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Comorbidity burden and health-related quality of life in men with advanced prostate cancer

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Abstract

Purpose

Identifying clinically relevant comorbidities and their effect on health-related quality of life (HRQoL) outcomes among men with advanced prostate cancer (APC) can inform patient care and improve outcomes; however, this is poorly understood. The aim of this observational study was to examine the prevalence of comorbidities, and the relationship of comorbidity burden to HRQoL and other patient-reported outcomes (PROs) among men with APC.

Methods

Participants were 192 men (average age 68.8) with APC (stage III or IV) who completed a psychosocial battery including measures of sociodemographic factors, HRQoL and other PROs, and the Charlson Comorbidity Index (CCI). Hierarchical multiple regression analysis was used to examine the relationships between CCI, HRQOL, and PROs.

Results

The vast majority (82%) of participants had at least one comorbidity, with the most common being: hypertension (59%), connective tissue disease or arthritis (31%), diabetes (24%), and problems with kidneys, vision, or another organ (24%). After controlling for covariates, regressions showed that a higher CCI score was significantly associated with worse HRQoL (p < 0.001), lower levels of positive affect (p < 0.05), and higher levels of depression (p < 0.05), fatigue (p < 0.001), pain (p < 0.01), stress (p < 0.01), and cancer-specific distress (p < 0.05).

Conclusions

Comorbidities were common among men with APC, and a greater CCI score was associated with detriments in several domains of HRQoL and other PROs. Our findings show the need to address comorbidities in the presence of a cancer diagnosis and subsequent treatment.

Trial registration clinicalTrials.gov identifier

NCT03149185.

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Data availability

The data are currently used for secondary analyses and manuscript development. The data that support the study may be available upon request with permission from the researchers who collected the data.

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Acknowledgements

The authors thank the patients who participated in the study, as well as the staff who recruited patients and worked continuously on delivering and improving care.

Funding

This study was supported by a National Cancer Institute (NCI) grant (R01CA157809) awarded to Dr. Frank Penedo. Dr. Roberto Benzo was supported by an NCI Training Grant (T32CA251064). Dr. Rina Fox was supported by the NCI (K08247973). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Flipse Building, 5thFloor, Coral Gables, Miami, FL, 33146, USA

    Roberto M. Benzo, Emily A. Walsh & Frank J. Penedo

  2. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA

    Patricia I. Moreno & Raymond R. Balise

  3. University of Arizona College of Nursing, Tucson, AZ, USA

    Rina S. Fox

  4. University of Arizona Cancer Center, Tucson, AZ, USA

    Rina S. Fox

  5. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Rina S. Fox & Betina Yanez

  6. Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA

    Carlos A. Silvera & Frank J. Penedo

  7. Department of Urology, University of Miami, Miami, FL, USA

    Raymond R. Balise

  8. Department of Health Outcomes and Behavior, Moffit Cancer Center, Tampa, FL, USA

    Laura B. Oswald

Authors
  1. Roberto M. Benzo
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  2. Patricia I. Moreno
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  3. Rina S. Fox
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  4. Carlos A. Silvera
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  5. Emily A. Walsh
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  8. Laura B. Oswald
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  9. Frank J. Penedo
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Contributions

All authors contributed to the study conception and design. Study design and data collection were performed by Frank Penedo, Patricia Moreno, Rina Fox, Emily Walsh, Betina Yanez, and Laura Oswald. Data analyses were performed by Roberto Benzo, Raymond Balise, and Frank Penedo. The first draft of the manuscript was written by Roberto Benzo and Carlos Silvera, and all authors commented on subsequent versions. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Frank J. Penedo.

Ethics declarations

Ethical approval

All study procedures that involved human participants were following the ethical standards of the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study procedures were approved by the Institutional Review Board at Northwestern University.

Consent to participate

Informed consent was obtained from all individual participants in the study.

Competing interests

The authors have no conflicts of interest to disclose.

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Benzo, R.M., Moreno, P.I., Fox, R.S. et al. Comorbidity burden and health-related quality of life in men with advanced prostate cancer. Support Care Cancer 31, 496 (2023). https://doi.org/10.1007/s00520-023-07962-6

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