Table 1 Published studies concerning bladder cancer and quality of life 2000–2018, N = 21
Topic | Authors | Year | Patient group | QoL instrument | Nb. of patients | Outcome | Main symptom topics | Limitations |
|---|---|---|---|---|---|---|---|---|
QoL before cystoscopy | Goossens-Laan et al. [12] | 2013 | All pts. with hematuria before cystoscopy: BC pts. vs. pts. with hematuria of other causes (OC) | WHOQOL-BREF, SF-12, IIEF, STAI-10 | 476 (87 BC pts.(61 NMIBC, 26 MIBC), 389 OC) | QoL comparable between BC and OC groups, Erectile dysfunction highest in BC group, MIBC lowest percentage of anxious personalities of pts. with BC. | Erectile dysfunction Anxiety General health perceptions, physical, emotional, social, fatigue, pain | Selected population (hematuria), only 26 MIBC pts. IIEF not used consistently |
QoL before and after RT and concurrent CT | Lagrange et al. [27] | 2011 | BC T2a-T4 before and up to 3 years after TUR + concurrent RT/CT (Phase II) | QLQ-C30 + BC specific questions + LENT-SOMA | 51 RT/CT | Satisfactory QoL for 67% of pts. Decrease in BC specific symptoms over time. | Bladder function Global health score Physical, personal, emotional, cognitive, social functioning | No data during treatment, QoL limited to pts. alive without disease |
Fung et al. [11] | 2014 | BC before and after BC diagnosis and treatment (77–88% NMIBC) | SF-36/VR-12 | 1476 (620 before, 856 after) | Deteriorating physical & mental component scores pre and post diagnosis. MIBC also clinically significant that persisted up to 10 yrs. after diagnosis. Co-morbidity a risk factor. | Physical and mental scores | Cross-sectional study, not comparable, only 179 BC pts. with 2 questionnaires. No data on treatment. | |
QoL during treatment (TUR/RT/CT) | Albers et al. [19] | 2002 | Gemcitabine for platinum-resistant or metastatic BC pts. (Phase II) | Validated QoL questionnaire (Spitzer et al.) | 25 CT | No overall difference during treatment, pain decreased significantly amongst responders, pain increased overall | Overall QoL, pain | Questionnaire not comparable to others. |
Roychowdhury et al. [14] | 2003 | GCis vs MVAC in metastatic BC pts. (Phase III) | EORTC QLQ-C30 | 326 (165 GCis, 161 MVAC) | Equal QoL between the two groups. Improvement in fatigue during treatment, not significant. | Overall QoL, fatigue | No BC specific questions, only metastatic disease, only baseline values | |
Herman et al. [18] | 2004 | Concurrent gemcitabine +RT, BC T2-T3 (Phase I) | FACT-G + FACT-BL | 23 RT/CT | Treatment related QoL: no significant differences were found | Urinary, bowel, erectile, global QoL | Few pts., no follow-up post treatment | |
Butt et al. [37] | 2008 | Advanced cancer in chemotherapy (many cancers, stages 3–4) | FACT-G + FACT-BL + non-validated instruments | 31 CT | Identified 5 major symptoms/concerns | Fatigue (48.4%), anxiety about progression, family worries, enjoy life, control bowels | No baseline data, no specification on when pts. answered questionnaire. No specific numbers for BC pts. | |
Joly et al. [16] | 2009 | Weekly paclitaxel for recurrence (Phase II), 93% metastatic BC pts. | FACT-G + FACT-BL + FACT-Taxane | 45 CT | No decrease in QoL scores, few patients experiences improvement on one or more parameters. | Overall QoL | Limited number of patients. QoL for non-responders not displayed. | |
De Santis et al. [17] | 2012 | GCar vs. M-CAVI in BC T3–4 w/N+/M+ disease, not fit for cystectomy or cisplatin (Phase II/III) | EORTC QLQ-C30 | 238 (119 GCar, 119 M-CAVI) | No difference in QoL between the two arms | Overall | 50% response rate after baseline. No QoL data provided | |
Huddart et al. [22] | 2017 | Selective bladder preservation vs. RC | EORTC QLQ-C30 + QLQ-BLM30 | 20 SBP | Stable QoL during and after treatment for SBP group | Overall, bowel, sexual | Baseline changes reported, no quantitative data. | |
QoL after treatment (TUR/RT/CT/RC) | Henningsohn et al. [23] | 2002 | All pts. MIBC, stages not specified, 1–19 yrs. after RT vs after cystectomy | Non-validated, self-made | 309 (58 RT, 251 cystectomy) + controls | Small diff. in sexual disturbances btw. The two groups. | Bowel, urinary, sexual, well-being (energy, anxiety, depression), lymphoedema | Older RT group, no adjustment. |
Zietman et al. [24] | 2003 | BC T2-4a, disease free, after TUR + RT + CT (+ salvage cystectomy), 1–15 yrs. after treatment. | Non-validated BC and RT specific questionnaires + SF-36 | 49 (31 with total completion) | Urinary functions like general population, + bowel problems | Urinary, bowel, sexual, global HRQOL | No comparison (baseline or other). | |
Matsuda et al. [35] | 2003 | BC Ta-T1:80%, T2-T4 20%), 5 yrs. after treatment | FACT-G+ FACT-BL | 95 (no subgrouping specified) | Poor sexual function after cystectomy | Overall QoL, social, functional, physical emotional well-being, urinary | Primarily (80%) Ta + T1 tumors, 4 pts. received CT. Only > 5 yr. survivors. | |
Fokdal et al. [26] | 2004 | BC T1-4bNxM0, 3–10 yrs. after RT treatment | LENT-SOMA | 53 RT, 63 population controls | Significantly more bothersome urinary, bowel and sexual symptoms in patients vs. controls. | Urinary, bowel, sexual | Retrospective, no baseline data. Telephone questionnaire by study leader, all disease free. | |
Allareddy et al. [25] | 2006 | BC Tis-T4, 6–15 yrs. after RC vs. IB treatment | FACT-G + FACT-BL | 82 RC, 177 IB | Poor sexual function after RC, no difference in overall scores | Overall QoL, sexual, urinary, bowel | ||
Hashine et al. [21] | 2008 | MIBC pts., but stages not specified, 1–14 yrs. after TUR + RT + CT vs TUR-BT for NMIBC | IPSS, SF-36 + EPIC | 33 MIBC vs 128 NMIBC | Comparable QoL in the two groups | Overall QoL, physical functioning, role-physical, urinary, bowel, pain. | Retrospective, no baseline data, NMIBC as controls | |
Singer et el. [30] | 2013 | BC, 64% MIBC and 26% NMIBC vs general population, 9 days-37 yrs. after treatment. | EORTC QLQ-C30 | 823 (210 NMIBC, 530 MIBC, 83 unknown), 2037 general population | Significantly worse QoL for BC vs general population, CT and RT + CT associated with more dyspnea, appetite loss, social functioning, constipation, nausea & vomiting | Physical, emotional, social, role, cognitive, global HS, fatigue, nausea, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, financial difficulties | Selection bias (inpatient, BC population not representative and not adjusted for comorbidities or extent of disease, different follow-up periods) | |
Kent et al. [38] | 2014 | 26% BC, 2–5 yrs. post disease | SF-36 | 161(no subgrouping specified) | Pts with low income, Hispanic ethnicity and pts. with recurrence experienced more bothersome symptoms. | 24% with symptoms. Of these: urinary symptoms, procedural pain, fatigue, diarrhea, abd. Pain, neuropathy, pain, rash. | No baseline data. | |
Mak et al. [20] | 2016 | MIBC T2-T4, 2–16 yrs. after RC vs TMT (TURB+CT + RT) | EuroQOL EQ-5D, EORTC QLQ-C30, QLQ-BLM30, EPIC, CTPS, IOCv2 | 173 (109 RC, 64 TMT) | Good Qol for RC &TMT, TMT had better bowel function and better sexual function | Overall QoL, urinary, bowel, sexual, | No baseline data, all patients > 2 yrs. free of disease,not prospective, different follow-up times | |
Mason et al. [36] | 2018 | MIBC + NMIBC, unknown disease stage | EQ-5D-5 L + FACT-BL + SDI-21 | 34 CT/RT + 61 RT | RT/CT group with more fatigue, more social distress, more anxiety but more content with sexual life than RC group | Overall QoL, mobility, self-care, pain, anxiety, social distress, financial, fatigue, sexual, bowel, urinary, emotional, functional well-being | Only prevalence of problems, no comparable QoL scores | |
Perlis et al. [13] | 2018 | MIBC post CT | BUSS | 34 CT + 15 CT/RT | Lower QoL compared to non-CT receivers, especially for patients with metastatic disease | Overall QoL, anxiety, fatigue, pain, urinary, bowel, sexual impairment | Validation study, only QoL scores for overall QoL, no specific time point, estimated at least 1 year free of disease |