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Table 3 Modified FACT-P Prostate subscale (version3). Questions 47–49 added to the FACT-P Prostate subscale (version3)

From: Analysis of health related quality of life (HRQoL) of patients with clinically localized prostate cancer, one year after treatment with external beam radiotherapy (EBRT) alone versus EBRT and high dose rate brachytherapy (HDRBT)

Additional Concern

Not at all

A little bit

Some- what

Quite a bit

Very much

     

35.

I am losing weight.......................................

0

1

2

3

4

     

36.

I have a good appetite...................................

0

1

2

3

4

     

37.

I have aches and pains that bother me

0

1

2

3

4

     

38.

I have certain areas of my body where I experience significant pain

0

1

2

3

4

     

39.

My pain keeps me from doing things I want to do...

0

1

2

3

4

     

40.

I am satisfied with my present comfort level..........

0

1

2

3

4

     

41.

I am able to feel like a man..............................

0

1

2

3

4

     

42.

I have trouble moving my bowels.....................

0

1

2

3

4

     

43.

I have difficulty urinating.......................................

0

1

2

3

4

     

44.

I urinate more frequently than usual...................

0

1

2

3

4

     

44.

I have difficulty starting to urinate......................

0

1

2

3

4

     

45.

My problems with urinating limit my activities......

0

1

2

3

4

     

46

I am able to have and keep an erection

0

1

2

3

4

     

47.

I have rectal bleeding....................................

0

1

2

3

4

     

48.

I have diarrhea.............................................

0

1

2

3

4

     

49.

I have blood in my urine.................................

0

1

2

3

4

     

50.

Looking at the above 15 questions, how much would you say these ADDITIONAL CONCERNS affect your quality of life? (circle one number)

 

0

1

2

3

4

5

6

7

8

9

10

 

Not at all

       

Very much so