Quality of Life Among Prostate Cancer Patients in Sarawak, Malaysia: A Cross-sectional Analysis of Demographic, Clinical and Treatment Factors

Abstract

Advancements in prostate cancer management improves survival but each treatment modality has its side effects. Quality of life (QOL) among survivors is equally important as survival. There is currently limited data regarding QOL among prostate cancer patients in Malaysia. The aim of this study was to determine the overall QOL and its determinants among prostate cancer patients in Sarawak. A cross-sectional study conducted across 4 major hospitals in Sarawak with 205 patients recruited via consecutive sampling. QOL were assessed with validated questionnaires consisted of European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-PR25 module in Malay & English version. The mean age of patients was 73.4 years (SD=6.8), majority comprised of Chinese ethnic (55.6%), secondary educational level (45.9%), married (92.2%), unemployed (86.3%) and have no difficulties in medical accessibility (92.7%). About 45.9% of the cohort were of metastatic disease state, 18.5% experienced disease progression, 69.8% were on ongoing active treatment, 74.6% is under androgen deprivation and 81.5% underwent non-surgical management. The mean global health status score was 73.6 (SD 19.9). From the QLQ-C30, the highest functioning and symptom scale were social functioning 83.2 (SD 22.5) and fatigue 32 (SD 22.8). As for QLQ-PR25, highest functional and symptom scale was sexual functioning 72.1 (SD 31.6) and urinary symptoms 31.0 (SD 20.2). Our study concludes that men below 80-year-old, Malay ethnicity, unmarried or widowed, employed, higher education level, and have access to medical care reported a better QOL. Factors such as advanced disease, usage of androgen deprivation therapy, presence of disease progression, and ongoing treatment are associated with a lower quality of life.