1
|
Dordoni P, Remmers S, Valdagni R, Bellardita L, De Luca L, Badenchini F, Marenghi C, Roobol MJ, Venderbos LDF. Cross-cultural differences in men on active surveillance' anxiety: a longitudinal comparison between Italian and Dutch patients from the Prostate cancer Research International Active Surveillance study. BMC Urol 2022; 22:110. [PMID: 35850672 PMCID: PMC9295436 DOI: 10.1186/s12894-022-01062-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Men diagnosed with localized prostate cancer (PCa) on active surveillance (AS) have shown to cope with anxiety caused by living with an ‘untreated cancer’ and different factors can influence the tolerance level for anxiety in these patients. The present study analyzes Italian (Milan) and Dutch (Rotterdam) men prospectively included in the Prostate cancer International Active Surveillance (PRIAS) trial, aiming to explore whether socio-demographic factors (i.e. age, relationship status, education, nationality) may be relevant factors in conditioning the level of anxiety at AS entry and over time. Methods Italian and Dutch men participating in the IRB-approved PRIAS study, after signing an informed consent, filled in the Memorial Anxiety Scale for PCa (MAX-PC) at multiple time points after diagnosis. A linear mixed model was used to assess the relationship between the level of patient’s anxiety and time spent on AS, country of origin, the interaction between country and time on AS, patients’ relationship status and education, on PCa anxiety during AS. Results 823 MAX-PC questionnaires were available for Italian and 307 for Dutch men, respectively. Median age at diagnosis was 64 years (IQR 60–70 years) and did not differ between countries. On average, Dutch men had a higher total MAX-PC score than Italian men. However, the level of their anxiety decreased over time. Dutch men on average had a higher score on the PCa anxiety sub-domain, which did not decrease over time. Minimal differences were observed in the sub-domains PSA anxiety and fear of recurrence. Conclusion Significant differences in PCa anxiety between the Italian and Dutch cohorts were observed, the latter group of men showing higher overall levels of anxiety. These differences were not related to the socio-demographic factors we studied. Although both PRIAS-centers are dedicated AS-centers, differences in PCa-care organization (e.g. having a multidisciplinary team) may have contributed to the observed different level of anxiety at the start and during AS. Trial registration This study is registered in the Dutch Trial Registry (www.trialregister.nl) under NL1622 (registration date 11-03-2009), ‘PRIAS: Prostate cancer Research International: Active Surveillance—guideline and study for the expectant management of localized prostate cancer with curative intent’.
Collapse
Affiliation(s)
- Paola Dordoni
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sebastiaan Remmers
- Department of Urology, Erasmus Cancer Institute, Erasmus University Medical Center, Wytemaweg 80, kamer Na-1520, 3015 CN, Rotterdam, The Netherlands
| | - Riccardo Valdagni
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Lara Bellardita
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Letizia De Luca
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fabio Badenchini
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Cristina Marenghi
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Monique J Roobol
- Department of Urology, Erasmus Cancer Institute, Erasmus University Medical Center, Wytemaweg 80, kamer Na-1520, 3015 CN, Rotterdam, The Netherlands
| | - Lionne D F Venderbos
- Department of Urology, Erasmus Cancer Institute, Erasmus University Medical Center, Wytemaweg 80, kamer Na-1520, 3015 CN, Rotterdam, The Netherlands.
| |
Collapse
|
2
|
Hogan D, Yao HHI, Kanagarajah A, Ogluszko C, Tran PVP, Dundee P, O’Connell HE. Can multi-parametric magnetic resonance imaging and prostate-specific antigen density accurately stratify patients prior to prostate biopsy? JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158221084820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This study examines the diagnostic accuracy of multi-parametric magnetic resonance imaging (mpMRI) in a high-volume centre to potentially stratify patients prior to prostate biopsy. Methods: All biopsy naïve patients who had mpMRI prostate and transperineal biopsy of prostate (TPBx) in 2017 and 2018 were included. There were no exclusion criteria. All patients, regardless of the mpMRI result, underwent systematic template biopsy under general anaesthesia with cognitive target biopsy if indicated. Clinicopathological data were extracted from medical records. The primary outcome was the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of mpMRI prostate in the detection of prostate cancer (PCa) compared with template TPBx. Results: In total, 140 patients were included. Overall, 57.1% had a positive biopsy. A higher Prostate Imaging-Reporting and Data Systems (PI-RADS) score was associated with a higher risk of diagnosing clinically significant PCa (International Society of Urological Pathology (ISUP) ⩾ 2) ( p < 0.001). The sensitivity, specificity, NPV, and PPV of mpMRI in detecting clinically significant PCa with a PI-RADS ⩾ 3 lesion, was 95% (95% confidence interval (CI) 83.0–99.3%), 41% (95% CI 31.3–51.3%), 95.3% (95% CI 84.2–99.4%) and 39.2% (95% CI 29.4–49.6%), respectively. Combining this with prostate-specific antigen density (PSAD) of <0.15 further improved the NPV to 100% (86.3–100). Binomial logistic regression to understand the effects of PSA, DRE and PI-RADS score on predicting clinically significant PCa (ISUP ⩾ 2) found increasing PSA (odds ratio (OR) 1.06, (95% CI 1.00–1.11, p = 0.022)) and PI-RADS (OR 3.17, (95% CI 1.94–5.18, p < 0.001)) to be significant predictors. Malignant DRE was not a significant predictor ( p = 0.087). Conclusion: This study demonstrates that the high sensitivity and NPV of mpMRI combined with PSAD may play a pivotal role in stratifying men for prostate biopsy and help avoid biopsy and its associated morbidity in select patients. Level of Evidence: 2b (Oxford Centre for Evidence-Based Medicine: Levels of Evidence)
Collapse
Affiliation(s)
- Donnacha Hogan
- Department of Urology, Western Health, Australia
- University College Cork, Ireland
| | | | | | | | | | - Phil Dundee
- Department of Urology, Western Health, Australia
| | | |
Collapse
|
3
|
Chou MC, Chien CH, Chung HJ, Chuang CK, Wu CT, Pang ST, Liu KL, Chang YH. The Psychometric Properties of Taiwanese Version of the Memorial Anxiety Scale for Prostate Cancer. J Pain Symptom Manage 2021; 61:824-830. [PMID: 33198956 DOI: 10.1016/j.jpainsymman.2020.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 11/30/2022]
Abstract
CONTEXT The Memorial Anxiety Scale for Prostate Cancer (MAX-PC) has been used in different countries to assess the specific anxiety of patients with prostate cancer. OBJECTIVES This research aims to test the reliability and validity of the Taiwanese version of the MAX-PC (MAX-PC-T). METHODS Patients with prostate cancer in the urology clinics of three hospitals are recruited via a convenience sampling. Patients completed the MAX-PC-T, Positive and Negative Affect Schedule (PANAS), and the Short Form (SF)-12 Health Survey. The internal consistency is tested to determine the reliability of the MAX-PC-T. The correlation among the MAX-PC-T, PANAS, and SF-12 is used to test concurrent and discriminant validity. Confirmatory factor analysis is performed to determine the convergent and discriminant validity of the scale. RESULTS The MAX-PC-T conforms to the three structures of the original MAX-PC, which includes the prostate cancer anxiety subscale, prostate-specific antigen anxiety subscale, and fear of recurrence subscale. The factor loading of the items in each subscale is >0.50. The MAX-PC-T was significantly negatively correlated with the positive affect subscale of the PANAS and the mental component summary of the SF-12 and significantly positively correlated with the negative affect subscale of the PANAS. Cronbach's α value of internal consistency is 0.94 in the MAX-PC-T. CONCLUSION The MAX-PC-T demonstrates appropriate reliability and validity. It can be used with patients with prostate cancer to assess their specific anxiety.
Collapse
Affiliation(s)
- Mi-Chun Chou
- Department of Nursing, Chang Gung Memorial Hospital at Chia-Yi, Chia-Yi County, Taiwan; College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Ching-Hui Chien
- College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan.
| | - Hsiao-Jen Chung
- Department of Urology, Taipei Veterans General Hospital, Taipei City, Taiwan; Department of Urology, School of Medicine, Shu-Tien Urological Institute, National Yang-Ming University, Taipei City, Taiwan
| | - Cheng-Keng Chuang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Tao-Yuan City, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan
| | - Chun-Te Wu
- College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan; Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Keelung, Kee-Lung City, Taiwan
| | - See-Tong Pang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Tao-Yuan City, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan
| | - Kuan-Lin Liu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Keelung, Kee-Lung City, Taiwan
| | - Ying-Hsu Chang
- College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan; Department of Urology, New Taipei City Municipal Tucheng Hospital, New Taipei City, Taiwan
| |
Collapse
|
4
|
Alvisi MF, Dordoni P, Rancati T, Avuzzi B, Nicolai N, Badenchini F, De Luca L, Magnani T, Marenghi C, Menichetti J, Silvia V, Fabiana Z, Roberto S, Riccardo V, Lara B. Supporting Patients With Untreated Prostate Cancer on Active Surveillance: What Causes an Increase in Anxiety During the First 10 Months? Front Psychol 2020; 11:576459. [PMID: 33363494 PMCID: PMC7753742 DOI: 10.3389/fpsyg.2020.576459] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/28/2020] [Indexed: 11/13/2022] Open
Abstract
Background The psychological burden possibly deriving from not immediately undergoing radical treatment for prostate cancer (PCa) could be a potential disadvantage of active surveillance (AS), especially in the eve of some relevant clinical exams [i.e., re-biopsy, prostate-specific antigen (PSA) test, and medical examination]. Even if it is known from the literature that the majority of PCa men in AS do not report heightened anxiety, there is a minority of patients who show clinically significant levels of anxiety after diagnosis. The present study aimed to investigate if demographic, clinical, and psychological variables at the entrance in AS (T0) were associated with the risk of developing clinically significant PCa-related anxiety 2 months before the first re-biopsy (T1) and to offer psychological support to improve quality of life (QoL). Materials and Methods A total of 236 patients participated in the PCa Research International: AS (PRIAS) protocol and in PRIAS-QoL study. Demographic/clinical features, health-related QoL domains, coping with cancer, PCa-related anxiety [Memorial Anxiety Scale for PCa (MAX-PC)], personality traits, and decision-making-related factors were assessed at T0. MAX-PC was also administered at T1. PCa-related anxiety at T1 was considered to be of clinical significance if the MAX-PC score was ≥1.5. Multivariable logistic regression coupled to bootstrap was used to detect factors associated with high levels of anxiety. Results The median age was 64.4 years. Fifty-six patients (24%) reported MAX-PC total score above the cutoff. Three factors were associated with a high level of PCa anxiety at T1: anxious preoccupation [odds ratio (OR) = 4.36], extraversion (OR = 1.9), and prostate-related symptoms (median OR = 0.46). Physical well-being was associated with a low PCa anxiety subscale (median OR = 0.15); neuroticism and functional well-being were associated with PSA anxiety (median OR = 7.05 and 0.73, respectively). Neuroticism and helplessness/hopelessness were associated with fear of progression (median OR = 18.1 and 5.8, respectively). Conclusion Only a partial portion of the sample experienced significant levels of anxiety after 10 months. Psychological assessment should be routinely conducted to detect risk factors (i.e., anxious preoccupation, extraversion) for increased anxiety, offering tailored psychological interventions aimed at promoting interpersonal awareness and emotional well-being.
Collapse
Affiliation(s)
| | - Paola Dordoni
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Tiziana Rancati
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Barbara Avuzzi
- Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Nicola Nicolai
- Department of Urology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fabio Badenchini
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Letizia De Luca
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Tiziana Magnani
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Cristina Marenghi
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Julia Menichetti
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Villa Silvia
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Zollo Fabiana
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Salvioni Roberto
- Department of Urology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Valdagni Riccardo
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Bellardita Lara
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | |
Collapse
|
5
|
Touzani R, Mancini J, Troïan J, Bouhnik AD, Cussenot O, Gravis G, Marino P. Adaptation and validation of the memorial anxiety scale for prostate cancer (MAX-PC) in a sample of French men. J Patient Rep Outcomes 2019; 3:60. [PMID: 31493106 PMCID: PMC6730978 DOI: 10.1186/s41687-019-0150-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/21/2019] [Indexed: 05/30/2023] Open
Abstract
Introduction The Memorial Anxiety Scale for Prostate Cancer (MAX-PC, 18 items) was developed to assess anxiety in prostate cancer patients. In the absence of a French version of this scale, we adapted the original English scale and evaluated its psychometric properties in a sample of French men diagnosed with prostate cancer in the previous 12 months. Methods The MAX-PC was translated from English to French and distributed online by two non-profit organizations (Seintinelles and ANAMACaP). The French questionnaire, which also included the Hospital Anxiety and Depression Scale (HADS) and a measure of health-related quality of life (SF12), was intended for adults diagnosed with prostate cancer in the previous 12 months. Factor structure was assessed using exploratory factor analysis (EFA) on data from 56.2% of the sample (n = 104, Seintinelles subsample) and confirmed using confirmatory factor analysis (CFA) on data from the rest of the sample (n = 81, ANAMACaP subsample). The reliability of the scale was measured using Cronbach’s alpha coefficient. Construct validity was assessed by calculating the correlation of the MAX-PC total score and subscale scores with the HADS total score and subscale scores and with the SF12 total score and subscale scores. Results Of the 185 respondents, 168 (90.8%) had complete data on all MAX-PC items. The average age of participants was 65.1 years (SD: 7.7). The three-factor structure defined in the original validation study was very similar in EFA and then confirmed by CFA. The MAX-PC showed good reliability, as Cronbach’s alpha coefficients for the scale and for its three subscales were 0.92, 0.90, 0.68, and 0.87, respectively. It also showed good construct validity. As expected, the MAX-PC total score was positively correlated with the HADS-Anxiety subscale score (r = 0.68, p < 0.001) and negatively correlated with the SF12-MCS subscale score (r = − 0.35, p < 0.001). Conclusion The French version of the MAX-PC shows adequate psychometric properties among French men with prostate cancer. This scale may be used in future studies and in routine clinical care to help health care providers identify patients who need psychological support due to prostate-cancer related anxiety.
Collapse
Affiliation(s)
- Rajae Touzani
- Institut Paoli-Calmettes, SESSTIM U1252, Marseille, France.,Aix Marseille Univ., INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
| | - Julien Mancini
- Aix Marseille Univ., APHM, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Hop Timone, BioSTIC, Biostatistique et Technologies de l'Information et de la Communication, Marseille, France
| | - Jaïs Troïan
- Aix-Marseille Univ., Laboratoire de Psychologie Sociale (LPSEA849), Aix-en-Provence, France
| | - Anne-Déborah Bouhnik
- Aix Marseille Univ., INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
| | - Olivier Cussenot
- APHP, Hôpitaux Universitaires Est Parisien, Service Urologie, Sorbonne Université, Paris, France
| | - Gwenaelle Gravis
- Medical Oncology, Institut Paoli Calmettes, Centre de Recherche en Cancérologie de Marseille, Aix Marseille Université, Marseille, France
| | - Patricia Marino
- Institut Paoli-Calmettes, SESSTIM U1252, Marseille, France. .,Aix Marseille Univ., INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.
| |
Collapse
|