Quality Versus Quantity of Life – What Is the – ProQuest

We live in an age of quantity – larger, faster, and more are equated with better. More time, more possessions, and more friends are “needed” to make life better. Quality is often a lost variable when quantity is the goal. Yet we are all aware that quality, that sensation that accompanies good food, a first kiss, or a beautiful day, contributes to making life worth living. For those receiving a prostate cancer diagnosis, making a treatment decision may mean having to choose between quality of life (QoL) and quantity. Despite the myriad of treatments available, valid, reliable, and comparable data that assess treatment-related or health-related QoL are lacking. The desire for quantity of life as an end-point is important, but this information is insufficient for those needing to make treatment decisions. Our inability to describe the quality of that survival hampers the decision-making process. Living wills and health care durable power of attorney documents allow us to describe the quality we would like in our lives – and provides legal means for our next of kin to intervene, if necessary. The ability to consistently and scientifically describe survival with or without treatment does not exist. In an era in which evidence-based practice is desired, reviewing this may be worthwhile. Review of the Literature In the 2nd century, Galen, like Hippocrates, believed the patient was incurable once a diagnosis of cancer was made. Since there was no curative treatment, intervention was thought to be more harmful than no treatment at all. General advances in cancer treatment began in the 19th century, when anesthesia became available. Objective tumor response and survival have traditionally been used to assess cancer treatment outcomes. In 1948, Karnofsky, Abelmann, Craver, and Burchenal reported the initial effort of physicians to systematically assess the effect of cancer treatments on a patient’s QoL, not just on quantity of life. Over the last decade, the patient’s well-being has been recognized as being as important as cancer treatment. QoL instruments are currently being used in clinical trials to predict survival and response to treatment, and to screen for psychological morbidity. Historically, anxiety, depression, and distress have been used as prostate cancer treatment outcome measures. These variables may also be expected responses to a diagnosis of prostate cancer….