Department of Health Science Research, Mayo Clinic, Jacksonville, FL, USA.
Psychooncology. 2013 Jun;22(6):1328-35. doi: 10.1002/pon.3138. Epub 2012 Aug 1.
Cancer-specific anxiety (CSA) can affect treatment decisions and is common in men following surgery for prostate cancer (PCa). We hypothesized that CSA is also associated with factors affecting quality of life. Herein, we examine the association of CSA with psychosocial factors and PCa aggressiveness in a cohort of men 1 year after prostatectomy for localized PCa.
From our prospective PCa Registry, we identified 365 men who underwent prostatectomy for localized PCa who completed the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) and Expanded Prostate Cancer Index Composite at 1-year follow-up. We evaluated the association of scores on the MAX-PC with demographics, clinicopathologic features, sexual function, and depression scores using Wilcoxon Rank Sum and Kendall's tau correlation tests.
Higher scores on the MAX-PC (i.e., higher anxiety) are associated with younger age (p < 0.01) and non-Caucasian race (p < 0.01). Men with higher MAX-PC scores also reported poor sexual satisfaction/function (p < 0.01) and increasing depressive symptoms (p < 0.01). Finally, although higher anxiety is associated with several pathologic features of aggressiveness (stage, positive margins, PSA at 1 year; all p-values < 0.01), we noted several men with clinically indolent disease who reported significant anxiety.
Our data suggest that higher levels of CSA are associated with poor sexual function and increased depressive symptoms 1 year after prostatectomy. Moreover, we noted demographic and pathologic features associated with higher CSA as well. If confirmed, our data support development of models to predict men at high risk of CSA following PCa surgery and targeted referral for additional counseling.
癌症特异性焦虑（CSA）会影响治疗决策，在前列腺癌（PCa）手术后的男性中很常见。我们假设 CSA 也与影响生活质量的因素有关。在此，我们在一组接受局部前列腺切除术治疗局限性前列腺癌 1 年后的男性中，检查 CSA 与心理社会因素和 PCa 侵袭性之间的关系。
我们从我们的前瞻性 PCa 登记处中确定了 365 名接受局部前列腺切除术治疗局限性前列腺癌的男性，这些患者在 1 年随访时完成了前列腺癌记忆焦虑量表（MAX-PC）和扩展前列腺癌指数综合量表。我们使用 Wilcoxon 秩和检验和 Kendall's tau 相关检验评估 MAX-PC 评分与人口统计学、临床病理学特征、性功能和抑郁评分之间的相关性。
MAX-PC 评分较高（即焦虑程度较高）与年龄较小（p < 0.01）和非白种人种族（p < 0.01）相关。MAX-PC 评分较高的男性还报告了较差的性满意度/功能（p < 0.01）和抑郁症状增加（p < 0.01）。最后，尽管较高的焦虑与侵袭性的几个病理学特征相关（分期、阳性切缘、1 年 PSA；所有 p 值均<0.01），但我们注意到一些患有临床惰性疾病的男性报告了明显的焦虑。
我们的数据表明，在前列腺切除术后 1 年，较高水平的 CSA 与较差的性功能和增加的抑郁症状相关。此外，我们还注意到与较高 CSA 相关的人口统计学和病理学特征。如果得到证实，我们的数据支持开发预测 PCa 手术后 CSA 风险较高的男性的模型，并进行针对性的咨询转介。
