Quality of life in newly diagnosed bladder cancer patients

It has been postulated that bladder cancer impacts health-related quality of life (HRQoL),but research is limited. This research is particularly important as survival for non-muscle invasive bladder cancer (NMIBC) is high, and these patients will need to live with acceptable HRQoL for many years. I investigated HRQoL in 1258 muscle invasive bladder cancer (MIBC) and NMIBC patients participating in the Bladder Cancer Prognosis Programme. Although I found no major difference in HRQoL around time of diagnosis between NMIBC and MIBC patients, I did find that different parts of HRQoL seemed to influence survival of NMIBC and MIBC. Also, patients prefer an invasive but accurate cystoscopy over a hypothetical non- invasive but less accurate urinary biomarker. Additionally, the European Organization of Research and Treatment of Cancer (EORTC) developed a quality of life questionnaire specifically for NMIBC (EORTC NMIBC-24). In this thesis, I have strengthened the structure of this questionnaire that was previously published by another UK research group. Finally, I found only a small difference in physical health between patients with incontinent and continent urinary diversion in a meta-analysis. These findings were discussed in each of the results chapters, and put into wider context in the general discussion chapter