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.
1229 prostate cancer survivors between two and five years post-diagnosis were invited to complete a postal questionnaire including a FOR scale, Decisional Regret Scale and the EORTC QLQ C30 health-related quality of life (HRQoL) instrument. Multiple regression analysis explored the impact of three blocks of factors on FOR: (i) demographic characteristics and disease extent, (ii) primary treatment received and health status (treatment side-effects and HRQoL), and (iii) treatment appraisals, specifically satisfaction with information received regarding treatment and level of regret experienced over treatment decisions.
The final multivariable model explained 27% of variance in 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.
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.
Psycho-oncology. 2017 Jan 26 [Epub ahead of print]
Rebecca Maguire, Paul Hanly, Frances J Drummond, Anna Gavin, Linda Sharp
National College of Ireland., National Cancer Registry Ireland., Queens University Belfast., Newcastle University.