Determinants of quality of life of bladder cancer survivors five years after treatment in France

OBJECTIVES: The aim of the population-based study presented here was to evaluate quality of life (QOL) among bladder cancer survivors at least five years after diagnosis, ascertain the long term effects of treatments, and investigate important pathological and sociodemographic factors influencing the QOL of such survivors. METHODS: A Functional Assessment of Cancer Therapy (FACT) questionnaire with a bladder-specific option (FACT-Bl), was sent by mail to patients randomly selected from the database of the Isère and Tarn cancer registries in France. Ninety-five valid completed questionnaires were returned by 78 males and 17 females, with a median age of 72 years (range, 33-90). The pathological information contained in the completed questionnaires was examined. RESULTS: Of the 95 patients (76 with a superficial tumor, 17 with an invasive tumor), 20 had undergone total cystectomy. Total cystectomy clearly deteriorates the autonomy of survivors (ECOG-PSR), as well as their scores on the bladder cancer-specific sub-scale in sexuality-related questions. Survivors claimed impotency and loss of sexual interest after the cystectomy. In contrast, neither the type of treatment nor the time from the most recent major treatment were score-modifying factors. Negative psychological effects of treatments in the long-term were not observed. Rather, patients' QOL was affected by their autonomy in daily life and by old age. In addition, familial situation had a critical impact on emotional and Familial/Social Well-being. CONCLUSION: The present study showed the long-term negative effect of total cystectomy on survivors. Survivor autonomy and other sociodemographic backgrounds were also determinants of their QOL. The maintenance of good health, sexual function and active family relationships should be promoted so that patients can lead full lives after treatment.