Quality of life in long-term survivors of bladder cancer

BACKGROUND. The quality of life (QOL) of long-term survivors of bladder cancer in a population-based registry was assessed. METHODS. The Functional Assessment of Cancer Therapy (FACT-BL) instrument was used to evaluate QOL in a population-based sample of bladder cancer patients. QOL scores were compared between those undergoing radical cystectomy (RC) or those with an intact bladder (BI) and between continent and conduit urinary diversion groups. The influence of current age and time since diagnosis of cancer on QOL were also examined. Multivariate regression analyses were performed to examine the influence of age, time since diagnosis, current condition, treatment, stage of cancer, and comorbid conditions on QOL. RESULTS. A total of 259 patients participated in the study who had undergone RC (n = 82) or other therapy (BI) (n = 177). There were no differences in general QOL scores between RC and BI groups and between the 2 urinary diversion groups, but patients undergoing RC had worse sexual function scores. QOL scores for BI patients tended to decrease with increasing age (P = .01). Presence of comorbid conditions lowered QOL (P<.05). CONCLUSIONS. General QOL does not vary among long-term bladder cancer survivors regardless of treatment, but sexual functioning can be adversely affected in those undergoing cystectomy. Long-term QOL declines even in those with intact bladders, particularly in those with comorbidities.