Background
Men with metastatic prostate cancer (mPC) experience disease and treatment related symptoms which can impact health-related quality of life (QOL). Sleep disturbance is an under-recognised symptom in cancer patients which can negatively impact QOL. This study aims to describe the prevalence of sleep disturbance, contributing factors and impact on QOL in men with metastatic prostate cancer in two cancer centres in Sydney.
Method
In this cross-sectional study, men with mPC were recruited through outpatient oncology clinics at Campbelltown and St Vincent’s Hospitals. Participants completed validated questionnaires assessing their sleep quality, symptoms and QOL, including the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity index (ISI) and EORTC QOL Questionnaire and Prostate Questionnaires. Age, Eastern Cooperative Oncology Group Score, date of diagnosis and current treatment was recorded by the treating clinician.
Results
40 men have been surveyed to date, with 38 having complete data (median age 75 years [60-88]; 60% with castrate resistant disease). 27 patients (70%) scored ≥5 in the PSQI, indicating poor sleep. 21% of these patients had moderate insomnia (ISI>15), and 1 patient reported severe insomnia (ISI>22). Compared to patients with normal sleep, those with poor sleep were more likely to report urinary symptoms (9% vs. 44%, p=0.04) and higher mean pain indices (6/100 vs. 29/100, p=0.009). There was no difference in hot flushes reported by those with poor sleep compared to normal sleep. Quality of life indices tended to be worse in patients with poor sleep (mean 73/100) compared to those with normal sleep (mean 61/100), however this was not statistically significant (p=0.13).
Conclusion
There was a high prevalence of sleep disturbance in this population of men with mPC, associated with urinary symptoms and pain. Recruitment is ongoing, with a planned 80 participants. Further analyses will address associations between treatments, side effects and other cancer symptoms.