Management and Health Related Quality of Life Among Patients With Prostate Cancer at Kenyatta National Hospital: a Descriptive Cross-sectional Study

Abstract

Background: Advances made in the screening, diagnosis and management of prostate cancer have improved the survival rates of patients. However, the majority of these treatments including surgery, radiation therapy and pharmacotherapy, have an impact on the subsequent health-related quality of life of these patients. Since it is an important prognostic factor of survival, failure to evaluate the health-related quality of life and its predictors in these patients typically results in long-term deficits in their overall well-being, that is, their physical, social, emotional and mental health. Objectives: The objective of this study was to evaluate the management and health-related quality of life among patients with prostate cancer at Kenyatta National Hospital. Methodology: This was a descriptive cross-sectional study. The sample size of 62 patients who met the eligibility criteria was selected through simple random sampling on the respective clinic days of the cancer treatment centre and urology clinic. Data was collected through a pre-tested structured questionnaire and Health-related Quality of Life (HRQoL) tools (EORTC-QLQ-C30 and EORTC-QLQ-PR25) after which it was analysed using STATA version 13 software. Descriptive analysis was used to summarise the continuous and categorical variables. Spearman’s rho (rs) correlation was used to determine the predictors of HRQoL based on the strength and significance of association because, on analysis, the data was not normally distributed. The level of significance was set a 0.05. Results: Participants within this study had a mean age of 70.5 ( 7.35) years. The majority (52, 83.9%) of the patients had a PSA above 20 ng/ml. 21 (33.9%) were graded as Gleason group 5 and 41 (66.1%) Stage IV disease at diagnosis. Fifty (80.9%) participants were on hormonal therapy, with the majority of them being on combined androgen blockade. The overall HRQoL was 65.1. Fatigue, one of the major complaints among these patients, was negatively associated with physical functioning (p = 0.0005), role functioning (p = 0.0026), social functioning (p= 0.0001), financial difficulties (p= 0.0077) and quality of life (p= 0.0050). Conclusion: Fatigue was the most common predictor of poor HRQoL in several scales of measurement. Recommendation: Strategies should be employed to ensure the early detection and treatment of PC. The management of PC should be streamlined to align with established national and international treatment guidelines. For those on management, frequent assessment of HRQoL should be carried out and interventions instituted immediately.