Long-term quality of life after radical prostatectomy in wives of men in the postoperative adjuvant androgen deprivation trial

Purpose: We examined quality of life in spouses of men in the Post-Adjuvant Androgen Deprivation trial after radical prostatectomy. Methods: Men at high risk of prostate cancer recurrence were randomized to receive androgen deprivation therapy or observation. Forty-three couples completed telephone interviews every 6 months for 2 years assessing women's mood disturbance, mental and physical health, and sexual function and bother as well as men's symptoms and sociodemographic and marital variables. We used linear mixed modeling to explore relationships between wives' quality of life and time, treatment group, and men's symptoms. Results: Women's mental health functioning improved over time (p<0.05). Furthermore, women with husbands in the observation group had worse mood disturbance (p=0.01) and poorer mental health (p=0.02) than women with husbands in treatment. Men's symptoms were associated with worse physical health in wives (p=0.02). Women also reported worse sexual function at 18 and 24 months compared with baseline (p=0.02), but ratings of sexual bother were unrelated to time, treatment, and symptoms. Conclusions: These exploratory results are consistent with research demonstrating that spousal cancer-related distress decreases over time. Treatment group differences suggest that an examination of caregiving in the context of uncertainty is warranted. Also, the physical burden of caregiving may intensify when men have more symptoms. To inform interventions, future studies should clarify how treatment and symptoms influence wives' distress by examining expectations and communication.