Measuring the Impact of Common Prostate Cancer Survivorship Conditions With Health Utilities

Area of Science:

• Urology
• Oncology
• Health Economics

Background:

• Prostate cancer (CaP) survivorship presents challenges including stress urinary incontinence (SUI) and erectile dysfunction (ED).
• Patient perception of disease impact and treatment effectiveness is crucial for quality of life.
• Health State Utility (HSU) instruments offer a standardized method to quantify patient-reported outcomes.

Purpose of the Study:

• To evaluate how prior disease exposure influences the perceived impact of SUI and ED in CaP survivors.
• To compare the impact of SUI and ED on Quality-Adjusted Life-Years (QALYs) between disease-exposed (DE) and disease-naïve (DN) cohorts.
• To assess the effect of surgical interventions, inflatable penile prosthesis (IPP) for ED and artificial urinary sphincter (AUS) for SUI, on QALYs.

Main Methods:

• Two cohorts were established: DE patients treated for CaP and DN individuals recruited via Qualtrics®.
• Participants assessed standardized clinical scenarios of SUI and ED using four HSU instruments, averaged to calculate QALYs.
• The impact of IPP and AUS on health-related QALYs was analyzed and compared between cohorts and conditions.

Main Results:

• The DE cohort reported significantly less impact from both SUI and ED compared to the DN cohort.
• SUI had a greater negative impact on QALYs than ED across both cohorts.
• IPP treatment for ED did not significantly alter overall QALYs, whereas AUS treatment for SUI demonstrated significant QALY improvements in both groups.

Conclusions:

• Disease exposure appears to induce adaptation, reducing the perceived impact of CaP survivorship issues.
• HSU instruments provide objective comparisons of disease impact and surgical intervention effectiveness between patient groups.
• Surgical interventions like AUS offer tangible QALY benefits for SUI, while IPP's impact on ED requires further investigation due to observed heterogeneity.