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Instrument Summary for Prostate Cancer

Please note that this section is an archive and is no longer being updated.

Development: The European Organization of Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ) was developed in 1986 by the European Organization for Research and Treatment of Cancer to integrate a modular approach for evaluating the quality of life of patients with cancer.¹

Purpose: To provide an assessment of global health related quality of life specific to cancer patients, including prostate cancer.

Useful Facts: The EORTC-QLQ consists of 30 items that focus on the functioning and symptoms of cancer patients.² There are six multi-items that focus on: physical function, role function, emotional function, cognitive functioning, social function, and global health related quality of life.² The EORTC-QLQ includes nine single-item symptom scales: fatigue, pain, dyspnea, and gastro-intestinal problems. The scales on the EORTC-QLQ range from 0-100, where a higher score would indicate higher level of functioning.

VA Relevance: The EORTC-QLQ has been used with the veteran population in looking at health-related quality of life. One study investigated the quality of life of veterans who were newly diagnosed with prostate cancer. The study found that at 12 months veterans who had a localized disease had quality of life changes that varied some during and after treatment.³ However, the quality of life in patients who had a metastatic disease varied less and were able to return to near baseline values at 12 months.³

Availability: A sample of the EORTC-QLQ is available for download through the EORTC Quality of life group website.

References:

1. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, De Haes JC, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: A Quality of Life Instrument for use in International Clinical Trails in Oncology. Journal of National Cancer Institute. 1993; March: 85(5): 365-376. [Abstract ]
2. Visser A, Van Andel G, Willems P, Voogt E, Dijkstra A, Rovers P, Goodkin K, Kurth K. Changes in Health-Related Quality of Life of men with Prostate Cancer 3 months after Diagnosis: The Role of Psychosocial Factors and Comparisment with Benign Prostate Hyperplasia Patients. Patient Education and Counseling. 2003; 49: 225-232. [Abstract ]
3. Siston AK, Knight SJ, Slimack NP, Chmiel JS, Nadler RB, Lyons TM, Kuzel TM, Moran EM, Sharifi R, Bennett CL. Quality of Life after a Diagnosis of Prostate Cancer among Men of Lower Socioeconomic Status: Results from the Veterans Affairs Cancer of the Prostate Outcomes Study. Urology. 2003; 61(1): 172-178. [Abstract ]

Development: The Prostate Cancer Index (PCI) was developed by Dr. Mark Litwin from the University of California, Los Angeles, department of Urology.¹

Purpose: The PCI was designed to assess outcomes and quality of life in prostate cancer survivors.

Useful Facts: The PCI is a self-administered, multi-item disease specific instrument to evaluate the health concerns that are related to the quality of life in men with prostate cancer.² The PCI is one of the most used prostate cancer-specific health related quality of life assessment tools.³ The PCI has been found to have good reliability and validity for men in the United States.³

VA Relevance: The PCI was used with the veteran population in a study assessing health-related quality of life in men with erectile dysfunction. The PCI was used to assess sexual function and sexual bother in this study.⁴ This study found that within the veteran's population, sexual function correlated highly with marital interaction, and with general health perceptions.⁴ Sexual bother did not correlate with any of the health-related quality of life domains.⁴

Availability: The PCI can be downloaded from the UCLA Department of Urology website.

References:

1. UCLA Department of Urology website, Accessed January 2006. Available: http://www.uclaurology.com/common/patients.cfm
2. Litwin MS, Hay RD, Fink A, Ganz PA, Leake B, Brook RH. The UCLA Prostate Cancer Index: Development, Reliability, and Validity of a Health-Related Quality of Life Measure. Med Care. 1998; July: 36(7): 1002-1012. [Abstract ]
3. Karakiewicz PI, Kattan MW, Tanguay S, Elhilali MM, Bazinet M, Scardino PT, Aprikian AG. Cross-cultural Validation of the UCLA Prostate Cancer Index. Urology. 2003; 61(2): 302-307. [Abstract ]
4. Litwin MS, Nied RJ, Dhanani N. Health-Related Quality of Life in Men with Erectile Dysfunction. Journal of General Internal Medicine. 1998; March: 13(3): 159-166. [Abstract ]

Development: The original Functional Assessment of Cancer Therapy-General (FACT-G) was developed by Cella et al.¹ to evaluate the quality of life in patients receiving cancer treatment. In 1992 with the collaboration with the Meyer L. Prentis Comprehensive Cancer Center, a prostate cancer subscale was developed for this instrument, the Functional Assessment of Cancer Therapy-Prostate (FACT-P).²

Purpose: The FACT-P was developed to assess the health-related quality of life specific to prostate cancer patients.

Useful Facts: The FACT-P is a self-report questionnaire that consists of the FACT-G, which has 29 items, and the FACT-P, which includes 12 items that are specific to prostate cancer.³ The FACT-P includes items related to sexuality, bowel/bladder functioning and pain.²

VA Relevance: The FACT-P has been used with the veteran population to assess quality of life. In one study conducted at the Michael E. DeBakey VA Medical Center, the quality of life in prostate cancer patients undergoing radiotherapy was evaluated using the FACT-P along with other instruments. They found that patients had significantly lower scores on the Prostate Cancer Specific (PCS) and the Physical Well-Being (PWB) subscales on the FACT-P midway through radiotherapy versus before starting the therapy.⁴

Availability: The FACT-P can be found in the article by Esper et al. (1997).

References:

1. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J. The Functional Assessment of Cancer Therapy Scale: Development and Validation of the General Measure. Journal of Clinical Oncology. 1993; March: 11(3): 570-579. [Abstract ]
2. Esper P, Mo F, Chodak G, Sinner M, Cella D, Pienta KJ. Measuring Quality of Life in Men with Prostate Cancer Using the Functional Assessment of Cancer Therapy-Prostate Instrument. Urology. 1997; 50(6): 920-928. [Abstract ]
3. Feigenberg SJ, Lee R, Desilvio ML, Winter K, Pisansky TM, Bruner DW, Lawton C, Morton G, Baikadi M, Sandler H. Health-Related Quality of Life in Men Receiving Prostate Brachytherapy on RTOG 98-05. Int. J. Radiation Oncology Biol. Phys. 2005; 62(4): 956-964. [Abstract ]
4. Monga U, Kerrigan AJ, Thornby J, Monga TN, Zimmerman KP. Longitudinal Study of Quality of Life in Patients with Localized Prostate Cancer Undergoing Radiotherapy. Journal of Rehabilitation Research & Development. 2005; May/June: 42(3): 391-400. [Abstract ]

Expert-recommended Instruments

Development: The Short Form - 36 Health Survey (SF-36) was developed by John Ware, Ph.D. to evaluate the general health of patients.¹ The SF-36 was developed to compare general and specific populations.¹

Purpose: The SF-36 is an instrument designed to measure the generic health status in the general population.

Useful Facts: The SF-36 is a short form health survey with 36 questions. It can be self administered or administered by a trained interviewer using a standardized script for face to face or phone interview.² The SF-36 takes approximately five to ten minutes to administer and can be administered to individuals who are 14 years of age or older.² The SF-36 obtains an 8-scale profile of functional health, well-being scores, psychometrically-based physical and mental summary measures, and a preference-based health utility index.³ The SF-36 is a valid, reliable, general measure and has been used in the health services research.⁴ Note that a METRIC Instrument Review of the SF-36 is available.

VA Relevance: The SF-36 has been used with the veteran population to assess health related quality of life. In one study the impact of health behaviors on health related quality of life was measured in male veterans using the SF-36. They found that several health factors were associated with health care utilization and health related quality of care was negatively affected by poor health behaviors.⁵

Availability: The MOS SF-36 from RAND is available free from their website. The SF-36 (version 2) from Quality Metric may be purchased from their website. The SF-36V may be obtained by contacting Lewis E. Kazis, ScD via email [lek@bu.edu].

References:

1. Ware JE. SF-36 Health Survey Update. Spine. 2000; 25(24): 3130-3139. [Abstract ]
2. Medical Outcome Short Form (36) Health Survey. Accessed April 2006. Available: http://www.swin.edu.au.
3. Ware, JE. SF-36 Health Survey Update. Accessed April 2006. Available: http://www.sf-36.org/tools/SF36.shtml.
4. Romeis JC, Heath AC, Hong Xian D, Eisen SA, Scherrer JF, Pedersen NJ, Fu Q, Bucholz KK, Goldberg J, Lyons MJ, Waterman B, Tsuang MT, True WR. Heritability of SF-36 among Middle-Age, Middle-Class, Male-Male Twins. Medical Care. 2005: November: 43(11): 1147-1154. [Abstract ]
5. Borzecki AM, Lee A, Kalman D, Kazis LE. Do Poor Health Behaviors Affect Health-related Quality of Life and Healthcare Utilization among Veterans? The Veterans Health Study. Journal of Ambulatory Care Manage. 2005: 28(2): 141-156. [Abstract ]