Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC‐CP)
A Clinical Tool to Measure Urinary, Bowel, Sexual and Vitality/Hormonal Health Date: ___ /___ /___
Patients: Please answer the following questions by checking the appropriate checkbox. All questions are
about your health and symptoms in the LAST FOUR WEEKS. Select one answer for each question.
1. Overall, how much of a problem has your urinary function been for you?
No problem Very small problem Small problem Moderate problem Big problem
2. Which of the following best describes your urinary control?
0 Total control 1 Occasional dribbling 2 Frequent dribbling 4 No urinary control
3. How many pads or adult diapers per day have you been using for urinary leakage?
0 None 1 One pad per day 2 Two pads per day 4 Three or more pads per day
4. How big a problem, if any, has urinary dripping or leakage been for you?
0 No problem 1 Very small problem 2 Small problem 3 Moderate problem 4 Big problem
CLINICIANS: ADD the answers from questions 2‐4 to calculate
the Urinary Incontinence Symptom Score (out of 12):
5. How big a problem, if any, has each No Very small Small Moderate Big
of the following been for you? problem problem problem problem problem
a. Pain or burning with urination 0 1 2 3 4
b. Weak urine stream/incomplete bladder emptying 0 1 2 3 4
c. Need to urinate frequently 0 1 2 3 4
CLINICIANS: ADD the answers from questions 5a‐5c to calculate the
Urinary Irritation/Obstruction Symptom Score (out of 12):
6. How big a problem, if any, has each No Very small Small Moderate Big
of the following been for you? problem problem problem problem problem
a. Rectal pain or urgency of bowel movements 0 1 2 3 4
b. Increased frequency of your bowel movements 0 1 2 3 4
c. Overall problems with your bowel habits 0 1 2 3 4
CLINICIANS: ADD the answers from questions 6a‐6c
to calculate the Bowel Symptom Score (out of 12):
7. How would you rate your ability to reach orgasm (climax)?
0 Very good 1 Good 2 Fair 3 Poor 4 Very poor to none
8. How would you describe the usual quality of your erections?
Firm enough Firm enough for masturbation
0 1 2
Not firm enough for 4 None at all
for intercourse and foreplay only any sexual activity
9. Overall, how much of a problem has your sexual function or lack of sexual function been for you?
0 No problem 1 Very small problem 2 Small problem 3 Moderate problem 4 Big problem
CLINICIANS: ADD the answers from questions 7‐9 to
calculate the Sexual Symptom Score (out of 12):
10. How big a problem, if any, has each No Very small Small Moderate Big
of the following been for you? problem problem problem problem problem
a. Hot flashes or breast tenderness/enlargement 0 1 2 3 4
b. Feeling depressed 0 1 2 3 4
c. Lack of energy 0 1 2 3 4
CLINICIANS: ADD the answers from questions 10a‐10c to calculate
the Vitality/Hormonal Symptom Score (out of 12):
CLINICIANS: Add the five domain summary scores to calculate the Overall Prostate Cancer QOL Score (out of 60):
