1
|
Kobayashi M, Kijima T, Yashi M, Kamai T. Prostate-specific antigen kinetics contributes to decision making for biopsy referral: the predictive implication for PSA retest in patients with elevated PSA levels. Prostate Int 2023; 11:27-33. [PMID: 36910897 PMCID: PMC9995685 DOI: 10.1016/j.prnil.2022.08.001] [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: 07/22/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 11/30/2022] Open
Abstract
Background It is common to repeat prostate-specific antigen (PSA) measurements for men with PSA elevation before prostate biopsy. In this scenario, they may have considerable psychological distress in fear of the presence of cancer until retests. We assessed possible clinical factors causing transient PSA rise and explored the parameters predictive of subsequent PSA change. Methods As interfering conditions, the history of ejaculation, bicycling, and any types of infections were assessed using the questionnaire. The pattern of PSA change was compared in association with the various clinical factors. Predictive significance of PSA kinetics such as coefficient of variation (CV) and PSA velocity (PSAV) for PSA values at retest was evaluated. Results The rate of reversion to the normal range was 38.3% at retest. The rate of 12.8% of men showed a large increase by ≥20%, whereas 38.2% of men showed a large decline by ≥20% from the baseline. Men with younger age (≤60 years), small prostate (<20 cc), and prior history of ejaculation or infections showed significantly larger PSA decrease than their counterparts. Those with large CV or PSAV before the baseline more frequently showed PSA decrease below the age-specific cutoff or decline by ≥10% from the baseline at retest. These parameters associated with PSA kinetics had independent predictive values for relevant PSA change at retest. Conclusions Ejaculation and any types of infections should be avoided before PSA tests. Men with large PSA fluctuation before the baseline are likely to show a significant PSA decrease at retest. This predictive information may help both physicians to determine whether to proceed to an immediate biopsy and patients to reduce their psychological burden.
Collapse
Affiliation(s)
- Minoru Kobayashi
- Department of Urology, Utsunomiya Memorial Hospital, Tochigi, Japan
| | - Toshiki Kijima
- Department of Urology, Dokkyo Medical University, Tochigi, Japan
| | - Masahiro Yashi
- Department of Urology, Dokkyo Medical University, Tochigi, Japan
| | - Takao Kamai
- Department of Urology, Dokkyo Medical University, Tochigi, Japan
| |
Collapse
|
2
|
Mao J, Dai Y, Wang L, Pan S, Wang W, Yu H. 'Is it painful'? A qualitative study on experiences of patients before prostate needle biopsy. BMJ Open 2022; 12:e056619. [PMID: 36367812 PMCID: PMC9462132 DOI: 10.1136/bmjopen-2021-056619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To assess the experiences and emotional reactions of men prior to receiving a prostate needle biopsy (PNB). DESIGN This was a qualitative study involving (1) material research and filter, (2) interviewer training, (3) cognitive semistructured interviews with open-ended questions, (4) data analysis, including translation and back translation and (5) group discussions to determine common themes in the data. All interviews were digitally audio-recorded. The thematic analysis was conducted by repeatedly reading the data manuscript and engaging in group discussion. SETTING AND PARTICIPANTS A total of 30 participants with suspected prostate cancer (PC) who were scheduled to receive a PNB were interviewed. Eligible participants were Chinese native men aged 51-77 years, and the study was conducted in China between September and December 2020. All participants were informed about the purpose of the study and provided written informed consent. RESULTS Four main themes were identified based on the interview content: (1) fear (of pain, adverse effects and bad results), (2) impact of lower urinary tract symptoms (on emotional impact, work and sleeping), (3) inner struggles (relating to hesitation, regret and embarrassment) and (4) lifestyle change (including diet, exercise and receipt of traditional Chinese medicine). CONCLUSIONS This patient cohort had a low level of knowledge about PC and PNB. Providing additional education about these topics would help to reduce patient fear and anxiety and improve experiences of the procedure.
Collapse
Affiliation(s)
- Jinjiao Mao
- The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- School of Medicine and Nursing Sciences, Huzhou University, Huzhou, Zhejiang, China
| | - Yun Dai
- The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Lijuan Wang
- The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shucheng Pan
- The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wei Wang
- The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hongwei Yu
- School of Medicine and Nursing Sciences, Huzhou University, Huzhou, Zhejiang, China
| |
Collapse
|
3
|
Sefik E, Gunlusoy B, Eker A, Celik S, Ceylan Y, Koskderelioglu A, Basmaci I, Degirmenci T. Anxiety and depression associated with a positive prostate biopsy result: A comparative, prospective cohort study. Int Braz J Urol 2020; 46:993-1005. [PMID: 32822128 PMCID: PMC7527087 DOI: 10.1590/s1677-5538.ibju.2019.0719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 01/14/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose To investigate the course of anxiety and depression before and after transrectal ultrasound-guided prostate biopsy (TRUS-Bx) and in the postoperative 1st month when the histopathological biopsy result was obtained. Methods In between June 2017- January 2019, 204 patients who underwent TRUS-Bx and completed the questionnaires assessing anxiety and depression were included in the study. Questionnaires were completed immediately before the biopsy, immediately after the biopsy and at the end of the first month when the histopathological biopsy results were given. State-Trait Anxiety Inventory (STAI), Hospital Anxiety and Depression Scale (HADS) and perceived stress scale (PSS) forms were used to assess anxiety and depression. After the histopathological examination patients were divided into two groups as patients without cancer (Group 1) and with cancer (Group 2). Data was compared between the groups. Results PSA level was negatively correlated with STAI TX-1 scores of the patients immediately after TRUS-Bx, whereas it was positively correlated with STAI TX-1 and TX-2 30 days after the TRUS-Bx. PSA level was positively correlated with HADS-A and HADS-D scores immediately before and 30 days after TRUS-Bx. Biopsy results showed a significant difference in 30 day post-biopsy related data. STAI TX-1, STAI TX-2, HADS-A, HADS-D and PSS scores were higher in Group 2 compared with Group 1. Conclusions Pre-biopsy anxiety disappeared after bx, but there was a significant increase in anxiety and depression in patients after the diagnosis of malignancy. Patients were seriously concerned about the diagnosis of prostate cancer.
Collapse
Affiliation(s)
- Ertugrul Sefik
- Department of Urology, Health Sciences University, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Bulent Gunlusoy
- Department of Urology, Health Sciences University, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Anil Eker
- Department of Urology, Health Sciences University, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Serdar Celik
- Department of Urology, Health Sciences University, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Yasin Ceylan
- Department of Urology, Health Sciences University, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Asli Koskderelioglu
- Department of Neurology, Health Sciences University, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Ismail Basmaci
- Department of Urology, Health Sciences University, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Tansu Degirmenci
- Department of Urology, Health Sciences University, Bozyaka Training and Research Hospital, Izmir, Turkey
| |
Collapse
|
4
|
Zhu J, Chen R, Davidsson S, Carlsson J, Messing-Eriksson A, Fridfeldt J, Andrén O, Andersson SO, Valdimarsdóttir U, Fang F, Fall K. Psychological and physiological impacts of a fast-track diagnostic workup for men with suspected prostate cancer: Preliminary report from a randomized clinical trial. Cancer Commun (Lond) 2020; 40:239-242. [PMID: 32255568 PMCID: PMC7238668 DOI: 10.1002/cac2.12021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/03/2020] [Accepted: 03/11/2020] [Indexed: 02/05/2023] Open
Affiliation(s)
- Jianwei Zhu
- Department of Orthopedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, 610000, P. R. China
| | - Ruoqing Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 77, Sweden.,Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, 701 85, Sweden
| | - Sabina Davidsson
- Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, 701 85, Sweden
| | - Jessica Carlsson
- Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, 701 85, Sweden
| | - Anna Messing-Eriksson
- Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, 701 85, Sweden
| | - Jonna Fridfeldt
- Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, 701 85, Sweden
| | - Ove Andrén
- Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, 701 85, Sweden
| | - Sven-Olof Andersson
- Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, 701 85, Sweden
| | - Unnur Valdimarsdóttir
- Department of Orthopedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, 610000, P. R. China.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 77, Sweden.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, 02115, SA
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Katja Fall
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, 701 85, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, 171 77, Sweden
| |
Collapse
|