Symptom and function profiles of men with localized prostate cancer

BACKGROUND Men diagnosed with localized prostate cancer seek information on how treatment options may impact their health‐related quality of life (HRQOL). The authors used latent profile analysis (LPA) to group men according to their symptom burden and functional status and to identify patient characteristics associated with each HRQOL profile. METHODS Patients completed the Patient‐Reported Outcomes Measurement Information System and the Expanded Prostate Index Composite measures 3 months after treatment initiation. Anxiety, depression, fatigue, sleep disturbance, pain, diarrhea, urinary obstruction, urinary incontinence, erectile function, and sex satisfaction were modeled jointly using LPA, and the analysis was adjusted for covariates to examine associations between patient characteristics and profiles. RESULTS One‐third of the 373 men were not non‐Hispanic white (26% were black). Four LPA profiles were identified. Men who experienced the “best HRQOL” were less likely to receive treatment, to be older, and to smoke. Men in the second best profile experienced symptoms similar to men in the best HRQOL group but reported poor sexual and urinary function, because they were more likely to receive therapy. The third profile included men with increased symptom burden and poor functioning who were likely to undergo prostatectomy and to have increased comorbidity. The “worst HRQOL” group experienced the worst symptoms and the poorest functioning, and these men were more likely to be younger, to have more comorbidities, and to smoke. CONCLUSIONS LPA revealed that men who receive the same treatment can experience very different HRQOL impact. Understanding the factors most associated with poorer HRQOL allows clinicians to focus their care on individuals most in need of symptom management and support. Cancer 2018;124:2832‐2840. © 2018 American Cancer Society A novel methodology, latent profile analysis, is used to identify 4 groups of men with localized prostate cancer who experience different symptom burden and functional impact 3 months after treatment initiation. Men in poorer health states are likely to be younger, to smoke, to have increased comorbidities, and to undergo prostatectomy or receive radiation therapy.