# Comprehensive assessment of lower limb edema and its association with quality of life among men with prostate cancer

## TL;DR

Lower limb edema is common in men with prostate cancer and negatively affects their quality of life, but it is often overlooked and under-discussed.

## Contribution

This study is the first to comprehensively assess the prevalence and impact of lower limb edema in prostate cancer patients using bioimpedance and quality of life questionnaires.

## Key findings

- Lower limb edema was found in 11% of prostate cancer patients.
- Patients with LLE reported significantly lower quality of life scores and more symptoms.
- Most patients with LLE wanted more information on managing their condition.

## Abstract

Lower limb edema (LLE) is characterized by swelling due to fluid accumulation and is an under-recognized condition in men with prostate cancer. This study investigated the prevalence of LLE and explored its impact on daily living, depression, and health-related quality of life (HRQoL).

This cross-sectional study included men with prostate cancer who attended follow-up at the Department of Urology, Rigshospitalet, Denmark, during a 3-month period. LLE was defined as an L-Dex ≥ 10, measured by using bioimpedance spectroscopy, combined with self-reported symptoms (≥ 2 of heaviness, swelling, or tightness) using items from European Organisation for Research and Treatment of Cancer Quality of Life (EORTC) QLQ-VU34. HRQoL, depression, and the impact of LLE on daily living were assessed using self-reported questionnaires.

Among 401 patients, LLE was identified in 45 (11%) patients. Self-reported swelling before diagnosis, comorbidities, BMI ≥ 30, and androgen deprivation therapy (ADT) showed the highest odds of LLE. Patients with LLE demonstrated lower HRQoL scores in global health, physical, role, and social functioning and reported higher bowel and hormonal treatment-related symptoms (p < 0.05). LLE impacted daily activities, including walking (42%) and clothing choices (41%). Most patients (76%) wanted more information on managing LLE symptoms.

LLE is prevalent among men with prostate cancer and is associated with poorer HRQoL and daily living. Despite its impact, many patients report a lack of information and express a desire for more knowledge about the condition. Improved patient education and attention to potential underlying causes are crucial for timely treatment of LLE.

The online version contains supplementary material available at 10.1007/s00520-025-09613-4.