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Chowdhury E, Horrocks T, McAteer G, Gillanders D. Examining the impact of androgen deprivation therapy, masculine self-esteem, and psychological flexibility on distress and quality of life in men with prostate cancer. Psychooncology 2024; 33:e6277. [PMID: 38282234 DOI: 10.1002/pon.6277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/29/2023] [Accepted: 12/13/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE Studies suggest that androgen deprivation therapy (ADT) exacerbates psychological and quality of life (QoL) issues associated with prostate cancer (PCa). However, quantitative research examining underlying psychosocial mechanisms for this is limited. We examined the association of PCa symptoms with distress and QoL in ADT-treated and ADT-naïve patients, and the influence of masculine self-esteem and psychological flexibility (PF) on these relationships. METHODS Secondary analysis of a quantitative, cross-sectional survey of 286 PCa patients. Independent samples t-tests, moderation, and conditional process analysis were used to assess relationships between predictor, mediator, moderator, and outcome variables. RESULTS ADT was associated with greater PCa symptomology, lower masculine self-esteem, and lower QoL. Moderation analysis showed that ADT potentiated adverse impacts of PCa symptomology on distress and QoL. High PF attenuated these relationships, though less so for ADT-treated participants. Conditional process analysis showed that masculine self-esteem mediated the predictive effect of symptoms on distress across treatments. However, ADT did not moderate this indirect effect, nor was moderation conditional on PF. CONCLUSION PF appears to: (1) attenuate psychological distress in ADT patients; and (2) improve distress, QoL, and masculine self-esteem in ADT-naïve patients. Interventions targeting PF may thus be a viable adjunct to established approaches. However, their effects may be comparatively limited in ADT patients, who may benefit from more intensive and tailored treatment.
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Affiliation(s)
- Emil Chowdhury
- Section of Clinical and Health Psychology, School of Health in Social Science, Medical School, University of Edinburgh, Edinburgh, UK
| | - Thomas Horrocks
- Section of Clinical and Health Psychology, School of Health in Social Science, Medical School, University of Edinburgh, Edinburgh, UK
| | - Gareth McAteer
- Section of Clinical and Health Psychology, School of Health in Social Science, Medical School, University of Edinburgh, Edinburgh, UK
| | - David Gillanders
- Section of Clinical and Health Psychology, School of Health in Social Science, Medical School, University of Edinburgh, Edinburgh, UK
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Martín-Núñez J, Raya-Benítez J, López-López L, Calvache-Mateo A, Heredia-Ciuró A, Navas-Otero A, Valenza MC. Efficacy in urinary symptom burden, psychological distress, and self-efficacy of education-enhanced interventions in prostate cancer patients: a systematic review and meta-analyses. Support Care Cancer 2023; 31:340. [PMID: 37191890 DOI: 10.1007/s00520-023-07803-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/09/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Worldwide, prostate cancer is both the second-most diagnosed cancer and most common solid tumor in men. Prostate cancer patients present with a symptom burden that is compounded by the impact of medical oncology treatment, affecting different domains of their perceived health status. Education active techniques are a key role in chronic disease to increase participation in their recovery. PURPOSE The purpose of the current review was to examine the efficacy of education-enhanced in urinary symptom burden, psychological distress, and self-efficacy in patients diagnosed with prostate cancer. METHODS A wide search of the literature was conducted for articles from their inception to June 2022. Only randomized controlled trials were included. Data extraction and methodologic quality assessment of the studies were carried out by two reviewers. We previously registered the protocol of this systematic review on PROSPERO (CRD42022331954). RESULTS A total of six studies were included in the study. After education-enhanced intervention showed significant improvements in any of perceived urinary symptom burden, one in psychological distress, and one in self-efficacy in the experimental group. The meta-analysis showed that education-enhanced interventions have a significant effect on depression. CONCLUSION Education-enhanced could have positive effects on urinary symptom burden, psychological distress, and self-efficacy in prostate cancer survivors. Our review was unable to demonstrate the best timing to apply education-enhanced strategies.
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Affiliation(s)
- Javier Martín-Núñez
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Julia Raya-Benítez
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Laura López-López
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Andrés Calvache-Mateo
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Alejandro Heredia-Ciuró
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Alba Navas-Otero
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Marie Carmen Valenza
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain.
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Wang T, Tan JYB, Yao LQ, Huilin Cheng, Zhao I, Eliseeva S, Polotan MJ. Effects of somatic acupoint stimulation on anxiety and depression in cancer patients: An updated systematic review of randomized controlled trials. Complement Ther Clin Pract 2023; 51:101735. [PMID: 36812735 DOI: 10.1016/j.ctcp.2023.101735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/19/2023] [Accepted: 02/04/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES To explore the effectiveness of somatic acupoint stimulation (SAS) for cancer patients with anxiety and depression. METHODS Thirteen electronic databases were searched systematically until August 2022. Randomized controlled trials (RCTs) investigating SAS for anxiety and/or depression in cancer patients were retrieved. Methodological quality of the included studies was assessed by utilizing the Cochrane Back Review Group Risk of Bias Assessment Criteria. Evidence level was assessed by using the approach of Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Both meta-analysis and descriptive analysis were conducted for outcome assessment. RESULTS Twenty-eight records were finally included including 22 journal articles and six ongoing registered clinical trials. The overall methodological quality and level of evidence of the included studies were suboptimal, with no high-quality evidence identified. Moderate evidence showed that SAS could significantly decrease the anxiety of cancer patients (Acupuncture: [random effect model, SMD = -0.52, 95% CI = -0.79 to -0.24, p = 0.0002] and Acupressure: [random effect model, SMD = -0.89, 95% CI = -1.25 to -0.52, p < 0.00001]. While for depression, although the data analysis indicated that SAS can decrease depression significantly (Acupuncture: [random effect model, SMD = -1.26, 95% CI = -2.08 to -0.44, p = 0.003] and Acupressure: [random effect model, SMD = -1.42, 95% CI = -2.41 to -0.42, p = 0.005]), relevant evidence was rated as low. No statistically significant difference was identified between true and sham acupoints stimulation for both anxiety and depression. CONCLUSIONS This systematic review provides the latest research evidence to support SAS as a promising intervention for alleviating anxiety and depression in cancer patients. However, the research evidence should be interpreted prudently as methodological concerns were identified in some included studies, and some sub-group analyses were performed with a relatively small sample size. More rigorously designed large-scale RCTs with placebo-controlled comparisons are warranted to generate high-quality evidence. REGISTRATION The systematic review protocol has been registered with PROSPERO (CRD42019133070).
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Affiliation(s)
- Tao Wang
- Charles Darwin University, Faculty of Health, Brisbane Centre, 410 Ann Street, Brisbane, QLD, Australia.
| | - Jing-Yu Benjamin Tan
- Charles Darwin University, Faculty of Health, Ellengowan Drive, Darwin, NT, Australia.
| | - Li-Qun Yao
- Charles Darwin University, Faculty of Health, Brisbane Centre, 410 Ann Street, Brisbane, QLD, Australia.
| | - Huilin Cheng
- Charles Darwin University, Faculty of Health, Ellengowan Drive, Darwin, NT, Australia; The Hong Kong Polytechnic University, School of Nursing, Hung Hom, Kowloon, Hong Kong Special Administrative Region.
| | - Isabella Zhao
- Charles Darwin University, Faculty of Health, Brisbane Centre, 410 Ann Street, Brisbane, QLD, Australia; Queensland University of Technology, Cancer & Palliative Outcomes Centre, Kelvin Grove, QLD, Australia.
| | - Sabina Eliseeva
- Charles Darwin University, Faculty of Health, Brisbane Centre, 410 Ann Street, Brisbane, QLD, Australia; Thornlands General Practice, Thornlands, Redland, QLD, Australia.
| | - Mary Janice Polotan
- Charles Darwin University, Faculty of Health, Brisbane Centre, 410 Ann Street, Brisbane, QLD, Australia; Thornlands General Practice, Thornlands, Redland, QLD, Australia.
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Lee HJ, Kim YA, Ryu SY, Chun M, Yim CY, Kang HT, Kang JH, Huh JS, Kim JH, Lim KH, Jung SY, Kwon HC, Goh E, Lee YS, Ju HY, Yun EH, Chang YJ. The Positive Effects of Cancer Survivor Support Service on Distress in South Korea: A Nationwide Prospective Study. Front Med (Lausanne) 2022; 9:769221. [PMID: 35237619 PMCID: PMC8882982 DOI: 10.3389/fmed.2022.769221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background and Aim Cancer survivors are gradually increasing, however, they suffer from various difficulties. We aimed to investigate the characteristics of cancer survivors and the effects of the services of the Korean Cancer Survivorship Center Pilot Project launched by the South Korean government on distress. Methods A prospective observational cohort study was performed on cancer survivors who completed primary treatment. Cancer survivors' distress and symptoms such as fatigue, pain, depressive mood, anxiety, and insomnia were evaluated by well-trained nurses. Regarding their needs, medical and psychosocial support services were provided. Results This study included 1,921 cancer survivors, with a mean age of 57.3 years (68.7% females). Breast cancer was most common, followed by stomach and colorectal cancer. Psychosocial and medical support decreased the percentage of the high-distress group from 50.9 to 30.5% and decreased the percentage of cancer survivors with high scores in fatigue, pain, anxiety, depressive mood, and insomnia. The independent predictors of a low distress level after the use of the services were older age, the relief of fatigue, pain, and insomnia. Conclusion This study showed that psychosocial and medical support is associated with the lower distress and physical and mental symptoms of cancer survivors. Psychosocial and medical support could contribute to distress relief in cancer survivors. Further management strategies for fatigue, pain and insomnia are required.
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Affiliation(s)
- Hyun Jeong Lee
- Division of Cancer Control and Policy, National Cancer Center, Goyang, South Korea
- National Cancer Survivorship Center, National Cancer Center, Goyang, South Korea
- Department of Psychiatry and Behavioral Science, National Cancer Center, Goyang, South Korea
- Department of Psychiatry, Seoul National University, Seoul, South Korea
| | - Young Ae Kim
- Division of Cancer Control and Policy, National Cancer Center, Goyang, South Korea
- National Cancer Survivorship Center, National Cancer Center, Goyang, South Korea
- *Correspondence: Young Ae Kim
| | - Seong Yeob Ryu
- Department of Surgery, Chonnam National University Medical School, Gwangju, South Korea
| | - Mison Chun
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, South Korea
| | - Chang-Yeol Yim
- Department of Internal Medicine, Chonbuk National University Medical School, Research Institute of Clinical Medicine of Chonbuk National University, Jeonju, South Korea
- Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea
| | - Hee-Taik Kang
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, South Korea
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Jung Hun Kang
- Division of Hematology-Oncology, Department of Internal Medicine, College of Medicine, Gyeong-Sang National University, Jinju, South Korea
- Department of Medicine, Gyeongsang National University Hospital, Jinju, South Korea
| | - Jung-Sik Huh
- Department of Urology, School of Medicine, Jeju National University, Jeju, South Korea
| | - Jong-Heun Kim
- Department of Psychiatry and Behavioral Science, National Cancer Center, Goyang, South Korea
| | - Kyu-Hyoung Lim
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - So-Youn Jung
- Breast Cancer Center, National Cancer Center, Goyang, South Korea
| | - Hyoung-Cheol Kwon
- Department of Radiation Oncology, Chonbuk National University Hospital, Jeonju, South Korea
- Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, South Korea
- Department of Radiation Oncology, Chonbuk National University Medical School, Jeonju, South Korea
| | - Eurah Goh
- Department of Family Medicine, Postgraduate College of Medicine, Kangwon National University, Chuncheon, South Korea
| | - Yeon-Seung Lee
- Division of Cancer Control and Policy, National Cancer Center, Goyang, South Korea
| | - Hee Young Ju
- Cancer Survivorship Branch, National Cancer Center, Goyang, South Korea
- Department of Pediatrics, Samsung Medical Center, Seoul, South Korea
| | - E. Hwa Yun
- Division of Cancer Control and Policy, National Cancer Center, Goyang, South Korea
- National Cancer Survivorship Center, National Cancer Center, Goyang, South Korea
- Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, South Korea
| | - Yoon Jung Chang
- Division of Cancer Control and Policy, National Cancer Center, Goyang, South Korea
- National Cancer Survivorship Center, National Cancer Center, Goyang, South Korea
- Center for Cancer Prevention and Detection, National Cancer Center, Goyang, South Korea
- National Hospice Center, National Cancer Center, Goyang, South Korea
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, South Korea
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The relationship between sleep hygiene, mood, and insomnia symptoms in men with prostate cancer. Support Care Cancer 2022; 30:4055-4064. [PMID: 35064327 DOI: 10.1007/s00520-021-06680-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/03/2021] [Indexed: 01/27/2023]
Abstract
PURPOSE Insomnia symptoms are commonly experienced by men after prostate cancer (PCa) treatment. Here we explored how sleep hygiene behaviours and psychological symptoms are associated with insomnia symptoms in PCa patients. METHODS An online survey was posted on social media and sent to mailing lists of PCa and general cancer organisations. The survey collected information on demographic, sleep hygiene, and psychological symptoms using validated questionnaires. RESULTS Data from 142 participants were compared based on the absence (age = 68.3 ± 8.9 years) and presence (age = 66.6 ± 9.0 years) of insomnia symptoms. Participants with insomnia symptoms had significantly higher levels of anxiety, depression, fatigue, and sleepiness as well as poorer sleep hygiene than those without insomnia symptoms. Control variables (age, number of comorbidities, and BMI) accounted for 11.9% of the variance in insomnia symptoms. Including treatment history contributed to an additional 1.6% of the variance in insomnia symptoms. Adding sleepiness, fatigue, anxiety, and depressive symptoms to the model explained an additional 44.6% of the variance in insomnia symptoms. Furthermore, including the sleep hygiene item 'I think, plan, or worry when I am in bed' and 'I sleep in an uncomfortable bedroom' explained an additional 3.6% of the variance in insomnia symptoms. CONCLUSIONS Poor sleep hygiene, fatigue, sleepiness, anxiety, and depressive symptoms were all associated with worse insomnia symptoms in PCa patients. Improving sleep hygiene and treating psychological conditions may potentially help prevent and/or alleviate insomnia symptoms in PCa patients.
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The psychological impact of prostate cancer after treatment: a critical review of the literature. JOURNAL OF RADIOTHERAPY IN PRACTICE 2021. [DOI: 10.1017/s1460396921000455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Aim:
This critical review of the literature seeks to understand the psychological impact that treatment interventions may have on prostate cancer (PC) survivors.
Materials and Methods:
A literature search was conducted using databases of peer-reviewed literature. The search terms used were devised using the building-blocks technique to divide the query into facets. The articles were manually assessed for relevance and appraised using the relevant Critical Appraisal Skills Programme (CASP) tool. Government guidelines and regulations were also used following a manual search on the National Institute for Health and Care Excellence (NICE) website. This process resulted in a total of 12 sources being included in the critical review.
Results:
The key themes that arose from the review were masculinity, depression, anxiety and psychological implications related to sexual functioning. Psychological impact varies on an individual basis and is influenced by the quality of a patient’s experience during and after treatment in relation to sufficient information giving and support.
Findings:
Open communication should be encouraged by healthcare professionals to assess patient mental wellbeing. The extent of psychological impact varies on an individual basis; however, there are predictive factors that can make an individual more at risk of being affected psychologically post-PC treatment.
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Granell M, Senín A, Barata A, Cibeira MT, Gironella M, López-Pardo J, Motlló C, Garcia-Guiñón A, Ben-Azaiz R, Abella E, Soler A, Canet M, Martí JM, Martino R, Sierra J, de Larrea CF, Oriol A, Rosiñol L. Predictors of return to work after autologous stem cell transplantation in patients with multiple myeloma. Bone Marrow Transplant 2021; 56:2904-2910. [PMID: 34404917 DOI: 10.1038/s41409-021-01429-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/16/2021] [Accepted: 07/30/2021] [Indexed: 11/09/2022]
Abstract
Return to work (RTW) is a marker of functional recovery in cancer patients, with quality of life, financial and social implications. We investigated frequency and factors associated with RTW in a cohort of patients younger than 66 years, with newly diagnosed multiple myeloma (MM), uniformly treated with a bortezomib-based induction followed by autologous stem cell transplantation (ASCT). Socio-economic and working status data were collected by a self-administered questionnaire. One hundred and eighty-six patients entered the study. Of whom, 145 (78%) where employed at diagnosis, which was more frequent in younger (median 55 vs. 60 years, p < 0.001), men (59.3% vs. 34.2%, p = 0.004), and with college studies (44.8% vs. 24.4%, p = 0.008). Forty-three (30%) of the 145 patients who had a job at diagnosis, RTW after ASCT in a median of 5 (range 1-27) months. Factors independently associated with RTW were having three or more children (HR 2.87, 95% CI 1.33-6.18), college studies (HR 2.78, 95% CI 1.21-6.41), and a family income >40 × 103€/year (HR 2.31, 95% CI 1.12-4.78). In conclusion, the frequency of RTW herein reported in MM patients seems lower than reported in other malignancies. The risk factors observed may guide the design RTW programs.
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Affiliation(s)
- Miquel Granell
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Alicia Senín
- Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Badalona, Spain
| | - Anna Barata
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain. .,Health Outcomes and Behavior Department, Moffitt Cancer Center, Tampa, FL, US.
| | - Maria-Teresa Cibeira
- Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Mercedes Gironella
- Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jordi López-Pardo
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Motlló
- Hematology Department, Hospital Sant Joan de Déu Manresa, Barcelona, Spain
| | | | - Randa Ben-Azaiz
- Hematology Department, Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eugènia Abella
- Hematology Department, Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alfons Soler
- Hematology Department, Hospital Universitari Parc Taulí Sabadell, Barcelona, Spain
| | - Marta Canet
- Hematology Department, Hospital Universitari Mútua de Terrassa, Barcelona, Spain
| | - Josep Ma Martí
- Hematology Department, Hospital Universitari Mútua de Terrassa, Barcelona, Spain
| | - Rodrigo Martino
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jorge Sierra
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlos Fernández de Larrea
- Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Albert Oriol
- Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Badalona, Spain
| | - Laura Rosiñol
- Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
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Dickinson K, Lim A, Kupzyk KA. Demographic, Symptom, and Lifestyle Factors Associated With Cancer-Related Fatigue in Men With Prostate Cancer. Oncol Nurs Forum 2021; 48:423-430. [PMID: 34142995 DOI: 10.1188/21.onf.423-430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To identify potential demographic, symptom, and lifestyle factors associated with cancer-related fatigue (CRF) in men with prostate cancer. SAMPLE & SETTING Data were retrieved from men with prostate cancer across the disease trajectory who were enrolled in the Genitourinary Cancer Collaborative Registry-Prostate Cancer. METHODS & VARIABLES Self-reported data on demographic characteristics, lifestyle habits (smoking history, alcohol consumption, physical activity/exercise, dietary habits, and vitamins/supplements), and symptom experiences (measured using the Brief Fatigue Inventory, European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Prostate Cancer and -Bone Metastasis, and Pittsburgh Sleep Quality Index) were included in the registry. RESULTS Demographic (younger age) and symptom (sleep quality, urinary, bowel, hormone-related, and sexual activity) correlates of CRF were identified. Higher levels of moderate to vigorous exercise and activities were associated with lower CRF in the sample as a whole. However, there was no association between CRF and physical activity in men with bone metastasis. IMPLICATIONS FOR NURSING CRF is a common and burdensome symptom among individuals with cancer and survivors. Identification of demographic, symptom, and lifestyle factors associated with CRF can enhance understanding of this symptom and contribute to early risk assessment and intervention.
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Rice SM, Kealy D, Ogrodniczuk JS, Seidler ZE, Montaner G, Chambers S, Oliffe JL. The Anxiety Depression Pathway Among Men Following a Prostate Cancer Diagnosis: Cross-Sectional Interactions Between Anger Responses and Loneliness. Am J Mens Health 2021; 15:15579883211023699. [PMID: 34142615 PMCID: PMC8216379 DOI: 10.1177/15579883211023699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/17/2021] [Indexed: 11/15/2022] Open
Abstract
Anger has been a largely neglected emotion in prostate cancer research and intervention. This paper highlights the role of anger in the anxiety depression pathway among men with prostate cancer, and whether its impact is dependent on loneliness. Data are presented from a sample of men with prostate cancer (N = 105, M = 69.12 years, prostatectomy = 63.8%) and analysed using conditional process analysis. Dimensions of anger were evaluated as parallel mediators in bi-directional anxiety and depression pathways. Loneliness was evaluated as a conditional moderator of identified significant mediation relationships. Moderate severity depression (16.5%) was endorsed more frequently than moderate severity anxiety (8.6%, p = .008), with 19.1% of the sample reporting past two-week suicide ideation. Consistent with hypotheses, anger-related social interference (but not other dimensions of anger) significantly mediated the anxiety-depression pathway, but not the reverse depression-anxiety pathway. This indirect effect was conditional on men experiencing loneliness. Sensitivity analyses indicated the observed moderated mediation effect occurred for affective, but not somatic symptoms of depression. Findings support anger-related social interference (as opposed to anger frequency, intensity, duration or antagonism) as key to explaining the previously established anxiety-depression pathway. Results underscore the need for enhanced psychosocial supports for men with prostate cancer, with a particular focus on relational aspects. Supporting men with prostate cancer to adaptively process and manage their anger in ways that ameliorate negative social consequences will likely enhance their perceived social support quality, which may in turn better facilitate post-diagnosis recovery and emotional adjustment.
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Affiliation(s)
- Simon M. Rice
- Orygen, Parkville, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Australia
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - John S. Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Zac E. Seidler
- Orygen, Parkville, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Gabriela Montaner
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia
- Faculty of Health, University of Technology Sydney, Sydney NSW, Australia
| | - John L. Oliffe
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
- Department of Nursing, The University of Melbourne, Australia
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Hartung TJ, Moustsen IR, Larsen SB, Wreford Andersen EA, Suppli NP, Johansen C, Tjønneland A, Friberg AS, Kjær SK, Brasso K, Kessing LV, Mehnert A, Dalton SO. Antidepressant prescriptions and associated factors in men with prostate cancer and their female partners. J Cancer Surviv 2020; 15:536-545. [PMID: 33051756 PMCID: PMC8272693 DOI: 10.1007/s11764-020-00947-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 09/28/2020] [Indexed: 11/06/2022]
Abstract
Purpose To estimate the risk of first-time antidepressant prescriptions as a proxy for depression or anxiety and associated risk factors in patients with prostate cancer and their female partners. Methods We followed all men (n = 25,126) and their female cohabiting partners (n = 8785) without a history of cancer or antidepressants from the Danish Diet, Cancer and Health cohort from 1997 to 2014 or 2010, respectively. We estimated the cumulative incidence of first-time antidepressant prescriptions in men with prostate cancer compared with cancer-free men and their respective female partners, using the Danish National Prescription Registry. Sociodemographic, lifestyle-related, and clinical risk factors were assessed using Cox regression models. Results A total of 1828 men were diagnosed with prostate cancer of whom 15% received antidepressants. The unadjusted hazard ratio of antidepressant prescription was 2.18 (95%CI, 1.92, 2.48) for men with prostate cancer and 1.27 (95%CI, 0.87, 1.85) for their partners, compared with cancer-free men and their partners, respectively. After adjusting for sociodemographic, lifestyle-related, and comorbidity factors, this risk was 2-fold to 4-fold increased among patients, but not significantly increased among partners. Significant risk factors among patients were curative and palliative treatment (vs. active surveillance and watchful waiting), nonlocalized disease, and short education. Conclusions Men with prostate cancer have a higher risk of receiving antidepressant medication than cancer-free men. Clinical characteristics can help clinicians in identifying patients at a high risk of depression or anxiety. Implications for Cancer Survivors Men with prostate cancer who experience symptoms of depression or anxiety should seek professional help early on. Patient education could aid in raising awareness and reducing the stigma associated with mental disorders. Electronic supplementary material The online version of this article (10.1007/s11764-020-00947-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tim J Hartung
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103, Leipzig, Germany.
| | - Ida Rask Moustsen
- Unit of Survivorship, The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Signe Benzon Larsen
- Unit of Survivorship, The Danish Cancer Society Research Center, Copenhagen, Denmark.,Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Nis P Suppli
- Mental Health Centre Copenhagen, Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christoffer Johansen
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103, Leipzig, Germany.,Unit of Survivorship, The Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne S Friberg
- Unit of Survivorship, The Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Susanne K Kjær
- Unit of Virus, Lifestyle and Genes, The Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Gynecology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Klaus Brasso
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lars V Kessing
- Psychiatric Center Copenhagen, Department O, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103, Leipzig, Germany
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11
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Sharpley CF, Christie DRH, Bitsika V. Depression and prostate cancer: implications for urologists and oncologists. Nat Rev Urol 2020; 17:571-585. [PMID: 32733038 DOI: 10.1038/s41585-020-0354-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 02/07/2023]
Abstract
Many patients with prostate cancer experience severe levels of depression, which can negatively affect their treatment and disease course. Some prostate cancer treatments can increase the severity of a patient's depression, for example, by increasing anhedonia and erectile dysfunction. Depression is often thought of as a unitary phenomenon, but multiple subtypes can be distinguished. This variety of manifestations challenges the successful application of universal antidepressant treatment options and argues for a multi-symptom assessment process that considers a patient's disease burden and their particular form of depression. Inclusion of screening and detailed diagnosis of depression can be argued to be part of good practice, and clinicians are urged to consider when and how this might be accomplished within their urological practice.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.
| | - David R H Christie
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.,Genesiscare, John Flynn Private Hospital, Tugun, Queensland, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
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12
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Esser P, Mehnert-Theuerkauf A, Friedrich M, Johansen C, Brähler E, Faller H, Härter M, Koch U, Schulz H, Wegscheider K, Weis J, Kuba K, Hinz A, Hartung T. Risk and associated factors of depression and anxiety in men with prostate cancer: Results from a German multicenter study. Psychooncology 2020; 29:1604-1612. [PMID: 32658367 DOI: 10.1002/pon.5471] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVE In order to optimize psycho-oncological care, studies that quantify the extent of distress and identify certain risk groups are needed. Among patients with prostate cancer (PCa), findings on depression and anxiety are limited. METHODS We analyzed data of PCa patients selected from a German multi-center study. Depression and anxiety were assessed with the PHQ-9 and the GAD-7 (cut-off ≥7). We provided physical symptom burden, calculated absolute and relative risk (AR and RR) of depression and anxiety across patient subsets and between patients and the general population (GP) and tested age as a moderator within the relationship of disease-specific symptoms with depression and anxiety. RESULTS Among 636 participants, the majority reported disease-specific problems (sexuality: 60%; urination: 52%). AR for depression and anxiety was 23% and 22%, respectively. Significant RR were small, with higher risks of distress in patients who are younger (eg, RRdepression = 1.15; 95%-CI: 1.06-1.26), treated with chemotherapy (RRdepression = 1.46; 95%-CI: 1.09-1.96) or having metastases (RRdepression = 1.30; 95%-CI: 1.02-1.65). Risk of distress was slightly elevated compared to GP (eg, RRdepression = 1.13; 95%-CI: 1.07-1.19). Age moderated the relationship between symptoms and anxiety (Burination = -0.10, P = .02; Bsexuality = -0.11, P = .01). CONCLUSIONS Younger patients, those with metastases or treatment with chemotherapy seem to be at elevated risk for distress and should be closely monitored. Many patients suffer from disease-specific symptom burden, by which younger patients seem to be particularly distressed. Support of coping mechanisms associated with disease-specific symptom burden seems warranted.
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Affiliation(s)
- Peter Esser
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Christoffer Johansen
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.,Oncology Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Unit of Survivorship, The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center Mainz, Mainz, Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Martin Härter
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Uwe Koch
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Schulz
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joachim Weis
- Comprehensive Cancer Center, University Medical Center Freiburg, Freiburg, Germany
| | - Katharina Kuba
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Tim Hartung
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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13
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de Boer AG, Torp S, Popa A, Horsboel T, Zadnik V, Rottenberg Y, Bardi E, Bultmann U, Sharp L. Long-term work retention after treatment for cancer: a systematic review and meta-analysis. J Cancer Surviv 2020; 14:135-150. [PMID: 32162193 PMCID: PMC7182621 DOI: 10.1007/s11764-020-00862-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/29/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE Almost half of people diagnosed with cancer are working age. Survivors have increased risk of unemployment, but little is known about long-term work retention. This systematic review and meta-analysis assessed work retention and associated factors in long-term cancer survivors. METHODS We searched Medline/Pubmed, Embase, PsychINFO, and CINAHL for studies published 01/01/2000-08/01/2019 reporting work retention in adult cancer survivors ≥ 2 years post-diagnosis. Survivors had to be in paid work at diagnosis. Pooled prevalence of long-term work retention was estimated. Factors associated with work retention from multivariate analysis were synthesized. RESULTS Twenty-nine articles, reporting 21 studies/datasets including 14,207 cancer survivors, were eligible. Work retention was assessed 2-14 years post-diagnosis. Fourteen studies were cross-sectional, five were prospective, and two contained both cross-sectional and prospective elements. No studies were scored as high quality. The pooled estimate of prevalence of long-term work retention in cancer survivors working at diagnosis was 0.73 (95%CI 0.69-0.77). The proportion working at 2-2.9 years was 0.72; at 3-3.9 years 0.80; at 4-4.9 years 0.75; at 5-5.9 years 0.74; and 6+ years 0.65. Pooled estimates did not differ by cancer site, geographical area, or study design. Seven studies assessed prognostic factors for work retention: older age, receiving chemotherapy, negative health outcomes, and lack of work adjustments were associated with not working. CONCLUSION Almost three-quarters of long-term cancer survivors working at diagnosis retain work. IMPLICATIONS FOR CANCER SURVIVORS These findings are pertinent for guidelines on cancer survivorship care. Professionals could focus support on survivors most likely to have poor long-term work outcomes.
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Affiliation(s)
- Angela Gem de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Steffen Torp
- Department of Health, Social & Welfare Studies, University College of South-Eastern Norway, Notodden, Norway
| | - Adela Popa
- Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Trine Horsboel
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Vesna Zadnik
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Yakir Rottenberg
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Edit Bardi
- Kepler Universitäts Klinikum, Linz, Austria
| | - Ute Bultmann
- University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, United Kingdom.
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14
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Watt HMG, Bucich M, Dacosta L. Adolescents' Motivational Profiles in Mathematics and Science: Associations With Achievement Striving, Career Aspirations and Psychological Wellbeing. Front Psychol 2019; 10:990. [PMID: 31316409 PMCID: PMC6610331 DOI: 10.3389/fpsyg.2019.00990] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/15/2019] [Indexed: 11/13/2022] Open
Abstract
Pertinent to concern in Australia and elsewhere regarding shortages in STEM fields, motivational expectancies and values predict STEM study and career aspirations. Less is known about how "cost" values may deter, and how expectancies/values and costs combine for different profiles of learners to predict achievement aspirations and psychological wellbeing outcomes. These were the aims of the present study using established measures of perceived talent, intrinsic and utility values, and a new multidimensional "costs" measure as the platform to explore a typology of mathematics/science learners. Grade 10 Australian adolescents (N = 1,172; 702 girls) from 9 metropolitan Sydney/Melbourne schools completed surveys early 2012/2013. Latent profile analyses educed profiles within each of mathematics and science: "Positively engaged" scored high on positive motivations, low on costs; "Struggling ambitious" were high for both positive motivations and costs; "Disengaged" exhibited generally low scores on positive motivations but high costs. MANOVAs examined mathematics/science profile differences on clustering variables, experienced learning environments, achievement background and striving, career aspirations and psychological wellbeing. Positively engaged/Struggling ambitious were distinguished by high costs perceived by Struggling ambitious, associated with debilitated psychological wellbeing, but not eroding achievement striving. A greater proportion of boys was in this risk type. Disengaged students reported lowest STEM-related career aspirations, aimed marks and history of results; in mathematics, a greater proportion of girls was in this risk type. Profiles could be conceptualized along dimensions of achievement striving and psychological wellbeing. Similar profiles for mathematics and science, and coherent patterns of antecedents and outcomes, suggest several theoretical and educational implications.
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Affiliation(s)
- Helen M. G. Watt
- School of Education and Social Work, The University of Sydney, Sydney, NSW, Australia
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15
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McAteer G, Gillanders D. Investigating the role of psychological flexibility, masculine self‐esteem and stoicism as predictors of psychological distress and quality of life in men living with prostate cancer. Eur J Cancer Care (Engl) 2019; 28:e13097. [DOI: 10.1111/ecc.13097] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Gareth McAteer
- Section of Clinical and Health Psychology, School of Health in Social Science, Medical School University of Edinburgh Edinburgh UK
| | - David Gillanders
- Section of Clinical and Health Psychology, School of Health in Social Science, Medical School University of Edinburgh Edinburgh UK
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16
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Cancer-related symptoms, mental well-being, and psychological distress in men diagnosed with prostate cancer treated with androgen deprivation therapy. Qual Life Res 2019; 28:2741-2751. [PMID: 31115843 PMCID: PMC6761086 DOI: 10.1007/s11136-019-02212-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2019] [Indexed: 02/06/2023]
Abstract
Purpose There are known associations between treatment of prostate cancer (PCa) involving Androgen Deprivation Therapy (ADT) and psychological and physical side effects. We investigate the associations between cancer-related symptoms, health-related quality of life (HRQL), and poor psychological outcomes in men whose treatment for PCa involved ADT. Methods A cross-sectional postal questionnaire was administered to UK men 18–42 months post diagnosis of PCa. Men completed items on functional outcomes using the Expanded Prostate Cancer Index Composite (EPIC-26), EuroQol-5D (EQ-5D), and the European Organisation for Research and Treatment of Cancer (EORTC) Fatigue subscale. Psychological outcomes (mental well-being and psychological distress) were assessed using the Short Warwick–Edinburgh Mental Well-being Scale (SWEMWBS) and the Kessler 6-item scale (K6), respectively. Associations between explanatory variables and psychological outcomes were assessed using stepped logistic regression. Results 13,097 men treated with ADT completed a questionnaire. A minority of men reported poor mental well-being (15.5%) or severe psychological distress (6.6%). After controlling for sociodemographic and clinical variables, reporting clinically significant fatigue was strongly associated with severe psychological distress (OR 9.92; 95% CI 7.63 to 12.89) and poor well-being (OR 3.86; 95% CI 3.38 to 4.42). All cancer-related symptoms and HRQL variables were associated with both psychological outcomes. Conclusions While the majority of men treated with ADT did not report poor psychological outcomes, a small proportion reported severe problems. Clinically significant fatigue was demonstrated as a possible indicator of poor outcomes. Healthcare systems need to have clear protocols in place which specifically and routinely target psychological distress and fatigue. Electronic supplementary material The online version of this article (10.1007/s11136-019-02212-x) contains supplementary material, which is available to authorized users.
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17
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Heo J, Noh OK, Chun M, Oh YT, Kim L. Psychological distress among prostate cancer survivors in South Korea: A nationwide population-based, longitudinal study. Asia Pac J Clin Oncol 2019; 16:e125-e130. [PMID: 31069946 DOI: 10.1111/ajco.13160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 04/22/2019] [Indexed: 11/30/2022]
Abstract
AIM This time-dependent study aimed to analyze the prevalence of psychological distress in prostate cancer survivors by using claims data in South Korea. METHODS In a nationwide cohort, 32 005 patients were identified who were diagnosed with prostate cancer between January 2010 and December 2014. We referred the diagnostic codes of mental disorders as psychological distress. We categorized the prevalence of psychological distress based on age and specific times before and after the cancer diagnosis. RESULTS The median age at diagnosis of prostate cancer was 70 years. Among 32 005 patients, 3074 (9.6%) were diagnosed at least once with a mental disorder between 1 year before the cancer diagnosis and the last follow-up. Among the first diagnoses of each patient, the common mental disorders were anxiety (39.1%) and depression (33.0%). In the total cohort, there were 54 666 claims for mental disorders and over 48.0% (26 256) were for depression. The frequency of psychological distress peaked just before cancer diagnosis. Anxiety was frequent before diagnosis of prostate cancer, whereas depression was frequent after diagnosis. Although stress reaction/adjustment disorders were relatively high in the younger group, depression was relatively high in the elderly group. CONCLUSION Psychological distress in prostate cancer survivors showed different patterns of prevalence between before and after cancer diagnosis, as well as between age groups. Timely diagnosis and intervention for mental health could promote quality of life for prostate cancer survivors.
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Affiliation(s)
- Jaesung Heo
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - O Kyu Noh
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.,Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea.,Office of Biostatistics, Ajou Research Institute for Innovation Medicine, Ajou University Medical Center, Suwon, Republic of Korea
| | - Mison Chun
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Young-Taek Oh
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Logyoung Kim
- Health Insurance Review and Assessment Service, Seoul, Republic of Korea
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18
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Götze H, Friedrich M, Taubenheim S, Dietz A, Lordick F, Mehnert A. Depression and anxiety in long-term survivors 5 and 10 years after cancer diagnosis. Support Care Cancer 2019; 28:211-220. [PMID: 31001695 DOI: 10.1007/s00520-019-04805-1] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 04/07/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE Our study provides data on depression and anxiety in long-term cancer survivors, in men, women and various age groups, as well as identifies associated factors and coping-related resources. METHODS We present data obtained from 1002 cancer survivors across a large variety of tumour entities 5 years (cohort 1) and 10 years (cohort 2) after diagnosis, in a cross-sectional study. We analysed depression (PHQ-9) and anxiety (GAD-7) symptomatology in comparison with two large age- and sex-matched samples randomly selected from the general population. RESULTS Moderate to severe depression and anxiety were reported in 17% and 9% of cancer survivors, respectively. There were no significant differences between the 5 years and 10 years after diagnosis cohorts (p = 0.232). In both cohorts, we found higher depression and anxiety in women than in men (p < 0.001), and lower depression and anxiety in elderly patients (p < 0.001). Cancer survivors younger than 60 years of age were more depressed and anxious than the general population (p < 0.001). The variables, financial problems (Beta = 0.16, p < 0.001), global quality of life (Beta = - 0.21, p < 0.001) and cognitive function (Beta = - 0.30, p < 0.001), had the strongest association with depression and anxiety. CONCLUSIONS For the prevention of depression and anxiety in long-term cancer survivors, individual treatment of physical and psychological symptoms is as important as social support and professional counselling. Post-treatment, cognitive limitations should be carefully assessed in long-term cancer survivorship to distinguish them from symptoms of a mental disorder, especially since younger cancer survivors of working age and female survivors seem to be more affected by depression and anxiety.
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Affiliation(s)
- Heide Götze
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103, Leipzig, Germany.
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103, Leipzig, Germany
| | - Sabine Taubenheim
- Clinical Cancer Registry Leipzig, University Medical Center Leipzig, Leipzig, Germany
| | - Andreas Dietz
- Department of Otolaryngology, Head and Neck Surgery, University Medical Center Leipzig, Leipzig, Germany
| | - Florian Lordick
- University Cancer Center Leipzig (UCCL), University Medical Center Leipzig, Leipzig, Germany
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103, Leipzig, Germany
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19
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Zhang AY, Ganocy S, Fu AZ, Kresevic D, Ponsky L, Strauss G, Bodner DR, Zhu H. Mood outcomes of a behavioral treatment for urinary incontinence in prostate cancer survivors. Support Care Cancer 2019; 27:4461-4467. [PMID: 30903368 DOI: 10.1007/s00520-019-04745-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 03/08/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE This study aimed to assess whether prostate cancer survivors who received a behavioral intervention to urinary incontinence had experienced a significant mood improvement. METHODS One hundred fifty-three prostate cancer survivors with persistent incontinence were included in this secondary data analysis. They were randomly assigned to usual care or interventions that provided pelvic floor muscle exercises and self-management skills. All subjects had measures of anxiety, depression, and anger at baseline, 3 months (post-intervention), and 6 months (follow-up). Negative binomial regression analysis was performed to examine the group status, daily leakage frequency at 3 months, and their interactions at 3 months as predictors for mood outcomes at 6 months, controlling for demographic and medical variables. RESULTS The main effect of daily leakage frequency at 3 months significantly predicted anxiety at 6 months (p < .01). The group main effect on any mood outcomes at 6 months was not statistically significant. The interaction between the group and 3-month leakage had a significant effect on anxiety; intervention subjects achieving a significant leakage reduction at 3 months exhibited significantly less anxiety at 6 months than other subjects (p = .04). Age, employment status, and receiving surgery at baseline were significantly associated with less anxiety, depression, and anger at 6 months. CONCLUSIONS Reduced urinary incontinence significantly predicted less anxiety, especially among the intervention subjects. The findings suggest a significant association between a behavioral therapy of urinary incontinence and anxiety reduction in prostate cancer survivors.
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Affiliation(s)
- Amy Y Zhang
- School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106-4904, USA.
| | - Stephen Ganocy
- School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106-4904, USA
| | - Alex Z Fu
- Cancer Prevention and Control Program, Georgetown University Medical Center, 3300 Whitehaven Street NW, Suite 4100 - Milton Harris Bldg, Washington, DC, 20007, USA
| | - Denise Kresevic
- Department of Veterans Affairs Medical Center, Louis Stokes Cleveland, 10701 East Blvd, Cleveland, OH, 44106, USA
| | - Lee Ponsky
- School of Medicine; University Hospitals Cleveland Medical Center, Department of Urology, Case Western Reserve University, 19019 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Gerald Strauss
- Department of Veterans Affairs Medical Center, Louis Stokes Cleveland, 10701 East Blvd, Cleveland, OH, 44106, USA
| | - Donald R Bodner
- Department of Veterans Affairs Medical Center, Louis Stokes Cleveland, 10701 East Blvd, Cleveland, OH, 44106, USA.,School of Medicine; University Hospitals Cleveland Medical Center, Department of Urology, Case Western Reserve University, 19019 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Hui Zhu
- Department of Veterans Affairs Medical Center, Louis Stokes Cleveland, 10701 East Blvd, Cleveland, OH, 44106, USA
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20
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Doherty W, Bridge P. A Systematic Review of the Role of Penile Rehabilitation in Prostate Cancer Patients Receiving Radiotherapy and Androgen Deprivation Therapy. J Med Imaging Radiat Sci 2019; 50:171-178. [DOI: 10.1016/j.jmir.2018.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/16/2018] [Accepted: 09/12/2018] [Indexed: 12/23/2022]
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21
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Maguire R, Drummond FJ, Hanly P, Gavin A, Sharp L. Problems sleeping with prostate cancer: exploring possible risk factors for sleep disturbance in a population-based sample of survivors. Support Care Cancer 2019; 27:3365-3373. [PMID: 30627919 DOI: 10.1007/s00520-018-4633-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 12/27/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE This study aimed to investigate the prevalence of sleeping problems in prostate cancer survivors and to explore the role of predisposing, precipitating and perpetuating factors in this process. METHODS Using a cross-sectional design, 3348 prostate cancer survivors between 2 and 18 years post diagnosis reported experiences of insomnia using the QLQC30, along with their sociodemographic characteristics, health status and treatment(s) received. The EQ5D-5L and QLQPR25 assessed survivors' overall and prostate cancer-specific health-related quality of life. A hierarchical multiple regression analysis was constructed with three blocks: (1) predisposing (e.g. demographics at diagnosis), (2) precipitating (e.g. disease extent, treatment) and (3) perpetuating factors (e.g. side effects). RESULTS Nineteen percent of survivors reported significant problems sleeping. The final model accounted for 31% of the variance in insomnia scores (p < .001). In order of magnitude, associates of sleep disturbance were urinary symptoms (β = 0.22; p < .001), experiencing symptoms of depression/anxiety (β = 0.18; p < .001), hormone treatment-related symptoms (β = 0.12; p = .001), pain (β = 0.10; p < .001) and bowel symptoms (β = 0.06; p = .005). Having a lower education and more comorbidities at diagnosis also predicted sleep problems. CONCLUSION Results suggest that it is the ongoing adverse effects of prostate cancer and its treatment (e.g. urinary symptoms) that put survivors most at risk of sleep problems. Strong associations with symptoms of depression/anxiety were also observed. Findings highlight the need for health care practitioners to treat and manage adverse effects of prostate cancer treatment in order to mitigate sleep disturbance in survivors.
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Affiliation(s)
- Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland.
| | | | - Paul Hanly
- National College of Ireland, Mayor Street, Dublin 1, Ireland
| | | | - Linda Sharp
- Newcastle University, Newcastle upon Tyne, UK
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22
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Ahomäki R, Kero A, Koivisto M, Madanat-Harjuoja L, Malila N, Lähteenmäki PM. Purchases of antidepressants after cancer at a young age in Finland. Int J Cancer 2018; 144:1227-1233. [PMID: 30357818 DOI: 10.1002/ijc.31942] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 09/05/2018] [Accepted: 10/04/2018] [Indexed: 12/16/2022]
Abstract
According to previous studies, childhood cancer survivors have an elevated risk for late mental health effects. However, only few studies exist on young adulthood (YA) cancer survivors' mental health outcomes. In our study, we examined first time antidepressant (AD) medication purchases of childhood and YA cancer patients compared to siblings. The first time AD medication purchases of 7,093 cancer patients aged 0-34 years at diagnosis and a sibling cohort (N = 26,882) were retrieved from the Social Insurance Institution of Finland (Kela) since 1.1.1993. Cancer patients diagnosed between 1.1.1994 and 31.12.2004 were identified from the Finnish Cancer Registry and sibling controls via the Population Registry Centre. Statistical analyses were performed via the Cox regression model, and the hazard ratios (HR) were adjusted for age and gender. Increased hazard ratios for AD purchases were found in the younger (0-19 years at cancer diagnosis) [HR 5.2, 95%CI (3.7-7.2)] and older (age 20-34 years at cancer diagnosis) [HR 4.5, 95%CI (3.9-5.2)] cancer patient groups compared to siblings. The gender effect was similar in patients and controls, showing that females have higher risk for AD purchases than males. Males in the younger patient group had highest HR (5.6) for AD purchases compared to siblings. Patients with sarcoma or CNS tumor in the younger age group and leukemia or CNS malignancy in the older age group had the highest risk for AD medication purchases. The frequency and risk for AD purchases has been increasing during recent decades in both cancer patient age groups compared to siblings. Thus, cancer patients' psychological support should be properly assessed already after primary treatment. Certain diagnostic groups as well as female patients may require more psychological support than others.
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Affiliation(s)
- Ritva Ahomäki
- Turku University Hospital, Department of Pediatrics and Adolescent Medicine, and Turku University, Turku, Finland
| | - Andreina Kero
- Turku University Hospital, Department of Pediatrics and Adolescent Medicine, and Turku University, Turku, Finland
| | - Mari Koivisto
- University of Turku, Department of Biostatistics, Turku, Finland
| | | | - Nea Malila
- Finnish Cancer Registry, Helsinki, Finland.,School of Health Sciences, University of Tampere, Tampere, Finland
| | - Päivi M Lähteenmäki
- Turku University Hospital, Department of Pediatrics and Adolescent Medicine, and Turku University, Turku, Finland
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23
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Rice SM, Oliffe JL, Kelly MT, Cormie P, Chambers S, Ogrodniczuk JS, Kealy D. Depression and Prostate Cancer: Examining Comorbidity and Male-Specific Symptoms. Am J Mens Health 2018; 12:1864-1872. [PMID: 29957106 PMCID: PMC6199440 DOI: 10.1177/1557988318784395] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Depression in men with prostate cancer is a significant and complex issue that can challenge clinicians’ diagnostic efforts. The objective of the current study was to evaluate prototypic and male-specific depression symptoms and suicidal ideation in men with a diagnosis of prostate cancer relative to those with and without comorbidity. The Patient Health Questionnaire-9 (PHQ-9) and Male Depression Risk Scale-22 (MDRS-22) were completed online along with demographic and background variables by 100 men with a diagnosis of prostate cancer (n = 54 prostatectomy, n = 33 receiving active treatment). Hierarchical logistic regression was used to examine recent (past 2 weeks) suicide ideation. Over one-third of the sample (38%) reported a comorbidity, and this group had significantly higher total depression scores on the PHQ-9 (Cohen’s d = 0.65), MDRS-22 emotion suppression (d = 0.35), and drug use subscales (d = 0.38) compared to respondents without comorbidity. A total of 14% reported recent suicidal ideation, of which 71.4% of cases were identified by the PHQ-9 “moderate” cut-off, and 85.7% of cases were identified by the MDRS-22 “elevated” cut-off. After control variables, MDRS-22 subscales accounted for 45.1% of variance in recent suicidal ideation. While limited by the exclusive use of self-report data, findings point to the potential benefits of evaluating male-specific symptoms as part of depression and suicide risk screening in men with prostate cancer and the need to be mindful of the heightened risk for depression among men with prostate cancer who have comorbidity.
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Affiliation(s)
- Simon M Rice
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,2 Centre for Youth Mental Health, The University of Melbourne, Australia
| | - John L Oliffe
- 3 School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Mary T Kelly
- 3 School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Prue Cormie
- 4 Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,5 Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia
| | - Suzanne Chambers
- 6 Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia.,7 Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia.,8 Health & Wellness Institute, Edith Cowan University, Perth, Western Australia.,9 Institute for Resilient Regions, University of Southern Queensland, Australia.,10 Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - John S Ogrodniczuk
- 11 Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - David Kealy
- 11 Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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24
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Orom H, Biddle C, Underwood W, Nelson CJ. Worse Urinary, Sexual and Bowel Function Cause Emotional Distress and Vice Versa in Men Treated for Prostate Cancer. J Urol 2018; 199:1464-1469. [PMID: 29288122 PMCID: PMC7197257 DOI: 10.1016/j.juro.2017.12.047] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE Definitive therapy for prostate cancer (eg surgery or radiotherapy) often has side effects, including urinary, sexual and bowel dysfunction. The purpose of this study was to test whether urinary, sexual and bowel functions contribute to emotional distress during the first 2 years after treatment and whether distress may in turn decrease function. MATERIALS AND METHODS The study participants were 1,148 men diagnosed with clinically localized disease who were treated with surgery (63%) or radiotherapy (37%). Urinary, sexual and bowel functions were assessed with EPIC (Expanded Prostate Cancer Index Composite). Emotional distress was assessed with the NCCN® (National Comprehensive Cancer Network®) Distress Thermometer. Assessment time points were before treatment, and 6 weeks, and 6, 12, 18 and 24 months after treatment. We used time lagged multilevel models to test whether physical function predicted emotional distress and vice versa. RESULTS Men with worse urinary, bowel and sexual functions reported more emotional distress than others at subsequent time points. The relationships were bidirectional. Men who reported worse distress also reported worse urinary, bowel and sexual functions at subsequent time points. CONCLUSIONS Clinicians supported by practice and payer policies should screen for and facilitate the treatment of side effects and heightened emotional distress to improve well-being in survivors of prostate cancer. These interventions may be cost-effective, given that emotional distress can negatively impact functioning across life domains.
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25
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Maguire R, Hanly P, Drummond FJ, Gavin A, Sharp L. Expecting the worst? The relationship between retrospective and prospective appraisals of illness on quality of life in prostate cancer survivors. Psychooncology 2018; 27:1237-1243. [DOI: 10.1002/pon.4660] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/09/2018] [Accepted: 01/23/2018] [Indexed: 01/27/2023]
Affiliation(s)
| | - Paul Hanly
- National College of Ireland; Dublin Ireland
| | | | | | - Linda Sharp
- Newcastle University; Newcastle upon Tyne UK
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26
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Perry LM, Hoerger M, Silberstein J, Sartor O, Duberstein P. Understanding the distressed prostate cancer patient: Role of personality. Psychooncology 2017; 27:810-816. [PMID: 29125208 DOI: 10.1002/pon.4579] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 09/07/2017] [Accepted: 10/27/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate the relationship between personality and emotional distress in prostate cancer. Neuroticism and introversion were hypothesized to be associated with clinically significant symptoms of emotional distress, including depression, anxiety, and suicidal ideation. METHODS Men with a history of prostate cancer (n = 212) completed an NIH-funded cross-sectional study using well-validated measures of personality, depression, anxiety, and suicidal ideation. Covariates were age, education, time since diagnosis, comorbidity, and presence of metastases. RESULTS Emotional distress was reported by 37% of participants, including depression (23%), anxiety (15%), and suicidal ideation (10%). As hypothesized, men who were more neurotic were more likely to report emotional distress (44.5% vs 26.9%; OR = 2.78, P = .004), depression (31.9% vs 11.8%; OR = 4.23, P = .001), and suicidal ideation (29.4% vs 9.7%; OR = 4.15, P = .001). Introverts were more likely to report emotional distress (45.2% vs 28.7%; OR = 2.32, P = .012) and depression (30.8% vs 15.7%; OR = 2.57, P = .014). Men with metastases were more likely to report emotional distress (51.7% vs 31.2%; OR = 4.56, P < .001). CONCLUSIONS Neuroticism and introversion were associated with clinically significant emotional distress in men with prostate cancer. Findings suggest that, in the context of treatment for prostate cancer, patient distress reflects disease characteristics (eg, metastases presence) as well as stable personality traits. Implications for clinical care are discussed.
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Affiliation(s)
| | - Michael Hoerger
- Tulane University, New Orleans, LA, USA.,Tulane Cancer Center, New Orleans, LA, USA
| | - Jonathan Silberstein
- Tulane University, New Orleans, LA, USA.,Tulane Cancer Center, New Orleans, LA, USA
| | - Oliver Sartor
- Tulane University, New Orleans, LA, USA.,Tulane Cancer Center, New Orleans, LA, USA
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27
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Abstract
Most cancer survivors adjust well to life after cancer but some experience persisting negative mood, such as cancer-related fears, posttraumatic stress, anxiety, or depression. Mood fluctuations may not reach criteria for a clinical diagnosis but subclinical symptoms can interfere with quality of life. Women, adolescents, and young adults are particularly at risk for mood disturbances. Behavioral interventions, such as cognitive behavioral therapy and pharmacologic treatments, can effectively treat these distressing emotions. Much of the research on managing emotional needs after cancer has been completed with breast cancer survivors and more work is needed with diverse groups of survivors.
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Affiliation(s)
- Jean C Yi
- Biobehavioral Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-220, Seattle, WA 98109, USA
| | - Karen L Syrjala
- Biobehavioral Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-220, Seattle, WA 98109, USA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Box 356560, 1959 NE Pacific Street, Seattle, WA 98195, USA.
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28
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Spendelow JS, Eli Joubert H, Lee H, Fairhurst BR. Coping and adjustment in men with prostate cancer: a systematic review of qualitative studies. J Cancer Surviv 2017; 12:155-168. [PMID: 29063497 PMCID: PMC5884891 DOI: 10.1007/s11764-017-0654-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 10/07/2017] [Indexed: 01/04/2023]
Abstract
Purpose Prostate cancer (PCa) is one of the most common forms of cancer amongst males. Men’s coping responses are an important determinant of functioning and adjustment to this disease. Previous qualitative research exists in this area, but the current review sought to systematically review and summarise these studies. Methods A systematic review was conducted to identify studies concerned with men’s coping strategies in their attempts to live with PCa. A search of relevant electronic databases was conducted to identify studies that met inclusion criteria for this review. Methodological quality assessment was also undertaken for each included study. Results One hundred twenty-one publications were identified for initial screening, and 18 studies were included in the review. A total of five coping strategy categories or ‘meta-themes’ were identified across included studies. These categories were labelled ‘avoidance, minimisation, and withdrawal’, ‘directing cognition and attention’, ‘reframing masculinity and seeking support’, ‘retain pre-illness identity and lifestyle’, and ‘symptom/side-effect management’. Conclusions A range of coping strategies were reported by men with PCa. Some of these strategies appear to be partially influenced by gender roles and masculinities. Coping meta-themes reported in this review have also been found in other research on men’s coping. Strategies relating to flexible interpretation of gender roles/masculinities may be a particularly relevant category of coping responses due to the hypothesised beneficial impact of flexibility on psychological well-being. Implications for cancer survivors PCa survivors utilise a range of coping strategies, and the types of strategies used may have implications for men’s well-being. The ability to be flexible in both coping responses used, and in the view of oneself as a man may be particularly important skills in meeting the challenges associated with this disease.
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Affiliation(s)
| | - H Eli Joubert
- School of Psychology, University of Surrey, Guildford, GU2 7XH, UK
| | - Haymond Lee
- School of Psychology, University of Surrey, Guildford, GU2 7XH, UK
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29
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Kim SH, Seong DH, Yoon SM, Choi YD, Choi E, Song H. Predictors of health-related quality of life in Korean prostate cancer patients receiving androgen deprivation therapy. Eur J Oncol Nurs 2017; 30:84-90. [DOI: 10.1016/j.ejon.2017.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 08/23/2017] [Accepted: 08/26/2017] [Indexed: 01/19/2023]
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30
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Wiechno PJ, Poniatowska GM, Michalski W, Kucharz J, Sadowska M, Jonska-Gmyrek J, Nietupski K, Rzymowska J, Demkow T. Clinical significance of androgen secretion disorders in men with a malignancy. Med Oncol 2017; 34:123. [PMID: 28573637 PMCID: PMC5486517 DOI: 10.1007/s12032-017-0982-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 05/24/2017] [Indexed: 01/16/2023]
Abstract
Cancer and its treatment can lead in men to testosterone deficiency, accompanied by somatic and mental symptoms. Germ cell tumours and their treatment may disturb the pituitary-gonadal axis, hence leading to significant clinical abnormalities. In some prostate cancer patients, castration, temporary or permanent, is a desired therapeutic condition. Yet, it is burdened with various side effects of complex intensity and significance. Last but not least, patients in the terminal stage of a malignancy present with low testosterone concentrations as a part of anorexia-cachexia syndrome. Oncological management of such patients disturbs their homeostasis, androgen metabolism included, which results in numerous complications and worsens their quality of life. In the present paper, we analysed the frequency and sequelae of testosterone deficiency in some clinical scenarios, on the basis of original papers, meta-analyses and reviews available in PubMed. Androgen secretion disorders in male cancer patients depend on a cancer type, stage and methods of treatment. Number of testicular cancer survivors is increasing, and as a consequence, more patients cope with late complications, testosterone deficiency included. Hormone therapy in prostate cancer patients significantly prolongs survival, and then numerous men experience long-term adverse effects of androgen deficiency. Those, in turn, particularly the metabolic syndrome, may contribute to increased mortality. Androgen deficiency is a part of cancer anorexia-cachexia syndrome. The role of androgen deficiency in cancer patients is still under debate, and further studies are urgently needed to establish appropriate clinical guidelines.
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Affiliation(s)
- Pawel J Wiechno
- Department of Uro-Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 st, 02-781, Warsaw, Poland
| | - Grazyna M Poniatowska
- Department of Uro-Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 st, 02-781, Warsaw, Poland
| | - Wojciech Michalski
- Department of Uro-Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 st, 02-781, Warsaw, Poland
| | - Jakub Kucharz
- Department of Uro-Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 st, 02-781, Warsaw, Poland.
- Department of Experimental and Clinical Surgery, Jagiellonian University Medical College, Michalowskiego 12 st, Kraków, Poland.
| | - Malgorzata Sadowska
- Department of Uro-Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 st, 02-781, Warsaw, Poland
| | - Joanna Jonska-Gmyrek
- Department of Uro-Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 st, 02-781, Warsaw, Poland
| | - Karol Nietupski
- Department of Uro-Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 st, 02-781, Warsaw, Poland
| | - Joanna Rzymowska
- Department of Uro-Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 st, 02-781, Warsaw, Poland
| | - Tomasz Demkow
- Department of Uro-Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 st, 02-781, Warsaw, Poland
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31
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Meissner VH, Herkommer K, Marten-Mittag B, Gschwend JE, Dinkel A. Prostate cancer-related anxiety in long-term survivors after radical prostatectomy. J Cancer Surviv 2017; 11:800-807. [DOI: 10.1007/s11764-017-0619-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/05/2017] [Indexed: 01/05/2023]
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32
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Oba A, Nakaya N, Saito-Nakaya K, Hasumi M, Takechi H, Arai S, Shimizu N. Psychological distress in men with prostate cancer and their partners before and after cancer diagnosis: a longitudinal study. Jpn J Clin Oncol 2017; 47:735-742. [DOI: 10.1093/jjco/hyx066] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 04/26/2017] [Indexed: 12/26/2022] Open
Affiliation(s)
- Akira Oba
- Patient Support Center, Gunma Prefectural Cancer Center, Ota, Gunma
- Department of Psycho-Oncology, Gunma Prefectural Cancer Center, Ota, Gunma
| | - Naoki Nakaya
- Division of Personalized Prevention and Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi
| | - Kumi Saito-Nakaya
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi
| | - Masaru Hasumi
- Department of Urology, Gunma Prefectural Cancer Center, Ota, Gunma
| | | | - Seiji Arai
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
- Hematology-Oncology Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Nobuaki Shimizu
- Department of Urology, Gunma Prefectural Cancer Center, Ota, Gunma
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33
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van Stam MA, van der Poel HG, Bosch JLHR, Tillier CN, Horenblas S, Mols F, Aaronson NK. Prevalence and correlates of mental health problems in prostate cancer survivors: A case-control study comparing survivors with general population peers. Urol Oncol 2017; 35:531.e1-531.e7. [PMID: 28457651 DOI: 10.1016/j.urolonc.2017.03.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/22/2017] [Accepted: 03/27/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The purpose of this study was to identify factors associated with mental health (MH) problems in prostate cancer (PC) survivors. Toward this end, we evaluated (1) differences in the prevalence of MH problems between PC survivors and age-matched men from the general population (GenPop) and (2) correlates of MH in PC survivors and the GenPop. METHODS AND MATERIALS In this observational case-control study, we age-matched PC survivors (n = 644, alive≥5y after diagnosis of a stage I-IV carcinoma) recruited from Dutch community hospitals (Patient Reported Outcomes Following Initial treatment and Long-term Evaluation of Survivorship registry) with GenPop peers (n = 644) selected from a population-based sample recruited in general practices (NIVEL). MH was operationalized using the 5-item Mental Health Inventory of the Short Form Health Survey (SF-36). Potential correlates of MH included sociodemographic characteristics, health-related quality of life scores, and clinical characteristics (PC survivors only). We used analysis of (co)variance and chi-square tests to address the 2 research questions. RESULTS We observed clinically relevant MH symptoms in 14% of the PC survivors and 6% of the GenPop controls (P<0.01, odds ratio = 2.45 [1.66-3.62]). The most important correlates of lower MH scores in the PC survivors were being widowed, a lower educational level, lower general health perceptions, more bodily pain and urinary bother, and less sexual satisfaction. The most important correlates of lower MH scores in the GenPop were as follows: lower general health perceptions, more role limitations because of physical problems, and more bodily pain. CONCLUSIONS Our results indicate that long-term PC survivors have poorer MH, as assessed by the 5-item Mental Health Inventory questionnaire, than men of a comparable age from the GenPop without a history of PC. Attention to potentially modifiable factors associated with MH problems in PC survivors, such as urinary function and its related bother, bodily pain, and sexual satisfaction, may help to prevent or limit MH problems in this survivor population.
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Affiliation(s)
- Marie-Anne van Stam
- Urology Department, University Medical Center Utrecht, Utrecht, The Netherlands; Urology Department, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Henk G van der Poel
- Urology Department, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J L H Ruud Bosch
- Urology Department, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Corinne N Tillier
- Urology Department, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Simon Horenblas
- Urology Department, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Floor Mols
- Department of Medical and Clinical Psychology, Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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34
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Sharpley CF, Bitsika V, Christie DRH, Bradford R, Steigler A, Denham JW. Psychological resilience aspects that mediate the depressive effects of urinary incontinence in prostate cancer survivors 10 years after treatment with radiation and hormone ablation. J Psychosoc Oncol 2017; 35:438-450. [PMID: 28318448 DOI: 10.1080/07347332.2017.1306733] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Repeated surveys of prostate cancer (PCa) patients indicate that their prevalence of depression is well above that for their non-PCa peers. Although standard first-line treatments for depression are only about 35% effective, some recent comments have suggested that a focus upon the possible correlates (factors that aggravate or mediate depression) might help improve treatment efficacy. To investigate this issue, 144 10 year PCa survivors were asked about the frequency of urinary incontinence, a common side effect of some PCa treatments. The 53 patients who suffered urinary incontinence had significantly higher depression scores on the Zung Self-rating Depression Scale than those patients who did not report urinary incontinence. Using mediation analysis, patients' psychological resilience (PR) significantly mediated the depressive effects of urinary incontinence, but those effects were confined to just one of the five components of PR-a sense of control over the things that happen to oneself. Implications for treatment models of psychosocial oncology support for PCa survivors are discussed.
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Affiliation(s)
- Christopher F Sharpley
- a Brain-Behaviour Research Group , University of New England , Armidale , New South Wales , Australia
| | - Vicki Bitsika
- b Centre for Autism Spectrum Disorders , Bond University , Gold Coast , Queensland , Australia
| | - David R H Christie
- a Brain-Behaviour Research Group , University of New England , Armidale , New South Wales , Australia.,c Genesiscare , Tugun , Queensland , Australia
| | - Rosemary Bradford
- d School of Medicine and Public Health , University of Newcastle , Newcastle , New South Wales , Australia
| | - Allison Steigler
- d School of Medicine and Public Health , University of Newcastle , Newcastle , New South Wales , Australia
| | - James W Denham
- d School of Medicine and Public Health , University of Newcastle , Newcastle , New South Wales , Australia
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35
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Maguire R, Hanly P, Drummond FJ, Gavin A, Sharp L. Regret and fear in prostate cancer: The relationship between treatment appraisals and fear of recurrence in prostate cancer survivors. Psychooncology 2017; 26:1825-1831. [PMID: 28124398 DOI: 10.1002/pon.4384] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/09/2016] [Accepted: 01/23/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Fear of recurrence (FOR) is a key concern among survivors of all cancers. In prostate cancer, FOR varies with health and treatment type, but little is known about how survivors' appraisals of their treatment, and in particular, their level of regret over treatment decisions may affect this. METHODS A total of 1229 prostate cancer survivors between 2- and 5-years postdiagnosis were invited to complete a postal questionnaire including a FOR scale, Decisional Regret Scale, and the European Organization for Research and Treatment of Cancer QLQ C30 health-related quality of life (HRQoL) instrument. Multiple regression analysis explored the impact of 3 blocks of factors on FOR: (1) demographic characteristics and disease extent, (2) primary treatment received and health status (treatment side effects and HRQoL), and (3) treatment appraisals, specifically satisfaction with information received regarding treatment and level of regret experienced over treatment decisions. RESULTS The final multivariable model explained 27% of variance on FOR. Significant correlates of lower FOR included having localised disease, having undergone an invasive treatment, as well as health status (higher HRQoL and fewer ongoing side effects). Beyond this, appraisals of treatment significantly contributed to the model: More decisional regret and lower satisfaction with information received were associated with higher FOR. CONCLUSION These findings suggest that FOR may be mitigated by providing survivors with more information regarding treatment choices and the treatment itself so that men can make well-informed decisions and experience less future regret. Sensitivity analysis for variables predicting FOR among prostate cancer survivors is not suspected of having a recurrence.
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Affiliation(s)
| | - Paul Hanly
- National College of Ireland, Dublin, Ireland
| | | | - Anna Gavin
- Queen's University Belfast, Cork, Ireland
| | - Linda Sharp
- Newcastle University, Newcastle upon Tyne, United Kingdom
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36
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Sharpley C, Bitsika V, Christie D, Bradford R, Steigler A, Denham J. Total depression and subtypes in prostate cancer survivors 10 years after treatment. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2016] [Indexed: 12/28/2022]
Affiliation(s)
- C.F. Sharpley
- Brain-Behaviour Research Group; University of New England; Armidale NSW Australia
| | - V. Bitsika
- Centre for Autism Spectrum Disorders; Bond University; Robina Qld Australia
| | - D.R.H. Christie
- Brain-Behaviour Research Group; University of New England; Armidale NSW Australia
- Genesiscare; Tugun Qld Australia
| | - R. Bradford
- School of Medicine & Public Health; University of Newcastle; Callaghan NSW Australia
| | - A. Steigler
- School of Medicine & Public Health; University of Newcastle; Callaghan NSW Australia
| | - J.W. Denham
- School of Medicine & Public Health; University of Newcastle; Callaghan NSW Australia
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37
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Gavin AT, Donnelly D, Donnelly C, Drummond FJ, Morgan E, Gormley GJ, Sharp L. Effect of investigation intensity and treatment differences on prostate cancer survivor's physical symptoms, psychological well-being and health-related quality of life: a two country cross-sectional study. BMJ Open 2016; 6:e012952. [PMID: 27993906 PMCID: PMC5168701 DOI: 10.1136/bmjopen-2016-012952] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate effects on men's health and well-being of higher prostate cancer (PCa) investigation and treatment levels in similar populations. PARTICIPANTS PCa survivors in Ireland where the Republic of Ireland (RoI) has a 50% higher PCa incidence than Northern Ireland (NI). METHOD A cross-sectional postal questionnaire was sent to PCa survivors 2-18 years post-treatment, seeking information about current physical effects of treatment, health-related quality of life (HRQoL; EORTC QLQ-C30; EQ-5D-5L) and psychological well-being (21 question version of the Depression, Anxiety and Stress Scale, DASS-21). Outcomes in RoI and NI survivors were compared, stratifying into 'late disease' (stage III/IV and any Gleason grade (GG) at diagnosis) and 'early disease' (stage I/II and GG 2-7). Responses were weighted by age, jurisdiction and time since diagnosis. Between-country differences were investigated using multivariate logistic and linear regression. RESULTS 3348 men responded (RoI n=2567; NI n=781; reflecting population sizes, response rate 54%). RoI responders were younger; less often had comorbidities (45% vs 38%); were more likely to present asymptomatically (66%; 41%) or with early disease (56%; 35%); and less often currently used androgen deprivation therapy (ADT; 2%; 28%). Current prevalence of incontinence (16%) and impotence (56% early disease, 67% late disease) did not differ between RoI and NI. In early disease, only current bowel problems (RoI 12%; NI 21%) differed significantly in multivariate analysis. In late disease, NI men reported significantly higher levels of gynaecomastia (23% vs 9%) and hot flashes(41% vs 19%), but when ADT users were analysed separately, differences disappeared. For HRQoL, in multivariate analysis, only pain (early disease: RoI 11.1, NI 19.4) and financial difficulties (late disease: RoI 10.4, NI 7.9) differed significantly between countries. There were no significant between-country differences in DASS-21 or index ED-5D-5L score. CONCLUSIONS Treatment side effects were commonly reported and increased PCa detection in RoI has left more men with these side effects. We recommended that men be offered a PSA test only after informed discussion.
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Affiliation(s)
- Anna T Gavin
- N. Ireland Cancer Registry; Queen's University Belfast, Centre for Public Health, Belfast, N. Ireland
| | - David Donnelly
- N. Ireland Cancer Registry; Queen's University Belfast, Centre for Public Health, Belfast, N. Ireland
| | - Conan Donnelly
- N. Ireland Cancer Registry; Queen's University Belfast, Centre for Public Health, Belfast, N. Ireland
| | - Frances J Drummond
- Department of Epidemiology and Public Health, School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Eileen Morgan
- N. Ireland Cancer Registry; Queen's University Belfast, Centre for Public Health, Belfast, N. Ireland
| | - Gerard J Gormley
- Department of General Practice, Queen's University Belfast, Belfast, UK
| | - Linda Sharp
- Institute of Health & Society, Newcastle University, Newcastle-upon-Tyne, UK
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Downing A, Wright P, Wagland R, Watson E, Kearney T, Mottram R, Allen M, Cairnduff V, McSorley O, Butcher H, Hounsome L, Donnelly C, Selby P, Kind P, Cross W, Catto JWH, Huws D, Brewster DH, McNair E, Matheson L, Rivas C, Nayoan J, Horton M, Corner J, Verne J, Gavin A, Glaser AW. Life after prostate cancer diagnosis: protocol for a UK-wide patient-reported outcomes study. BMJ Open 2016; 6:e013555. [PMID: 27927667 PMCID: PMC5168696 DOI: 10.1136/bmjopen-2016-013555] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Prostate cancer and its treatment may impact physically, psychologically and socially; affecting the health-related quality of life of men and their partners/spouses. The Life After Prostate Cancer Diagnosis (LAPCD) study is a UK-wide patient-reported outcomes study which will generate information to improve the health and well-being of men with prostate cancer. METHODS AND ANALYSIS Postal surveys will be sent to prostate cancer survivors (18-42 months postdiagnosis) in all 4 UK countries (n=∼70 000). Eligible men will be identified and/or verified through cancer registration systems. Men will be surveyed twice, 12 months apart, to explore changes in outcomes over time. Second, separate cohorts will be surveyed once and the design will include evaluation of the acceptability of online survey tools. A comprehensive patient-reported outcome measure has been developed using generic and specific instruments with proven psychometric properties and relevance in national and international studies. The outcome data will be linked with administrative health data (eg, treatment information from hospital data). To ensure detailed understanding of issues of importance, qualitative interviews will be undertaken with a sample of men who complete the survey across the UK (n=∼150) along with a small number of partners/spouses (n=∼30). ETHICS AND DISSEMINATION The study has received the following approvals: Newcastle and North Tyneside 1 Research Ethics Committee (15/NE/0036), Health Research Authority Confidentiality Advisory Group (15/CAG/0110), NHS Scotland Public Benefit and Privacy Panel (0516-0364), Office of Research Ethics Northern Ireland (16/NI/0073) and NHS R&D approval from Wales, Scotland and Northern Ireland. Using traditional and innovative methods, the results will be made available to men and their partners/spouses, the funders, the NHS, social care, voluntary sector organisations and other researchers.
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Affiliation(s)
- Amy Downing
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
| | - Penny Wright
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Eila Watson
- Faculty of Health and Life Sciences, Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - Therese Kearney
- Northern Ireland Cancer Registry, Queens University Belfast, Royal Victoria Hospital, Belfast, UK
| | - Rebecca Mottram
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
| | - Majorie Allen
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
| | - Victoria Cairnduff
- Northern Ireland Cancer Registry, Queens University Belfast, Royal Victoria Hospital, Belfast, UK
| | - Oonagh McSorley
- Northern Ireland Cancer Registry, Queens University Belfast, Royal Victoria Hospital, Belfast, UK
| | - Hugh Butcher
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
- Yorkshire Cancer Patient Forum, c/o Strategic Clinical Network and Senate, Yorkshire and The Humber, Harrogate, UK
| | - Luke Hounsome
- National Cancer Registration and Analysis Service, Public Health England, Bristol, UK
| | - Conan Donnelly
- Northern Ireland Cancer Registry, Queens University Belfast, Royal Victoria Hospital, Belfast, UK
| | - Peter Selby
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
| | - Paul Kind
- Academic Unit of Health Economics, Institute of Health Sciences, University of Leeds, Leeds, UK
| | - William Cross
- Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK
| | - James W H Catto
- Academic Urology Unit, University of Sheffield, Medical School, Sheffield, UK
| | - Dyfed Huws
- Welsh Cancer Intelligence and Surveillance Unit, Cardiff, UK
| | - David H Brewster
- Public Health and Intelligence (NHS National Services Scotland), Edinburgh, UK
| | - Emma McNair
- Public Health and Intelligence (NHS National Services Scotland), Edinburgh, UK
| | - Lauren Matheson
- Faculty of Health and Life Sciences, Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - Carol Rivas
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Johana Nayoan
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Mike Horton
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
| | - Jessica Corner
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Julia Verne
- Knowledge and Intelligence Directorate, Public Health England, Bristol, UK
| | - Anna Gavin
- Northern Ireland Cancer Registry, Queens University Belfast, Royal Victoria Hospital, Belfast, UK
| | - Adam W Glaser
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
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Walker MS, Pohl GM, Houts AC, Peltz G, Miller PJE, Schwartzberg LS, Stepanski EJ, Marciniak M. Analysis of the psychological impact of cancer-related symptoms on patients with non-small cell lung cancer. Psychooncology 2016; 26:755-762. [PMID: 26790987 DOI: 10.1002/pon.4071] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 11/10/2015] [Accepted: 12/11/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND Patients with non-small cell lung cancer (NSCLC) experience adverse physical symptoms because of cancer, cancer treatment, and comorbidities. The relations among Cancer-Related Symptoms, Functional Impairment, and Psychological Symptoms in patients with NSCLC is not well understood. METHODS Retrospective analysis of patient-reported symptoms with the 38-item Patient Care Monitor survey, collected in routine clinical care for 1138 patients with NSCLC at eight US community oncology practices. Study sample was randomly split, and structural equation models examined the direct and mediated effects of Cancer-Related Symptoms and Functional Impairment on symptoms of acute distress (Distress) and depression (Despair) in the training sample. The training model was cross validated in testing sample. Results are presented for the full model using the entire sample. RESULTS Patients were 48.3% female, with mean age of 66.0 years. The most common comorbidities were anemia (60.8%) and respiratory disease (24.5%). Severity of Cancer-Related Symptoms was strongly and positively related to Functional Impairment and Psychological Symptoms in both training and testing models. The modeled effect of Functional Impairment on Distress and Despair was significant in the overall model using the total sample, and significant or near-significant in the training and testing models. The mediated effect of Cancer-Related Symptoms by Functional Impairment tended to be weaker than its direct modeled effect on Distress and Despair. CONCLUSIONS Despite prior research suggesting that Functional Impairment plays a larger role than symptom burden in depression in NSCLC, the independent modeled effects of Functional Impairment were no greater than the direct modeled effects of Cancer-Related Symptoms. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
| | | | | | - Gerson Peltz
- Eli Lilly and Company, Indianapolis, IN, USA.,Biogen, Cambrigde, MA, USA
| | | | | | | | - Martin Marciniak
- Eli Lilly and Company, Indianapolis, IN, USA.,GlaxoSmithKline, Durham, NC, USA
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