Reassessing the Quality of Life Burden of Prostate Cancer Survivorship

描述(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，包括大小便失禁、性功能障碍、疲劳以及精神和情感上的困难。那些幸运地发现并治疗了自己的癌症的男性往往对治疗的负担不屑一顾或轻描淡写。现有的衡量前列腺癌幸存者生活质量的指标侧重于直接或部分结果，而没有考虑到男性在多大程度上淡化了治疗结果，造成了我们对生存真正负担的认识上的差距。这项研究建议探索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个受益和损失来源--使总体结果能够得到评估。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。这个样本包括来自华盛顿州、加利福尼亚州和南卡罗来纳州的种族多样化的男性队列，他们两年后才被确诊。这项先导性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，并将有助于将PI确立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来量化前列腺癌幸存者中被忽视和被低估的生活质量(QOL)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很高，但生活质量并没有下降，这表明现有的衡量标准没有考虑到癌症诊断带来的心理后果，以及允许受试者无条件接受治疗结果的激进疗法带来的希望。这项工作将探索评估前列腺癌幸存者生活质量的新方法，以更恰当地平衡治疗的好处和负担。这项研究的结果将有助于患者、医生和政策制定者做出与前列腺癌治疗相关的决策。

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.