SUO 2017: Testicular Cancer And Surveillance: Impact On Patient Anxiety Over Time, The Princess Margaret Cancer Centre Experience

Washington, DC (UroToday.com) Introduction: Surveillance has become a standard of care for stage 1 testicular cancer. However, little is known about its effects on anxiety and mental health. With some centers advocating adjuvant therapy for higher risk stage I disease, partially on the basis of patient anxiety, a better understanding of patients’ response to surveillance is required.

Methods: The Princess Margaret Cancer Centre (PMCC) institutional cohort of testicular cancer patients was queried for all patients who were initiated on surveillance. From 2014-2017, all patients were asked to complete a comprehensive questionnaire, including the Edmonton Symptom Assessment System (ESAS), which is scored from 0 [no anxiety] to 10 [worst
possible anxiety]. Patients with a score ≥ 3 are prompted to complete a Generalized Anxiety Disorder 7 survey (GAD7), scored from 0 – 21, and correlates to mild (5), moderate (10), and severe anxiety (15+).

Results: Of 805 patients who completed at least one survey, 349 patients were initiated and maintained on surveillance at PMCC. Of these, 101 had non-seminomatous germ cell tumors (NSGCT) and 245 had seminoma. Patients completed between 1-18 surveys during follow-up (median 2, mean 3.4). On the first survey, there was a 100% response rate for ESAS, and 25.1% were prompted and completed GAD7 surveys; response rates diminished over time. ESAS-anxiety and GAD7 scores for all responders were stratified by time from initial PMCC consultation. Patients had consistently mild anxiety during the follow-up period, regardless of metric. ESAS-anxiety demonstrated median scores 0-1 for 10+ years of follow-up. Subset analysis of 82 patients who had a minimum of 2 responses within 6 months of orchiectomy demonstrated similar findings.

Conclusion: Patients on surveillance for testicular cancer have stable very mild anxiety during long-term follow-up. The authors conclude that Intervention based on concern for patient anxiety for higher-risk stage 1 testicular cancer is probably not justified.

Presented by: Thenappan Chandrasekar, Toronto, Canada

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, @GoldbergHanan, at the 18th Annual Meeting of the Society of Urologic Oncology, November 29-December 1, 2017 – Washington, DC
E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe