Quality of Life in Elderly Bladder Cancer Patients Following a Cystectomy.

ABSTRACT

INTRODUCTION: Bladder cancer is the ninth most common cancer worldwide. The most common treatment for invasive cancer is radical cystectomy and urinary diversion (ileal conduit, continent urinary reservoir, orthotopic neobladder). In elderly patients, the standards methods of urinary diversion have been the ileal conduit and ureterocutaneostomy. Quality of life is an important consideration for patients with urinary diversion. PURPOSE: The purpose of the present study was to review the literature on quality of life in elderly patients with bladder cancer following a cystectomy and urinary diversion. MATERIAL AND METHOD: A literature review was conducted using the electronic databases PubMed and Google scholar covering the period of time from 2006 to 2016. The following key words were entered "quality of life", "bladder cancer", "elderly" "cystectomy" and a combination thereof. The exclusion criteria for the articles were languages other than English. RESULTS: It was found that various questionnaires were used. Some instruments measure QoL in general, whereas others are more specific with respect to the unique ways in which urinary diversion can impact patients' lives. Furthermore, some findings are contradictory, with certain results indicating that there is no statistically significant difference between quality of life parameters when comparing patients with a neobladder to those with an ileal conduit. In another study, patients who underwent orthotopic neobladder reconstruction reported significantly better physical functioning, role functioning, social functioning and QoL in general throughout the first postoperative months compared to patients who had ileal conduit formation. CONCLUSIONS: All types of treatment have a number of advantages and disadvantages, the details of which should be explained to elderly patients thoroughly. This calls for comprehensive counseling sessions during which the patient and health professional discuss all relevant considerations.