Health-Related Quality of Life in Long-Term Prostate Cancer Survivors Who Received Hormone Therapy: A Scoping Review

TL;DR

This review finds that men with prostate cancer who received hormone therapy report worse long-term quality of life compared to those with local treatments.

Contribution

The study synthesizes evidence on long-term health-related quality of life in prostate cancer survivors who received hormone therapy, highlighting key gaps.

Findings

Hormone therapy recipients reported worse global health, physical, emotional, and social functioning compared to local therapy patients.

Survivors experienced greater symptom burdens, including bowel, urinary, and sexual issues.

Research on outcomes beyond 15 years is limited, and details on hormone regimens are insufficient.

Abstract

Many men now live for many years after prostate cancer diagnosis. Hormone therapy is one of the main treatments available, especially when the cancer is advanced, but its long-term effects on daily life are not well understood. In this review, we looked at studies of men who survived at least 5 years after prostate cancer diagnosis and had received hormone therapy. The findings show that, compared with men treated only with local therapies, such as surgery or radiation, those who had hormone therapy often reported poorer overall health, more physical and emotional difficulties, lower energy, and greater problems with social life. They also experienced more bowel, urinary, and sexual problems. In addition, very little research has followed men beyond 15 years. These insights highlight the need for clearer discussions with patients about long-term effects and for future studies to better understand how different hormone treatments affect long-term quality of life.

Prostate cancer accounts for the largest group of cancer survivors in men. Hormone therapy is essential, especially in advanced disease. While its short-term effects are well studied, research into the long-term effects on health-related quality of life (HRQOL) remains limited. Therefore, this review aims to synthesize and identify key gaps in the literature on HRQOL and symptom burden in long-term prostate cancer survivors who underwent hormone therapy. After searching four databases until 15 April 2025, we identified 14 observational studies that reported on general and prostate cancer-specific HRQOL in prostate cancer survivors ≥ 5 years post-diagnosis. Survivors who underwent hormone therapy reported worse global health status and physical, emotional, and social functioning compared to those treated with local therapies like prostatectomy or radiation. These survivors also experienced greater symptom burdens, alongside worse vitality and mental health. Prostate cancer-specific issues, such as bowel and urinary bother and sexual dysfunction, were also more pronounced in hormone therapy recipients. Nevertheless, outcomes beyond 15 years remain under-researched. The findings of this review highlight the importance of discussing long-term HRQOL compromises with patients who consider hormone therapy. However, they warrant cautious interpretation, particularly due to limited details on hormone therapy regimens and inadequate control for stage.

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