Quality of Life 2 Years After Diagnosis of Low-Risk Prostate Cancer in the Treatment Options for Prostate Cancer...

Current evidence-based best practices recommend an active surveillance (AS) protocol for men with low-risk prostate cancer (LRPC).

We evaluated quality of life (QOL) at baseline and at 2 years after diagnosis among men with LRPC in a prospective, population-based cohort of 1049 Black and White men from 2 cancer registries (metropolitan Detroit and Georgia). General and prostate cancer-specific QOL domains were assessed using the Short Form-12 and Expanded Prostate Cancer Index Composite-26 scales at baseline and 2-year follow-up. We compared changes in QOL between men who remained on AS and men who underwent curative treatment, overall and stratified by race.

At 2-year follow-up, 475 (45%) men underwent curative treatment with surgery or radiation and 574 (55%) remained on AS. At baseline, there were no meaningful differences in quality-of-life measures between men selecting curative treatment vs AS. At 2-year follow-up, men who underwent curative treatment reported significant declines in sexual function and urinary incontinence; men who remained on AS reported minimal to no decline in these domains (-27.6 vs -4.9, P < .001 for sexual function and -12.6 vs -0.4, P < .001 for urinary incontinence). QOL patterns were similar by race.

In a contemporary, diverse cohort, men who underwent curative treatment of LRPC had worse urinary and sexual function compared with men who remained on AS. These quality-of-life differences should inform the patient-physician treatment planning discussions for LRPC.