Patients' and doctors' perception of long-term morbidity in patients with testicular cancer clinical stage I
- 62 Downloads
Patient-based questionnaires were designed with the aim to identify and rank long-term somatic and psychosocial morbidity in patients with low-stage testicular cancer. A further intention was to compare patients' assessments with experienced doctors' general opinion on quality of life items in cured testicular cancer patients. In pilot study I, 103 tumour-free patients ranked items of physical and psychosocial morbidity after having had various kinds of treatment. Though the ranking procedure appeared to cause some difficulties amongst the patients and subsequently was abandoned, the results indicated considerable differences between the patients' and doctors' evaluations. In pilot study II patients were asked to score the different items. The questionnaire of pilot study II was completed by 107 patients from the Norwegian Radium Hospital (NRH) and 99 relapse-free patients from the Royal Marsden Hospital (RMH) with testicular cancer stage I at least 1 year after infradiaphragmatic radiotherapy (n = 94) or adjuvant chemotherapy (2 cycles,n=26), or patients who had been followed on the surveillance program (n = 86). A total of 93 doctors completed a similar questionnaire, thereby expressing their general opinion on long-term morbidity in comparable testicular cancer patients as seen during routine clinical follow-up. Both the irradiated patients and those on the surveillance program reported slight degrees of Raynaud-like phenomena, neurotoxicity and ototoxicity, most probably representing “background morbidity” in an age-matched general male population. Doctors tended to underestimate their patients' somatic morbidity, but often overestimated the degree of psychological distress, in particular in patients on the surveillance program. Significant differences between RMH and NRH patients with regard to sexual problems and to leisure time activity may be explained by cultural differences in the two countries. The items presented in the questionnaire used identify important issues for patients cured of testicular cancer which may be used in future multicentre trans-cultural studies assessing these patients' quality of life. This will provide sufficient data for psychometric testing and, together with the findings from patients' free comments, support the final design of a testicular cancer quality of life module.
Key wordsTesticular cancer stage I Long-term psychosocial and physical morbidity Doctors' and patients' assessment
Unable to display preview. Download preview PDF.
- 2.Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Fletcher H, Fleishman SB, Haes JCJM de, Kaasa S, Klee M, Osoba D, Razavi D, Role PB, Schraub S, Sneeuw K, Sullivan M, Takeda F, for the European Organization for Research and Treatment of Cancer Study Group on Quality of Life (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality of life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376PubMedGoogle Scholar
- 5.Cassileth BR, Soloway MS, Vogelzang NJ, Chou JM, Schellhammer PD, Seidmon EJ, Kennealey GT. members of the Zoladex Prostate Cancer Study Group (1992) Quality of life and psychological status in stage D prostate cancer. Quality Life Res 1:323–330Google Scholar
- 6.Cullen MH, Cook J, Woodroffe C, Murphy A, Warwick J, Ferry D (1994) Surveillance or immediate adjuvant chemotherapy for stage I nonseminomatous germ cell tumours of the testis (NSGCTT). Br J Cancer 69 [Suppl 21]: 14Google Scholar
- 7.Donohue JP, Thornhill JA, Foster RS, Rowland RG, Bihrle R (1993) Retroperitoneal lymphadenectomy for clinical stage A testis cancer (1965 to 1989): modifications of technique and impact on ejaculation. Urology 149:237–243Google Scholar
- 8.Douchez J, Droz JP, Desclaux B, Allain Y, Fargeot P, Caty A, Charrot P (1993) Quality of life in long-term survivors of nonseminomatous germ cell testicular tumors. Urology 149:498–501Google Scholar
- 9.Fallowfield L (1990) The quality of life. The missing measurement in health care. Methodological issues. (Human horizon series) Souvenir Press, London, pp 43–44Google Scholar
- 14.Fosså SD, Aaronson NK, Newling D, Cangh PJ van, Denis L, Kurth K-H, Pauw M de, members of the EORTC GU Group (1990) Subjective response to treatment of hormone-resistant metastatic prostatic cancer. Eur J Cancer Clin Oncol 26:1133–1136Google Scholar
- 15.Fosså SD, Jacobsen A-B, Aass N, Heilo A, Stenwig AE, Kummen O, Johannessen NB, Waaler G, Øgreid P, Borge L, Urnes T, Bjerklund-Johansen T (1994) How safe is surveillance in patients with histologically low-risk non-seminomatous testicular cancer in a geographically extended country with limited CT resources? Br J Cancer 74:652–658Google Scholar
- 24.Parmar H, Phillips RH, Lightman SL, Edwards L (1988) How would you like to have an orchidectomy for advanced prostatic cancer? Am J Clin Oncol 11:160–168Google Scholar
- 30.Sprangers MAG, Cull A, Bjordal K, Groenvold M, Aaronson NK, for the EORTC Study Group on Quality of Life (1993) The European Organization for Research and Treatment of Cancer approach to quality of life assessment: guidelines for developing questionnaire modules. Quality Life Res 2:287–295Google Scholar