Prostate-specific antigen (PSA) and distress: - a cross-sectional nationwide survey in men with prostate cancer in Sweden
Tóm tắt
The prostate-specific antigen (PSA) -value is often used during the prostate cancer trajectory as a marker of progression or response to treatment. Concerns about PSA-values are often expressed by patients in clinical situations. Today there is a lack of larger studies that have investigated the association between PSA-value and distress. The aim was to investigate the association between PSA-values and distress adjusted for sociodemographic factors, hormonal therapy and quality of life (QoL), among men with prostate cancer. In this cross-sectional survey of 3165 men with prostate cancer, members of the Swedish Prostate Cancer Federation, answered questions about sociodemographic factors, PSA, distress, QoL and treatments. Descriptive statistics, and bivariate and multivariable analyses were performed. The result was presented based on four PSA-value groups: 0–19, 20–99, 100–999, and ≥ 1000 ng/ml. Of the men, 53% experienced distress. An association between distress and PSA-values was found where higher PSA-values were associated with higher OR:s for experiencing distress in the different PSA-groups: 0–19 ng/ml (ref 1), 20–99 ng/ml (OR 1.25, 95% CI 1.01–1.55), 100–999 ng/ml (OR 1.47, 95% CI 1.12–1.94), ≥1000 ng/ml (OR 1.77, 95% CI 1.11–2.85). These associations were adjusted for sociodemographic factors and hormonal therapy. In the multivariable analyses, beside PSA-values, higher levels of distress were associated with being without partner or hormonal therapy. When adding QoL in the multivariable analysis, the association between PSA and distress did not remain significant. These results indicate that the PSA-values are associated with distress, especially for those with higher values. However, to be able to support these men, continued research is needed to gain more knowledge about the mechanisms behind the association between emotional distress and PSA-values.
Tài liệu tham khảo
Cancer incidence in Sweden 2014 [In Swedish]. [https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/statistik/2015-12-26.pdf].
Lynch T, Burgess M. Prostate-specific antigen test: an informed choice. Prim Health Care. 2011;21(3):16–21.
Appleton L, Wyatt D, Perkins E, Parker C, Crane J, Jones A, Moorhead L, Brown V, Wall C, Pagett M. The impact of prostate cancer on men's everyday life. Eur J Cancer Care. 2015;24(1):71–84.
Roth A, Passik S. Anxiety in men with prostate cancer may interfere with effective managment of the disease. Prim Care Cancer. 1996;16:30.
van de Wal M, van Oort I, Schouten J, Thewes B, Gielissen M, Prins J. Fear of cancer recurrence in prostate cancer survivors. Acta Oncol. 2016;55(7):821–7.
Hedestig O, Sandman P-O, Widmark A, Rasmussen BH. Meanings of prostate-specific antigen testing as narrated by men with localized prostate cancer after primary treatment. Scand J Urol Nephrol. 2008;42(2):101–9.
Shen MJ, Nelson CJ, Peters E, Slovin SF, Hall SJ, Hall M, Herrera PC, Leventhal EA, Leventhal H, Diefenbach MA. Decision-making processes among prostate Cancer survivors with rising PSA levels: results from a qualitative analysis. Med Decis Making. 2015;35(4):477–86.
Lofters A, Juffs HG, Pond GR, Tannock IF. “PSA-itis”: knowledge of serum prostate specific antigen and other causes of anxiety in men with metastatic prostate Cancer. J Urol. 2002;168(6):2516–20.
Eton DT, Shevrin DH, Beaumont J, Victorson D, Cella D. Constructing a conceptual framework of patient-reported outcomes for metastatic hormone-refractory prostate cancer. Value Health. 2010;13(5):613–23.
Nanton V, Docherty A, Meystre C, Dale J. Finding a pathway: information and uncertainty along the prostate cancer patient journey. Br J Health Psychol. 2009;14(3):437–58.
Holland JC, Andersen B, Breitbart WS, Compas B, Dudley MM, Fleishman S, Fulcher CD, Greenberg DB, Greiner CB, Handzo GF, et al. Distress management. J Natl Compr Cancer Netw. 2010;8(4):448–85.
Sharpley CF, Christie DR, Bitsika V. Do hormone treatments for prostate cancer cause anxiety and depression? Int J Clin Oncol. 2014;19(3):523–30.
Simard S, Thewes B, Humphris G, Dixon M, Hayden C, Mireskandari S, Ozakinci G. Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. J Cancer Surviv. 2013;7(3):300–22.
Nelson CJ, Weinberger MI, Balk E, Holland J, Breitbart W, Roth AJ. The chronology of distress, anxiety, and depression in older prostate cancer patients. Oncologist. 2009;14(9):891–9.
Lehuluante A, Fransson P. Are there specific health-related factors that can accentuate the risk of suicide among men with prostate cancer? Support Care Cancer. 2014;22(6):1673–8.
Fransson P, Tavelin B, Widmark A. Reliability and responsiveness of a prostate cancer questionnaire for radiotherapy-induced side effects. Support Care Cancer. 2001;9(3):187–98.
Koo KC, Park SU, Kim KH, Rha KH, Hong SJ, Yang SC, Chung BH. Predictors of survival in prostate cancer patients with bone metastasis and extremely high prostate-specific antigen levels. Prostate Int. 2015;3(1):10–5.
Dale W, Bilir P, Han M, Meltzer D. The role of anxiety in prostate carcinoma: a structured review of the literature. Cancer. 2005;104(3):467–78.
Tavlarides AM, Ames SC, Diehl NN, Joseph RW, Castle EP, Thiel DD, Broderick GA, Parker AS. Evaluation of the association of prostate cancer-specific anxiety with sexual function, depression and cancer aggressiveness in men 1 year following surgical treatment for localized prostate cancer. Psychooncology. 2013;22(6):1328–35.
Parker PA, Kudelka A, Basen-Engquist K, Kavanagh J, de Moor J, Cohen L. The associations between knowledge, CA125 preoccupation, and distress in women with epithelial ovarian cancer. Gynecol Oncol. 2006;100(3):495–500.
Simard S, Savard J, Ivers H. Fear of cancer recurrence: specific profiles and nature of intrusive thoughts. J Cancer Surviv. 2010;4(4):361–71.
Kazer MW, Harden J, Burke M, Sanda MG, Hardy J, Bailey DE. The experiences of unpartnered men with prostate cancer: a qualitative analysis. J Cancer Surviv. 2011;5(2):132–41.
Kamen C, Mustian KM, Heckler C, Janelsins MC, Peppone LJ, Mohile S, McMahon JM, Lord R, Flynn PJ, Weiss M, et al. The association between partner support and psychological distress among prostate cancer survivors in a nationwide study. J Cancer Surviv. 2015;9(3):492–9.
Ettridge KA, Bowden JA, Chambers SK, Smith DP, Murphy M, Evans SM, Roder D, Miller CL. “Prostate cancer is far more hidden...”: Perceptions of stigma, social isolation and help-seeking among men with prostate cancer. Eur JCancer Care. 2018;27(2):e12790.
Sharpley CF, Bitsika V, Wootten AC, Christie DR. Differences in major depressive disorder and generalised anxiety disorder symptomatology between prostate cancer patients receiving hormone therapy and those who are not. Psychooncology. 2014;23(12):1350–5.
Johanes C, Monoarfa RA, Ismail RI, Umbas R. Anxiety level of early- and late-stage prostate cancer patients. Prostate Int. 2013;1(4):177–82.
Orom H, Nelson CJ, Underwood W 3rd, Homish DL, Kapoor DA. Factors associated with emotional distress in newly diagnosed prostate cancer patients. Psychooncology. 2015;24(11):1416–22.
King AJL, Evans M, Moore THM, Paterson C, Sharp D, Persad R, Huntley AL. Prostate cancer and supportive care: a systematic reviewand qualitative synthesis of men’s experiences and unmet needs. Eur J Cancer Care. 2015;24:618–34.
Fransson P. Quality of life for members of Swedish prostate Cancer patient associations. Cancer Nurs. 2008;31(1):23–31.
Carlsson C, Baigi A, Killander D, Larsson US. Motives for becoming and remaining member of patient associations: a study of 1,810 Swedish individuals with cancer associations. Support Care Cancer. 2005;13(12):1035–43.
Fossa SD, Bengtsson T, Borre M, Ahlgren G, Rannikko A, Dahl AA. Reduction of quality of life in prostate cancer patients: experience among 6200 men in the Nordic countries. Scand J Urol. 2016;50(5):330–7.
Fossa SD, Dahl AA. Global quality of life after curative treatment for prostate Cancer: what matters? A study among members of the Norwegian prostate Cancer patient association. Clin Genitourin Cancer. 2015;13(6):518–24.