Patient and Partner Quality of Life and Psychosocial Adjustment Following Radical Prostatectomy

  • Andrea A. Thornton
  • Martin A. Perez
  • Beth E. Meyerowitz


We prospectively examined differences in quality of life and psychosocial adjustment in 80 prostate cancer patients and their partners (n = 65) beginning before radical prostatectomy and proceeding across the first year postsurgery. Both members of the couple experienced significant changes associated with the patient's cancer, however their experiences differed in some regards. Patients experienced reprieve from emotional distress and negative affect immediately following surgery despite worsened physical functioning. Partner quality of life and psychosocial adjustment scores were generally more constant from presurgery to postsurgery, with improvements noted 1 year later. For both patients and partners, cancer-specific stress symptoms declined progressively over the year. We also obtained partial support for the effectiveness of a single-session communication intervention on patient social/family wellbeing and partner general stress. Findings have implications for patient and partner adjustment following radical prostatectomy, and attest to the importance of incorporating partner evaluations into psychosocial oncology research.

quality of life prostate cancer radical prostatectomy psychosocial adjustment partners 


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  1. American Cancer Society. (2003). Cancer facts and figures—2003. Atlanta, GA: Author.Google Scholar
  2. Andersen, B. L. (1992). Psychological interventions for cancer patients to enhance quality of life. Journal of Consulting and Clinical Psychology, 60, 552-568.Google Scholar
  3. Baider, L., & Kaplan De-Nour, A. (1988). Adjustment to cancer: Who is the patient—the husband or the wife? Israel Journal of Medical Sciences, 24, 631-636.Google Scholar
  4. Baider, L., Peretz, T., & Kaplan De-Nour, A. (1989). Gender and adjustment to chronic disease: A study of couples with colon cancer. General Hospital Psychiatry, 11, 1-9.Google Scholar
  5. Bjorck, J. P., Hopp, D. P., & Jones, L. W. (1999). Prostate cancer and emotional functioning: Effects of mental adjustment, optimism, and appraisal. Journal of Psychosocial Oncology, 17, 71-85.Google Scholar
  6. Blanchard, C. G., Albrecht, T. L., & Ruckdeschel, J. C. (1997). The crisis of cancer: Psychological impact on family caregivers. Oncology, 11, 189-194.Google Scholar
  7. Braslis, K. G., Santa-Cruz, C., Brickman, A. L., & Soloway, M. S. (1995). Quality of life 12 months after radical prostatectomy. British Journal of Urology, 75, 48-53.Google Scholar
  8. Carver, C. S., Pozo, C., Harris, S. D., Noriega, V., Scheier, M. F., Robinson, D. S., et al. (1993). How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer. Journal of Personality and Social Psychology, 65, 375-390.Google Scholar
  9. Cella, D. F. (1994). F.A.C.T. Manual (Version 3). Chicago, IL: Rush-Presbyterian-St. Luke's Medial Center.Google Scholar
  10. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Mahwah, NJ: Erlbaum.Google Scholar
  11. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385-396.Google Scholar
  12. Dunkel-Schetter, C. (1984). Social support and cancer: Findings based on patient interviews and their implications. Journal of Social Issues, 40, 77-98.Google Scholar
  13. Esper, P., Mo, F., Chodak, G., Sinner, M., Cella, D., & Pienta, K. J. (1997). Measuring quality of life in men with prostate cancer using the functional assessment of cancer therapy—prostate instrument. Urology, 50, 920-928.Google Scholar
  14. Gray, R. E., Fitch, M. I., Phillips, C., Labrecque, M., & Klotz, L. (1999). Presurgery experiences of prostate cancer patients and their spouses. Cancer Practice, 7, 130-135.Google Scholar
  15. Greenfield, S., Kaplan, S., & Ware, J. E. (1985). Expanding patient involvement in care. Annals of Internal Medicine, 102, 520-528.Google Scholar
  16. Greenfield, S., Kaplan, S. H., Ware, J. E., Yano, E. M., & Frank, H. J. L. (1988). Patients' participation in medical care: Effects on blood sugar control and quality of life in diabetes. Journal of Gerontology and Internal Medicine, 3, 448-457.Google Scholar
  17. Hays, R. D., Sherbourne, C. D., & Mazel, R. M. (1993). The Rand 36-Item Health Survey 1.0. Health Economics, 2, 217-227.Google Scholar
  18. Helgeson, V. S., & Cohen, S. (1996). Social support and adjustment to cancer: Reconciling descriptive, correlational, and intervention research. ealth Psychology, 15, 135-148.Google Scholar
  19. Horowitz, M. J., Wilner, N., & Alvarez, W. (1979). Impact of event scale: A measure of subjective stress. Psychosomatic Medicine, 41, 209-218.Google Scholar
  20. Keitel, M. A., Zevon, M. A., Rounds, J. B., Petrelli, N. J., & Karakousis, C. (1990). Spouse adjustment to cancer surgery: Distress and coping responses. Journal of Surgical Oncology, 43, 148-153.Google Scholar
  21. Kornblith, A. B., Herr, H. W., Ofman, U. S., Scher, H. I., & Holland, J. C. (1994). Quality of life of patients with prostate cancer and their spouses. The value of a data base in clinical care. Cancer, 73, 2791-2802.Google Scholar
  22. Lavery, J. F., & Clarke, V. A. (1999). Prostate cancer: Patients' and spouses' coping and marital adjustment. Psychology, Health, and Medicine, 4, 289-302.Google Scholar
  23. Litwin, M. S., Hays, R. D., Fink, A., Ganz, P. A., Leake, B., Leach, G. E., et al. (1995). Quality-of-life outcomes in men treated for localized prostate cancer. JAMA, 273, 129-135.Google Scholar
  24. Litwin, M. S., McGuigan, K. A., Shpall, A. I., & Dhanani, N. (1999). Recovery of health related quality of life in the year after radical prostatectomy: Early experience. Journal of Urology, 161, 515-519.Google Scholar
  25. Litwin, M. S., Melmed, G. Y., & Nakazon, T. (2001). Life after radical prostatectomy: A longitudinal study. Journal of Urology, 166, 587-592.Google Scholar
  26. Lubeck, D. P., Litwin, M. S., Henning, J. M., Stoddard, M. L., Flanders, S. C., & Carroll, P. R. (1999). Changes in health-related quality of life in the first year after treatment for prostate cancer: Results from CaPSURE. Urology, 53, 180-186.Google Scholar
  27. Maher, E. L. (1982). Anomic aspects of recovery from cancer. Social Science Medicine, 16, 907-912.Google Scholar
  28. Manne, S. (1994). Couples coping with cancer: Research issues and recent findings. Journal of Clinical Psychology in Medical Settings, 1, 317-330.Google Scholar
  29. Manne, S. (1998). Cancer in the marital context: A review of the literature. Cancer Investigations, 16, 188-202.Google Scholar
  30. Meyer, T. J., & Mark, M. M. (1995). Effects of psychosocial interventions with adult cancer patients: A meta-analysis of randomized experiments. Health Psychology, 14, 101-108.Google Scholar
  31. Moore, K. N., & Estey, A. (1999). The early post-operative concerns of men after radical prostatectomy. Journal of Advanced Nursing, 29, 1121-1129.Google Scholar
  32. Northouse, L. L., Mood, D., Templin, T., Mellon, S., & George, T. (2000). patterns of adjustment to colon cancer. Social Science and Medicine, 50, 271-284.Google Scholar
  33. Northouse, P. G., & Northouse, L. L. (1987). Communication and cancer: Issues confronting patients, health professionals, and family members. Journal of Psychosocial Oncology, 5, 17-45.Google Scholar
  34. Oberst, M. T., & James, R. H. (1985). Going home: Patient and spouse adjustment following cancer surgery. Topics in Clinical Nursing, 7, 46-57.Google Scholar
  35. Oberst, M. T., & Scott, D. W. (1988). Postdischarge distress in surgically treated cancer patients and their spouses. Research in Nursing and Health, 11, 223-233.Google Scholar
  36. Pedersen, K. V., Carlsson, P., Rahmquist, M., & Varenhorst, E. (1993). Quality of life after radical retropubic prostatectomy for carcinoma of the prostate. European Journal of Urology, 24, 7-11.Google Scholar
  37. Perez, M. A., Meyerowitz, B. E., Lieskovsky, G., Reynolds, B., & Skinner, E. C. (1997). Quality of life and sexuality following radical prostatectomy in patients with prostate cancer who use or do not use erectile aids. Urology, 50, 740-746.Google Scholar
  38. Perez, M. A., Skinner, E. C., & Meyerowitz, B. E. (2002). Sexuality and intimacy following radical prostatectomy: Patient and partner perspectives. Health Psychology, 21, 288-293.Google Scholar
  39. Ptacek, J. T., Pierce, G. R., Ptacek, J. J., & Nogel, C. (1999). Stress and coping processes in men with prostate cancer: The divergent views of husbands and wives. Journal of Social and Clinical Psychology, 18, 299-324.Google Scholar
  40. Rand. (1992). Rand 36-Item Health Survey 1.0. Santa Monica, CA: Author.Google Scholar
  41. Shrader-Bogen, C. L., Kjellberg, J. L., McPherson, C. P., & Murray, C. L. (1997). Quality of life and treatment outcomes. Cancer, 79, 1977-1986.Google Scholar
  42. Spanier, G. B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family, 38, 15-28.Google Scholar
  43. Stanton, A. L., & Snider, P. R. (1993). Coping with a breast cancer diagnosis: A prospective study. Health Psychology, 12, 16-23.Google Scholar
  44. Thompson, S. C., Nanni, C., & Schwankovsky, L. (1990). Patient-oriented interventions to improve communication in a medical office visit. Health Psychology, 9, 390-404.Google Scholar
  45. Trijsburg, R. W., van Knippenberg, F. C. E., & Rijpma, S. E. (1992). Effects of psychological treatment on cancer patients: A critical review. Psychosomatic Medicine, 54, 489-517.Google Scholar
  46. Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (2000). SF-36 Health Survey: Manual and Interpretation Guide. Lincoln, RI: QualityMetric.Google Scholar
  47. Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063-1070.Google Scholar
  48. Wortman, C. B. (1984). Social support and the cancer patient: Conceptual and methodological issues. Cancer, 53(Suppl. 10), 2339-2360.Google Scholar
  49. Zilberg, N. J., Weiss, D. S., & Horowitz, M. J. (1982). Impact of Event Scale: A cross-validation study and some empirical evidence supporting a conceptual model of stress response syndromes. Journal of Consulting and Clinical Psychology, 50, 407-414.Google Scholar

Copyright information

© Plenum Publishing Corporation 2004

Authors and Affiliations

  • Andrea A. Thornton
    • 1
  • Martin A. Perez
    • 1
  • Beth E. Meyerowitz
    • 2
  1. 1.Department of Supportive Care, Pain, and Palliative MedicineCity of Hope National Medical CenterDuarte
  2. 2.Department of PsychologyUniversity of Southern CaliforniaLos Angeles

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