Quality of life after a diagnosis of Bladder Cancer: Longitudinal survey over the first year

Objectives

To describe the Health-Related Quality of Life (HRQoL) of participants in a prospective 12-month observational cohort study of new bladder cancer (BC) diagnoses and compare with national cancer and general population surveys.

Subjects/Patients and Methods

A prospective UK study in participants with new BC diagnoses at 13 NHS Trusts. HRQoL data was collected at 3, 6, 9 and 12 months. Questionnaires included EQ-5D, EORTC QLQ-C30, QLQ-NMIBC24 and QLQ-BLM30. Results were compared with the Cancer Quality of Life Survey and Health Survey for England.

Results

349 participants were recruited, 296 (85%) completed the first (baseline) and 233 (67%) the final survey. Participants underwent transurethral resection (TURBT) +/- intravesical therapy (n=238, 80%), radical cystectomy/radiotherapy (n=51, 17%) or palliation (n=7, 2%). At baseline, patients needing radical treatment reported worse HRQoL including lower social function (74.2 vs 83.8, p=0.002), increased fatigue (31.5 vs 26.1, p=0.03) and more future worries (39.2 vs 29.4, p=0.005) than TURBT participants. Post-treatment surveys showed no change/improvements for TURBT participants but deterioration for the radical cohort. At final survey, reports were similar to baseline, regardless of treatment. Radically treated participants continued to report poorer HRQoL including issues with body image (23.4 vs 12.5, p=0.007) and male sexual function (75.8 vs 40.4, p<0.001) compared to TURBT participants. Radically treated participants reported lower EQ-5D utility scores and more problems with usual activities than the general population.

Discussion

Patients undergoing TURBT can be reassured regarding HRQoL following treatment. However, those requiring radical treatment report greater changes in HRQoL with the need for appropriate clinical and supportive care to minimise the impact of treatments.