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可以与他们的疾病一起生活多年，通常要应对治疗的长期后果，包括肠和尿失禁、性功能障碍、疲劳以及精神和情绪困难。治疗的负担往往被那些觉得自己很幸运能够发现并治疗癌症的人忽视或轻视。现有的前列腺癌幸存者生活质量的衡量标准侧重于直接或部分的结果，而没有解决男性对治疗后果的轻视程度，这在我们对幸存者的真正负担的认识上造成了差距。本研究旨在探讨用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生存的综合概率——与健康结果相关的多种获益和损失来源——从而能够评估总体结果。通过与前列腺癌幸存者群体的一系列对话，我们将探索相关领域并引入调查项目以获得初步反馈。然后，这些项目将在100名前列腺癌幸存者的样本中进行测试和验证，这些样本来自先前的治疗前决策研究。该样本包括来自华盛顿州、加利福尼亚州和南卡罗来纳州的一组种族多样化的男性，他们在诊断后两年就开始了。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，并将帮助PI成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，利用经济支付意愿方法量化前列腺癌幸存者中被忽视和被低估的生活质量负担。目前对生活质量的估计发现，男性报告的副作用和负担水平很高，但生活质量没有下降，这表明现有的措施没有考虑到癌症诊断的心理后果，也没有考虑到积极治疗所灌输的希望，即允许受试者无条件接受治疗的后果。这项工作将探索评估前列腺癌幸存者生活质量的新方法，更适当地平衡治疗的益处和负担。本研究的结果将有助于患者、医生和政策制定者制定与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.