Small study finds that 3 years after prostate cancer treatment, men may report high quality of life and functioning
- Correspondence to : Dr Jeffrey Albaugh, NorthShore University HealthCare, 2180 Pfingsten Road, Suite 3000, Chicago, IL 60631, USA;
Implications for practice and research
The male patients in this study reported high levels of quality of life, with high ratings for overall physical functioning and health. They appeared to adjust to the diminished sexual function.
Nurses can use these outcomes and the results from other studies to inform patients.
Nurses should understand that each individual will have a different prediagnosis level of and valuation of sexual activity/function.
Further multicentred large studies are needed.
Nurses can provide patient education about common sexual problems encountered post prostate cancer treatment and the options for addressing those issues.
Prostate cancer is the most common non-skin cancer in men and quality of life continues to be a major focus of men after prostate cancer diagnosis and treatment. Jakobsson et al1 focused on quality of life in years 1, 2 and 3 after prostate cancer diagnosis, providing longitudinal outcomes from a single institution in Sweden (n=21). In addition to quantitative data, they collected qualitative data obtained from interviews with a cohort of six of the participants, which provides the men's own words, creating a richer context for the quantitative outcomes. Understanding quality of life after prostate cancer is relevant for nurses because ultimately quality of life is of importance to prostate cancer patients and their partners.
The purpose of this commentary is to examine the process and outcomes of the study to determine its place as evidence in supporting the practice of nursing. The design of this study was appropriate to investigate quality of life and daily life functioning in men after prostate cancer diagnosis using psychometrically sound tools to measure health-related quality of life and the salutogenic perspective. This descriptive longitudinal study looked at outcomes but, as with all descriptive studies, no variables were manipulated, but rather, the researchers simply analysed self-reported outcome data from the participants about their experience.
This study provides level 6 evidence2 or fair ranked evidence3 as a single institution study. However, further research is needed in order to provide sufficient evidence. The qualitative data were appropriately analysed to determine overarching themes. The sample size was small (n=21) and no information was provided about whether a power analysis was performed in order to determine the recommended sample size needed to examine quality of life in men with prostate cancer. Previous studies listed in the report have much larger sample sizes.
This study provides both quantitative and qualitative data revealing high quality of life and function in this small group of Swedish men, but low levels of sexual function and activity. This study must be taken in the context of a single institution with a small sample size, and findings should not be applied to the general population or other populations. The findings are presented in a narrative fashion with tables for outcome data and this format is appropriate and easy to follow. It would be helpful to have a table with demographic data to enhance understanding of the study population as well as a mean age. Demographic factors help the reader better understand the population since age, comorbid conditions and treatment may all impact sexual activity and function (sexual dysfunction being the most common long-term side effect of the treatments these men underwent). There is no information about sexual activity prior to initiating treatment for prostate cancer or baseline ability to function sexually. Previous larger multicentre research has shown that sexual dysfunction remains a long-term problem after prostate cancer treatment and impacts quality of life.4 This is important because if this group of Swedish men were not very sexually active prior to their prostate cancer diagnosis and treatment, the lack of sexual function will have little impact on their quality of life. Men who value sexual function and activity need to understand the impact of prostate cancer on sexual function. The fully enlightened patient is more likely to be prepared for changes in function and is therefore more likely to adjust to the issues better.
Competing interests JA has received royalties for his book ‘Reclaiming sex & intimacy after prostate cancer treatment’ with Anthony Jannetti Publishing and has acted on the Advisory Board/Speaker Bureau for Actient pharmaceutical/TIMM Medical.