Reassessing the Quality of Life Burden of Prostate Cancer Survivorship

描述（由申请人提供）：患有非转移性前列腺癌的男性与他们的疾病一起生活多年，经常应对治疗的长期后果，包括肠和尿失禁，性功能障碍，疲劳以及精神和情感困难。治疗的负担往往被那些感到幸运的男性忽视或淡化，他们发现并治疗了癌症。现有的前列腺癌幸存者生活质量的衡量标准集中在直接或部分结果上，并没有解决男性淡化治疗后果的程度，这在我们对生存的真正负担的认识上造成了差距。本研究旨在探讨支付意愿方法量化前列腺癌生存负担的可行性。这项工作的目标是估计综合生存概率-与健康结果相关的多种受益和损失来源-使整体结果得以评估。通过与前列腺癌幸存者团体的一系列对话，我们将探索相关领域，并介绍调查项目，以获得初步反馈。然后，这些项目将在先前治疗前决策研究的100名前列腺癌幸存者样本中进行测试和验证。该样本包括来自华盛顿州、加州州和南卡罗来纳州的诊断后2年的不同种族男性队列。这项试点研究将为全面评估生活质量奠定基础，深入了解前列腺癌筛查和治疗的整体价值，并将有助于确立PI作为前列腺癌生活质量评估的领导者。该项目将开发一种综合工具，使用经济支付意愿方法量化前列腺癌幸存者被忽视和低估的生活质量负担。目前对生活质量的估计发现，男性报告了高水平的副作用和负担，但生活质量没有降低，这表明现有的措施不能解释癌症诊断的心理后果，以及积极治疗所带来的希望，这些治疗允许受试者无条件地接受治疗的后果。这项工作将探索评估前列腺癌幸存者生活质量的新方法，更恰当地平衡治疗的益处和负担。这项研究的结果将有助于患者，医生和决策者在前列腺癌管理相关的决策。

DESCRIPTION (provided by applicant): Men with non-metastatic prostate cancer live many years with their disease, often coping with long-term consequences of treatment including bowel and urinary incontinence, sexual dysfunction, fatigue and mental and emotional difficulties. The burdens of treatment are often dismissed or downplayed by men who feel fortunate to have found and treated their cancer. Existing measures of quality of life among prostate cancer survivors focus on immediate or partial outcomes and do not address the extent to which men downplay treatment consequences, creating a gap in our knowledge of the true burdens of survivorship. This study proposes to explore the feasibility of willingness-to-pay methods for quantifying the burden of prostate cancer survivorship. The goal of this work is to estimate the integrated probabilities of survivorship - multiple sources of benefit and loss associated with health outcomes - enabling overall outcomes to be assessed. Through a series of dialogues with prostate cancer survivor groups, we will explore relevant domains and introduce survey items for initial feedback. These items will then be tested and validated in a sample of 100 prostate cancer survivors from a prior study of pre-treatment decision making. This sample includes a racially diverse cohort of men who are 2 years out from diagnosis from Washington State, California and South Carolina. This pilot study will lay the foundation for a comprehensive evaluation of quality of life gaining insight into the overall value of prostate cancer screening and treatment and will help establish the PI as a leader in quality of life assessment in prostate cancer. This project will develop a comprehensive instrument to quantify neglected and undervalued burdens of quality of life (QOL) among prostate cancer survivors using economic willingness-to-pay methods. Current estimates of QOL find men report high levels of side effects and burdens yet no diminished QOL, suggesting that existing measures do not account for the psychological consequences of a cancer diagnosis and the hope instilled by aggressive therapies that allow subjects to unconditionally accept the consequences of treatment. This work will explore new methods for evaluating QOL among prostate cancer survivors that more appropriately balance the benefits and burdens of treatment. The results of this study will aid patients, physicians, and policy makers in decisions related to prostate cancer management.