Prostate cancer is one of the most common solid tumour malignancies in developed countries (Pisani et al., 2002) and a leading cause of cancer death in American and European men (Bray et al., 2002; American Cancer Society, 2005). This chapter highlights the effects of prostate cancer on quality of life and reviews the behavioural and psychosocial interventions designed to educate men about prostate cancer, enhance decision-making, or improve quality of life.

Quality of life

Prostate cancer and its treatments result in disease-specific and more general problems in quality of life (Eton & Lepore, 2002) (see ‘Quality of Life’). The most common disease-specific problems are urinary and sexual dysfunction. Within a year after treatment, urinary problems often subside, but sexual problems tend to persist (e.g. Lubeck et al., 1999). In men with localized disease, general problems, such as difficulties in social-, emotional- and physical-functioning are reported considerably less often than genito-urinary problems, and may not occur at all in some men (e.g. Lubeck et al., 1999; Bisson et al., 2002; Lepore et al., 2003). Men with progressive disease are more likely to report social–emotional difficulties, as well as chronic pain and fatigue (e.g. Albertsen et al., 1997). It is not yet clear how pharmacological and surgical control of progressive prostate cancer influences general quality of life outcomes.

Interventions

Informed decision-making about testing

Prostate cancer is often indolent and frequently affects men with other life-threatening illnesses, so it is difficult to evaluate the effects of screening and treatments on prostate cancer outcomes.