Does partnership status affect the quality of life of men having robotic-assisted radical prostatectomy (RARP) for localised prostate cancer?

Abstract

INTRODUCTION: It has been shown that unpartnered men with prostate cancer have worse survival than partnered or married men. It is thought that marriage confers a survival benefit for men via the provision of greater social structure, support and promotion of health behaviours from the patients' wife. Further, it is thought that the increased social support that partnered men get from their partners may lower perceptions of stress, which may improve quality of life (QoL). METHOD: We aimed to investigate whether there are any differences in prostate cancer-specific QoL measure at baseline and at 12-months post-surgery between partnered and unpartnered men having RARP for localised prostate cancer. We investigated differences in patient-reported outcomes using the Expanded Prostate cancer Index Composite-26 (EPIC-26), the Sexual Health Inventory for Men (SHIM), and the Clark et al. Prostate Cancer Quality of Life Scales. RESULTS: five hundred and eighty-three of the men who were enrolled in the observational cohort study had a RARP and were eligible for this study. We selected only those who had completed the question on partnership status (n=540). The characteristics of these patients are summarised in table 1. The mean (sd) age was 62.0 (6.8) and the median (range) pre-operative PSA was 6.1 (0.6 - 81.0). There were no significant differences between partnered and unpartnered men in terms of age, pre-operative PSA, biopsy Gleason score, or nerve-sparing status. Differences between the groups were observed for clinical T-stage (p=.027) and preoperative sexually active status (p=.012). DISCUSSION: We found few difference between partnered and unpartnered men in terms of patient-reported quality of life outcomes following RARP for localised prostate cancer. Most importantly, our data show that men with prostate cancer have low sexual confidence, high PSA concern and a low outlook at 12-months post-RARP which could be immediate targets of interventions.