# Measurement of patients’ acceptable symptom levels and priorities for symptom improvement in advanced prostate cancer

## TL;DR

This study measures what symptom levels patients with advanced prostate cancer find acceptable and identifies subgroups based on symptom importance priorities.

## Contribution

The study introduces and validates a modified Patient-Centered Outcomes Questionnaire for advanced prostate cancer patients.

## Key findings

- The modified PCOQ showed construct validity with correlations to related constructs.
- Patients generally found low symptom severity acceptable, with sexual dysfunction being an exception.
- Three subgroups of patients were identified based on symptom importance ratings.

## Abstract

Limited research has evaluated the success criteria and priorities for symptom improvement of patients with cancer to inform patient-centered care. In this study, we adapted and tested a measure of these constructs, the Patient-Centered Outcomes Questionnaire (PCOQ), for patients with advanced prostate cancer. We compared acceptable symptom severity levels following symptom treatment across 10 symptoms and identified patient subgroups based on symptom importance.

Patients with advanced prostate cancer (N = 99) participated in a one-time survey, which included a modified version of the PCOQ, standard symptom measures, and additional clinical characteristics.

The modified PCOQ demonstrated construct validity through its correlations with related theoretical constructs. There was a moderate correlation between symptom severity and importance. Acceptable symptom severity levels were generally low, with sexual dysfunction having a higher acceptable severity than most other symptoms. Three patient subgroups were identified: (1) those who rated all symptoms as low in importance (n = 43); (2) those who rated all symptoms as moderately important (n = 33); and (3) those who rated all symptoms as highly important (n = 18). Subgroups were associated with functional status, fatigue, sleep problems, pain, and emotional distress.

The modified PCOQ demonstrated preliminary evidence of construct validity. Patients generally considered low symptom severity to be acceptable, with variations across symptoms. Results suggest that symptom severity and importance are related but distinct aspects of the symptom experience in advanced prostate cancer. Patients’ diverse priorities for symptom improvement point to the need for individualized treatment plans.

The online version contains supplementary material available at 10.1007/s00520-025-10299-x.