Why it matters: survival only counts if patients still want the life they’re living.
| Domain | Typical impact | Tools to measure | Key interventions |
|---|---|---|---|
| Fatigue / vitality | Mild–moderate (25–40 %) | EORTC QLQ-C30 Fatigue scale | Exercise ≥ 150 min/week, sleep hygiene |
| Sexual health | Libido loss > 60 % men on ADT | FACT-P, IPSS | PDE-5 inhibitors, counseling |
| Bone / musculoskeletal | Pain, fracture risk | BMD on DEXA | Bisphosphonate / Denosumab |
| Cognitive / mood | “Brain fog”, depression ~30 % | HADS, PHQ-9 | Physical activity, SSRIs/SNRIs |
| Financial | Copay burden | EQ-5D + local surveys | Generic drugs, public reimbursement pathways |
Rule of thumb: review QoL every 6 months and document in chart like a vital sign.
