Examining the influence of illness perception and financial toxicity on the quality of life of prostate cancer patients

Abstract
Background
Cancer of the prostate (CaP) is a public health problem that affects the male genitourinary system causing a significant threat to men’s quality of life (QoL). Experiencing financial constraints and poor illness perception may further compromise the QoL of men with CaP.

Methods
Aim: To examine the relationship between financial toxicity and illness perception with quality of life in men with CaP. The descriptive cross-sectional study used simple random sampling technique to recruit 173 men with CaP from four tertiary health facilities in Nigeria. Data were collected with the comprehensive score for financial toxicity (COST-FACIT), the brief illness perception questionnaire (Brief IPQ) and the functional assessment of cancer therapy-prostate (FACT-P). Analysis of data was carried out using analysis of variance, correlation and hierarchical regression analyses.

Results
The 173 participants had an average age of 71.57 ± 11.18, and 53.18% had one comorbid disease. Significant difference was found in overall QoL based on treatment site and number of comorbid diseases (P < 0.01). QoL had a significant inverse relationship with all the illness perception variables and a significant linear relationship with lower financial toxicity (P < 0.01). Furthermore, financial toxicity (P < 0.05) and four illness perception variables: consequences, identity, concern and illness understanding (P < 0.01), had significant individual influences on QoL of men with CaP.

Conclusions
Quality of life in men with CaP may be improved through mitigating the financial toxicity associated with accessing care and providing appropriate counseling about the illness and what to expect following prostate cancer diagnosis and during treatment.