Quality of life in patients with advanced bladder cancer. A randomized study comparing cystectomy and irradiation--the Danish Bladder Cancer Study Group (DAVECA protocol 8201).

The "quality of life" after treatment for advanced bladder cancer was investigated. The study was part of a randomized trial comparing the effect of preoperative irradiation (40 Gy) and cystectomy with radical radiation therapy (60 Gy) and salvage cystectomy. Patients answered a mailed questionnaire on psycho-social aspects. The first was filled in 6 months after treatment and was answered by 107 patients. The second was sent out 12-18 months later and was answered by 68 patients. From a general point of view, there were no consistent differences between the two treatment groups. In the first questionnaire, patients treated with radical irradiation and salvage cystectomy expressed a slightly more pessimistic outlook than patients treated with pre-operative irradiation and cystectomy. There was not such difference in the second questionnaire, but the latter group reported the largest reduction of social (sports, hobbies, etc.) and sexual activities. In conclusion, pre-operative information about treatment and post-operative life is an important but often neglected issue.