Prostate cancer can impact the quality of life, having a major effect on patients’ day-to-day life and overall well-being. According to a new Canadian survey of men who have or have had prostate cancer, prostate cancer’s physical manifestations can also lead to psychological and social concerns, both of which are more pronounced for those with later stages of the disease, when the tumor has metastasized or spread beyond the prostate.
The most reported physical concern (64%) for all men surveyed is being unable to maintain an erection; however, for men with advanced (stages 3 and 4) prostate cancer, the psychological concerns (69%) and social concerns (50%) are just as important. These issues include feelings of loss of masculinity, loss of dignity, loss of identity, and missing out on important life events.
More than one-third of all men living with prostate cancer (36%) say the disease has impacted their ability to participate in daily activities, such as using the bathroom, being physically active and travelling.
The survey was conducted between June 21 and July 7, 2013 on behalf of Janssen Inc., and in partnership with the advocacy organization, Canadian Cancer Survivor Network (CCSN).
The most significant, but not surprising finding was that on quality of life issues the impact of prostate cancer has a much greater significance for men with advanced prostate cancer (stages 3 and 4) than early stage prostate cancer (stages 1 and 2). In fact, 70% of men with prostate cancer who were in the early stages report having an excellent or very good quality of life compared to only 39% of men with advanced prostate cancer.
Men who are in the early stages of prostate cancer reported sexual dysfunction, urinary incontinence, and fatigue as the most common physical challenges they experienced; however, the impact is far greater for those living with advanced prostate cancer.
The good news is that 84% of all men surveyed indicated they are living their lives to the fullest,despite this, many reported that they are unable to enjoy life, including 50% of men with advanced prostate cancer and 19% of men with early stage prostate cancer.
Another finding is that caregivers play a very active role in the lives of men with prostate cancer. The survey found that caregivers provide approximately 25 hours of care per week and that the majority of the caregivers (69%) are spouses. Almost seven-in-ten (65%) reported they attend doctor visits and over half (57%) are involved in the treatment decisions of their the survivors. At least monthly, one-third of caregivers keeps up-to-date on medication and treatment options as well as learning about the disease.
The survey also revealed that more than half of men with prostate cancer (56 per cent) and caregivers (57%) wish better treatment options were available. This figure dramatically increases to 92% for men who identify themselves as having advanced prostate cancer.
The survey was conducted by an online questionnaire to poll 517 Canadian men who currently have or have had prostate cancer (including 73 men with stage 1 and 2, 26 men with stage 3 and 4 prostate cancer, and 418 men with no current evidence of the disease or prefer not to answer) as well as 256 caregivers. A probability sample of prostate cancer patients of the same size would yield a margin of error of +/- 4.3 per cent, 19 times out of 20. A probability sample of caregivers of the same size would yield a margin of error of +/- 6.1 per cent.
There are a number of take home messages from this survey.
1- Overall quality of life is impacted all men diagnosed with prostate cancer, no matter what the stage of the disease.
2- Men who were either stage 1 or stage 2 reported having a very high to excellent quality of life.
3- Men with advanced prostate cancer (stage 3 or 4) reported a significantly lower quality of life.
4- 84% of all prostate cancer survivors report they are living life to the fullest.
5- The single most important concern for all men diagnosed with prostate cancer was sexual function.
6- However, men with advanced prostate cancer (stage 3 and 4) also were equally concerned about psychological and social concerns resulting from the disease.
7- Caregivers are very involved and very important to men who have been diagnosed with prostate cancer.
8- The majority of caregivers are spouses. This leads to an almost never discussed issue, what happens to men without a spouse or partner? Malecare is about to launch a new program to help support men in this situation.
Joel T. Nowak, M.A., M.S.W.