OBJECTIVES: To evaluate prospectively the associations between illness uncertainty, anxiety, fear of progression, and general and disease-specific quality of life (QOL) in men with favorable risk prostate cancer undergoing active surveillance (AS).
PATIENTS AND METHODS: After meeting stringent enrollment criteria for an AS cohort study at a single tertiary care cancer center, 180 men with favorable-risk prostate cancer completed questionnaires at enrollment and every 6 months for up to 30 months. Questionnaires assessed illness uncertainty, anxiety, prostate-specific (Expanded Prostate Cancer Index Composite; EPIC) and general QOL (Short Form 12; SF-12) and fear of progression. We used linear mixed model analyses and multilevel mediation analyses.
RESULTS: EPIC sexual scores significantly declined over time (P < 0.05). Illness uncertainty was a significant predictor of all EPIC summary, SF12 physical component summary (PCS), mental component summary (MCS), and fear of progression scores (all P values, < 0.05), despite controlling for demographic and clinicopathologic factors. Anxiety predicted all EPIC summary, MCS, and fear of progression scores (all P values, < 0.05) but not PCS scores (P = 0.08). Scores on PCS, MCS, EPIC summary scales (except sexual scale), and fear of progression did not change significantly over the study period (all P values, >0.10).
CONCLUSION: Over the 2.5-year follow-up, QOL remained stable; only sexual function scores significantly declined. Illness uncertainty and anxiety were significant predictors of general and prostate-specific QOL and fear of progression. Interventions to reduce uncertainty and anxiety may enhance QOL for men with prostate cancer on AS.
Parker PA, Davis JW, Latini DM, Baum G, Wang X, Ward JF, Kuban D, Frank SJ, Lee AK, Logothetis CJ, Kim J. Are you the author?
The University of Texas MD Anderson Cancer Center, Houston, TX.
Reference: BJU Int. 2015 Feb 24. Epub ahead of print.