Severity of Cardiovascular Disease and Health-Related Quality of Life in Men with Prostate Cancer

OBJECTIVE: To evaluate the influence of comorbid cardiovascular disease severity on health-related quality of life (HRQL) in men treated with radical prostatectomy (RP) or radiotherapy (RT) for early stage prostate cancer. METHODS: Subjects (n = 830) with non-metastatic disease who had been diagnosed in 2000-2002 were drawn from Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE). The authors evaluated the influence of cardiovascular disease (CVD) severity on generic and disease-specific HRQL before and 6, 12, 18, and 24 months after treatment with RP or RT. HRQL was measured with the SF-36 and the UCLA Prostate Cancer Index. RESULTS: Men with moderate (n = 193) or severe (n = 51) cardiovascular disease had worse pre-treatment HRQL than did men without CVD (n = 293) (P < 0.01); HRQL scores were worse in men referred for RT. During 24 months of follow-up, men with moderate or severe CVD had worse SF-36 physical and mental component summaries and worse bowel function at all time points (P < 0.05). Men with severe CVD also experienced a slower recovery in physical function (P = 0.03) and sexual functioning (P = 0.02) than did men without CVD. CONCLUSIONS: Prostate cancer patients with moderate to severe CVD have worse HRQL during follow-up. Those with severe CVD recover their physical and sexual functioning more slowly after treatment.