Prostate cancer (PCa) survivors with diabetes have poorer health-related quality of life (HRQL) than those without diabetes, and this may have implications for prostate cancer treatment decisions, according to a new Dutch study.

Melissa S. Y. Thong, PhD, of the Department of Medical Psychology at Tilburg University in The Netherlands, and her colleagues, investigated the association between PCa, diabetes, and long-term general and cancer-specific HRQL in a cohort of men with non-metastatic PCa. The study, which is believed to be the first to measure the effects of prevalent and incident diabetes on long-term HRQL of patients with PCa, appears in an online report BJU International.

The researchers used data from self-administered surveys to assess the HRQL of men with localized disease or locally advanced disease. The surveys were completed at baseline (six months after initial diagnosis).  The participants were surveyed again at 12, 24, and 60 months after their initial diagnosis.

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The study included 1,811 men, including 13% with prevalent diabetes (pre-prostate cancer diagnosis) and 12% with incident diabetes (diagnosed after the prostate cancer diagnosis). A total of 1,357 men (75%) did not report diabetes on any surveys.

Men with prevalent diabetes in general had the poorest scores on general HRQL and non-diabetic men had the best scores, independent of treatment modality. In addition, the researchers found that men with prevalent diabetes had the lowest urinary control and sexual function scores over time. Conversely, men without diabetes had the highest scores. Men with incident diabetes had intermediate scores, reporting general and disease-specific HRQL scores lower than those of men without diabetes but similar or better than those with diabetes at baseline.

Study data “that prostate cancer survivors with diabetes could benefit from targeted interventions to improve decision-making at the time of diagnosis and during the course of the disease, as different prostate cancer treatments have variable impact on HRQL scores in men with diabetes,” the authors wrote.