New research from Ludwig-Maximilian University of Munich has unveiled significant insights into quality-of-life outcomes for genitourinary cancer patients, with findings presented at the 2025 ASCO Genitourinary Cancers Symposium. The studies examined health-related quality of life (HRQOL) in both bladder and prostate cancer patients, revealing unexpected urban-rural disparities and treatment impact patterns.
Rural Advantage in Bladder Cancer Recovery
In a comprehensive analysis of 1,514 bladder cancer patients who underwent radical cystectomy, researchers found that rural residents experienced better general health-related quality of life compared to their urban counterparts. The study, which included 938 rural and 576 urban patients, demonstrated significant differences during short-term follow-up (P = .001-.037).
At the 12-month mark, both populations showed strong correlations between physical functioning, emotional functioning, and urinary continence with overall HRQOL (P <.001). However, a notable distinction emerged in social support impact - rural residents exhibited a significant correlation between social/family wellbeing and increased HRQOL (P = .042), while urban residents did not show this association (P = .594).
"Physical- and emotional functioning equally affects HRQOL for rural and urban residents. While social/family wellbeing correlates with increased general HRQOL for rural residents only," explained Dr. Thilo Westhofen, the study's lead researcher.
ADT Impact on Prostate Cancer Patients
A parallel study examined 1,124 prostate cancer patients who received postoperative radiotherapy following radical prostatectomy. The research revealed concerning findings regarding androgen deprivation therapy (ADT) impact on quality of life.
Patients receiving ADT alongside postoperative radiotherapy experienced significantly worse long-term HRQOL, with effects persisting up to 48 months after radical prostatectomy (P = .001-.039). The median duration of ADT treatment was 21 months.
Key findings from the multivariable regression analysis identified ADT as an independent predictor of worse general HRQOL (OR, 0.68; 95% CI, 0.47-0.96; P = .03). Additional factors significantly impacting quality of life included:
- Erectile functioning (OR, 5.241; 95% CI, 2.48-11.06; P = .001)
- Urinary continence (OR, 1.655; 95% CI, 1.03-2.66; P = .037)
Assessment Methodology
Both studies utilized validated assessment tools, including the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) and disease-specific modules. The bladder cancer study additionally incorporated the Functional Assessment of Cancer Therapy-Bladder (FACT-BL) questionnaire.
These findings provide crucial insights for healthcare providers in tailoring support systems and treatment approaches based on patients' residential settings and specific treatment protocols. The research particularly highlights the need for enhanced quality of life monitoring in prostate cancer patients receiving ADT, and the potential benefits of strengthening social support systems in urban areas for bladder cancer patients.
