Prostate cancer-related anxiety in long-term survivors after radical prostatectomy
Menée en Allemagne auprès de 4 719 patients ayant survécu plus de 10 ans à un cancer de la prostate après une prostatectomie radicale (âge moyen : 75,2 ans), cette étude analyse les facteurs associés à des symptômes d'anxiété et de dépression (durée médiane de suivi : 11,5 ans)
Purpose : Knowledge of the psychological distress of long- and very long-term (>10 years) prostate cancer (PC) survivors is limited. This study intended to examine the parameters influencing anxiety related to prostate-specific antigen (PSA) and PC in long-term survivors after radical prostatectomy. Methods : We surveyed 4719 PC survivors from the German multicenter prospective database “Familial Prostate Cancer.” We evaluated the association of PC-related anxiety (MAX-PC) with sociodemographic characteristics, family history of PC, global health status/quality of life (EORTC QLQ-C30), depression and anxiety (PHQ-2; GAD-2), latest PSA level, time since radical prostatectomy, and current therapy. Results : The survey participants’ mean age was 75.2 years (SD = 6.5). Median follow-up was 11.5 years, and 19.5% of participants had survived more than 15 years since the initial treatment. The final regression analysis found that younger age, lower global health status/quality of life, higher depression and anxiety scores, higher latest PSA level, and shorter time since radical prostatectomy predicted increased PSA-related anxiety and PC anxiety. Familial PC was predictive only of PSA anxiety (all p < 0.05). The final model explained 12% of the variance for PSA anxiety and 24% for PC anxiety. Conclusions : PC-related anxiety remained relevant many years after prostatectomy and was influenced by younger age, psychological status, rising PSA level, and shorter time since initial treatment. Implications for Cancer Survivors : Survivors with these characteristics are at increased risk of PC-related anxieties, which should be considered by the treating physician during follow-up