Recall of pretreatment symptoms among men treated with radiotherapy for prostate cancer

Abstract

To determine the accuracy of patient recall of disease-specific symptoms and quality of life (QoL) in men treated with external beam radiotherapy (EBRT) for localized prostate cancer (LPC). One hundred and five patients enrolled in a prospective study of bladder, bowel, and sexual function, and QoL after radiotherapy for PC were requested to assess their baseline QoL and symptoms before treatment. About one year (mean 14.1 months; range 7-21 months) after treatment, they were asked to recall their baseline QoL and symptoms. Baseline and recall data were compared. Both QoL and symptoms were measured with established instruments, the European Organization for Research and Treatment of Cancer (EORTC) group's QLQ-C30 questionnaire and the Prostate Cancer Symptom Scale (PCSS). Eighty-five of 105 patients (81%) returned the questionnaires. Altogether, the recall of symptoms was poor. Urinary and intestinal symptoms were scored worse at recall than they had actually been at baseline. By contrast, patients tended to remember their baseline sexual function as having been better than it had actually been. The recall of QoL was good. The only QoL domain with a difference between recall and baseline data was that measured in the global health status/QoL scale of the QLQ-C30 questionnaire. The effect did not vary with age or time of follow-up since baseline. Men treated with EBRT for LPC do not accurately recall their pretreatment symptoms or QoL about 1 year after treatment. The accuracy of recall was not affected by time since EBRT (7-21 months). Age did not influence the recall bias. More precise data on impairments in QoL after EBRT in patients with LPC are therefore obtained from baseline and prospective follow-up studies.