Quality of Life Research

, 16:399 | Cite as

What contributes more strongly to predicting QOL during 1-year recovery from treatment for clinically localized prostate cancer: 4-weeks-post-treatment depressive symptoms or type of treatment?

  • Patrick O. MonahanEmail author
  • Victoria Champion
  • Susan Rawl
  • R. Brian Giesler
  • Barbara Given
  • Charles W. Given
  • Debra Burns
  • Silvia Bigatti
  • Kristina M. Reuille
  • Faouzi Azzouz
  • Jingwei Wu
  • Michael Koch



Research on prostate cancer and quality of life (QOL) has focused on the effects of treatment type on subsequent QOL, without considering effects of depressive symptoms. The present purpose is to test the independent contribution of depressive symptoms (measured within 4 weeks after treatment) and treatment type in predicting QOL measured 4, 7, and 12 months following treatment for clinically localized prostate cancer.


The 105 patients (all Stage I–II) were newly treated with radical prostatectomy, external beam radiation (EBR) or brachytherapy. Age ranged from 42 to 80 (mean = 64); 88% Caucasian and 9% African American. Repeated measures mixed linear models were adjusted for age, race, education, and marital status.


Depressive symptoms significantly (p < 0.01) predicted 8 of 10 disease-specific and 7 of 7 generic QOL outcomes. Treatment type significantly (p < 0.01) predicted urinary function and bowel bother but no generic QOL outcomes.


Depressive symptoms appears to predict a wider range of QOL outcomes (measured 4–12 months after treatment) than treatment type; however, when treatment is significant its effect sizes are slightly larger than depressive symptoms. Health care providers should (1) assess depressive symptoms in prostate cancer patients before and after treatment, and (2) provide psychosocial (e.g., counseling, support groups) and pharmacologic treatment options for improving depressive symptoms.


Depression Depressive symptoms Prostate cancer Quality of life Treatment 



This research was conducted in affiliation with the Mary Margaret Walther Program for Cancer Care Research and the Behavioral Cooperative Oncology Group. We thank the editor and two anonymous reviewers whose suggestions led to a strengthened analysis and discussion.


  1. 1.
    American Cancer Society (2006). Cancer Facts and Figures 2006. Atlanta, American Cancer SocietyGoogle Scholar
  2. 2.
    Eton DT, Lepore SJ (2002). Prostate cancer and health-related quality of life: A review of the literature. Psycho-Oncology 11(4):307–26CrossRefPubMedGoogle Scholar
  3. 3.
    Cella DF, Tulsky DS (1993). Quality of life in cancer: Definition, purpose, and method of measurement. Cancer Invest 11(3):327–36CrossRefPubMedGoogle Scholar
  4. 4.
    Giesler RB (2000). Assessing the quality of life in patients with cancer. Curr Probl Cancer 24(2): 53–2CrossRefGoogle Scholar
  5. 5.
    Talcott JA, Rieker P, Clark JA, et al. (1998). Patient-reported symptoms after primary therapy for early prostate cancer: Results of a prospective cohort study. J Clin Oncol 16(1):275–83PubMedGoogle Scholar
  6. 6.
    Gelblum DY, Potters L, Ashley R, Waldbraum R, Wang X, Leibel S (1999). Urinary morbidity following ultrasound-guided transperineal prostate seed implantation. Int J Radiat Oncol Biol Phys 45(1):59–7PubMedGoogle Scholar
  7. 7.
    Rondorf-Klym LM, Colling J (2003). Quality of life after radical prostatectomy. Oncol Nurs Forum 30(2):E24–E32CrossRefPubMedGoogle Scholar
  8. 8.
    Schag CA, Ganz PA, Wing DS, Sim MS, Lee JJ (1994). Quality of life in adult survivors of lung, colon and prostate cancer. Qual Life Res 3(2): 127–41CrossRefPubMedGoogle Scholar
  9. 9.
    Lim AJ, Brandon AH, Fiedler J, et al. (1995). Quality of life: Radical prostatectomy versus radiation therapy for prostate cancer. J Urol 154(4): 1420–425CrossRefPubMedGoogle Scholar
  10. 10.
    Borghede G, Karlsson J, Sullivan M (1997). Quality of life in patients with prostatic cancer: Results from a Swedish population study. J Urol 158(4):1477–485CrossRefPubMedGoogle Scholar
  11. 11.
    Roth AJ, Kornblith AB, Batel-Copel L, Peabody E, Scher HI, Holland JC (1998). Rapid screening for psychological distress in men with prostate carcinoma: A pilot study. Cancer 82(10):1904–908CrossRefPubMedGoogle Scholar
  12. 12.
    Pirl WF, Siegel GI, Goode MJ, Smith MR (2002). Depression in men receiving androgen deprivation therapy for prostate cancer: A pilot study. Cancer 82(10):1904–908CrossRefPubMedGoogle Scholar
  13. 13.
    Kurtz ME, Kurtz JC, Stommel M, Given CW, Given B (2001). Physical functioning and depression among older persons with cancer. Cancer Pract 9(1):11–8CrossRefPubMedGoogle Scholar
  14. 14.
    Sellick SM, Crooks DL (1999). Depression and cancer: An appraisal of the literature for prevalence, detection, and practice guideline development for psychological interventions. Psycho-Oncology 8(4):315–33CrossRefPubMedGoogle Scholar
  15. 15.
    Herrmann C, Brand-Driehorst S, Kaminsky B, Leibing E, Staats H, Ruger U (1998). Diagnostic groups and depressed mood as predictors of 22-month mortality in medical inpatients. Psychosomatic Med 60(5):570–77Google Scholar
  16. 16.
    McDaniel JS, Musselman DL, Nemeroff CB (1997). Cancer and depression: Theory and treatment. Psychiat Ann 27(5):360–64Google Scholar
  17. 17.
    Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P (2000). The unmet supportive care needs of patients with cancer. Supportive Care Review Group. Cancer 88(1):226–37CrossRefPubMedGoogle Scholar
  18. 18.
    Given CW, Stommel M, Given B, Osuch J, Kurtz ME, Kurtz JC (1993). The influence of patients’ symptoms and functional states on patients’ depression and family caregivers’ reaction and depression. Health Psychol 12(4):277–85CrossRefPubMedGoogle Scholar
  19. 19.
    Giesler RB, Miles BJ, Cowen ME, Kattan MW (2000). Assessing quality of life in men with clinically localized prostate cancer: Development of a new instrument for use in multiple settings. Qual Life Res 9(6):645–65CrossRefPubMedGoogle Scholar
  20. 20.
    Ware JE, Jr, Sherbourne CD (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–83CrossRefPubMedGoogle Scholar
  21. 21.
    Radloff LS (1977). The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas 1:385–01CrossRefGoogle Scholar
  22. 22.
    Andrykowski MA, Curran SL, Studts JL, et al (1996). Psychosocial adjustment and quality of life in women with breast cancer and benign breast problems: A controlled comparison. J Clin Epidemiol 49(8): 827–34CrossRefPubMedGoogle Scholar
  23. 23.
    Clark JA, Wray N, Brody B, Ashton C, Giesler B, Watkins H (1997). Dimensions of quality of life expressed by men treated for metastatic prostate cancer. Soc Sci Med 45(8):1299–309CrossRefPubMedGoogle Scholar
  24. 24.
    The SAS System for Windows [computer program]. Version Eight. Cary, NC: SAS Institute Inc., 1999Google Scholar
  25. 25.
    Giesler RB, Given B, Given CW, et al (2005). Improving the quality of life of prostate cancer patients: A randomized trial testing the efficacy of a nurse-driven intervention. Cancer 104(4):752–62CrossRefPubMedGoogle Scholar
  26. 24.
    Cohen J. Statistical Power Analysis for the Behavioral Sciences, 2nd edn. New York: Academic Press, 1988Google Scholar
  27. 27.
    Bottomley A (1998). Depression in cancer patients: A literature review. Eur J Cancer Care (Engl) 7(3):181–91CrossRefGoogle Scholar
  28. 28.
    Newport DJ, Nemeroff CB (1998). Assessment and treatment of depression in the cancer patient. J Psychosom Res 45(3):215–37CrossRefPubMedGoogle Scholar
  29. 29.
    Gregoire I, Kalogeropoulos D, Corcos J (1997). The effectiveness of a professionally led support group for men with prostate cancer. Urol Nurs 17(2):58–6PubMedGoogle Scholar
  30. 30.
    Chan KS, Orlando M, Ghosh-Dastidar B, Duan N, Sherbourne CD (2004). The interview mode effect on the Center for Epidemiological Studies Depression (CES-D) scale: An item response theory analysis. Med Care 42(3):281–89CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Patrick O. Monahan
    • 1
    • 2
    • 3
    Email author
  • Victoria Champion
    • 2
    • 3
    • 4
  • Susan Rawl
    • 2
    • 3
    • 4
  • R. Brian Giesler
    • 5
  • Barbara Given
    • 3
    • 6
  • Charles W. Given
    • 3
    • 7
  • Debra Burns
    • 2
    • 8
  • Silvia Bigatti
    • 9
  • Kristina M. Reuille
    • 4
  • Faouzi Azzouz
    • 1
    • 2
  • Jingwei Wu
    • 1
  • Michael Koch
    • 1
    • 2
  1. 1.Department of MedicineIndiana University School of MedicineIndianapolisUSA
  2. 2.Indiana University Cancer CenterIndianapolisUSA
  3. 3.Behavioral Cooperative Oncology GroupIndiana UniversityIndianapolisUSA
  4. 4.Indiana University School of NursingIndianapolisUSA
  5. 5.Department of PsychologyButler UniversityIndianapolisUSA
  6. 6.College of NursingMichigan State UniversityLansingUSA
  7. 7.College of Human MedicineMichigan State UniversityLansingUSA
  8. 8.Indiana University School of MusicIndianapolisUSA
  9. 9.Department of PsychologyIndiana UniversityIndianapolisUSA

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