree, and 45% had an annual household income over $30,000. Seventy percent of patients reported comorbidities. Prior radical prostatectomy or external beam irradiation were each reported by
Comment
Our study has two important findings. First, marital status appears to be associated with rates of decline in the physical and emotional domains of the HRQOL in different ways toward the end of life. Married men tended to decline in the physical domains at a slower rate than did single men. The declines in the emotional domains, however, appear unrelated to marital status; both married and unmarried men have reason to become depressed toward the end of life. Loneliness may have a significant
Acknowledgements
To Laura Abraham and Kellie Ma, who assisted with data collection and management, for their vigilant work.
References (17)
- et al.
Quality of life before death for men with prostate cancerresults from the CaPSURE database
J Urol
(2001) - et al.
Last daysa study of the quality of life of terminally ill cancer patients
J Chronic Dis
(1986) - et al.
The importance of marital and socioeconomic status in incidence and survival of prostate canceran analysis of complete Norwegian birth cohorts
Prev Med
(1997) - et al.
Morbidity and disability in older persons in the years prior to death
Am J Public Health
(1991) - et al.
The quality of life in the year before death
Am J Public Health
(1992) Measuring quality of care at the end of lifea statement of principles
J Am Geriatr Soc
(1997)- et al.
The RAND 36-Item Health Survey 1.0
Health Econ
(1993) Coefficient alpha and the internal structure of tests
Psychometrika
(1951)
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