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Long-term quality of life after radical prostatectomy in wives of men in the postoperative adjuvant androgen deprivation trial

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Abstract

Purpose

We examined quality of life in spouses of men in the Post-Adjuvant Androgen Deprivation trial after radical prostatectomy.

Methods

Men at high risk of prostate cancer recurrence were randomized to receive androgen deprivation therapy or observation. Forty-three couples completed telephone interviews every 6 months for 2 years assessing women’s mood disturbance, mental and physical health, and sexual function and bother as well as men’s symptoms and sociodemographic and marital variables. We used linear mixed modeling to explore relationships between wives’ quality of life and time, treatment group, and men’s symptoms.

Results

Women’s mental health functioning improved over time (p < 0.05). Furthermore, women with husbands in the observation group had worse mood disturbance (p = 0.01) and poorer mental health (p = 0.02) than women with husbands in treatment. Men’s symptoms were associated with worse physical health in wives (p = 0.02). Women also reported worse sexual function at 18 and 24 months compared with baseline (p = 0.02), but ratings of sexual bother were unrelated to time, treatment, and symptoms.

Conclusions

These exploratory results are consistent with research demonstrating that spousal cancer-related distress decreases over time. Treatment group differences suggest that an examination of caregiving in the context of uncertainty is warranted. Also, the physical burden of caregiving may intensify when men have more symptoms. To inform interventions, future studies should clarify how treatment and symptoms influence wives’ distress by examining expectations and communication.

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Acknowledgments

Patients in the PAAD Trial received free study drug from TAP Pharmaceutical (Lake Forest, IL, USA), AstraZeneca (Wilmington, DE, USA), or Schering Plough (Kenilworth, NJ, USA). First author’s work was supported by an NCI Cancer Prevention and Control Training Program, Center for Health Promotion and Prevention Research, University of Texas-Houston School of Public Health–National Cancer Institute/NIH Grant #2R25CA57712. Second author’s work was supported by an NCI K07 career development award (K07 CA113641). Fourth author’s work was supported by an NIH T32 Training Grant (CA079449) and an American Urological Association Foundation Scholarship.

The authors wish to thank Dr. Jane G. Zapka for her comments on this manuscript.

Conflict of interest

The authors do not have a conflict of interest to report. We have full control of all primary data and agree to allow the journal to review the data if requested.

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Authors and Affiliations

  1. Department of Medicine, Division of Biostatistics and Epidemiology, Medical University of South Carolina, MSC 955, Charleston, SC, 29425-9550, USA

    Katherine Regan Sterba

  2. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX, 77030, USA

    Richard J. Swartz

  3. Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, P. O. Box 1330, Houston, TX, 77030, USA

    Karen Basen-Engquist

  4. Department of Urologic Sciences, University of British Columbia, Level 6, 2775 Laurel St., Vancouver, BC, V5Z 1M9, Canada

    Peter C. Black

  5. Department of Urology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Curtis A. Pettaway

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  1. Katherine Regan Sterba
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Correspondence to Katherine Regan Sterba.

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Sterba, K.R., Swartz, R.J., Basen-Engquist, K. et al. Long-term quality of life after radical prostatectomy in wives of men in the postoperative adjuvant androgen deprivation trial. Support Care Cancer 19, 1117–1124 (2011). https://doi.org/10.1007/s00520-010-0916-8

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  • DOI: https://doi.org/10.1007/s00520-010-0916-8

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