van de Wal Marieke, van Oort Inge, Schouten Joost, Thewes Belinda, Gielissen Marieke, Prins Judith
a Department of Medical Psychology , Radboud University Medical Center , Nijmegen , The Netherlands ;
b Department of Urology , Radboud University Medical Center , Nijmegen , The Netherlands.
Acta Oncol. 2016 Jul;55(7):821-7. doi: 10.3109/0284186X.2016.1150607. Epub 2016 Mar 3.
Background High fear of cancer recurrence (FCR) is an understudied topic in prostate cancer (PCa) survivors. This study aimed to detect the prevalence, consequences and characteristics associated with high FCR in PCa survivors. Material and methods This cross-sectional study included patients diagnosed with localized PCa and treated with curative radical prostatectomy between 1992 and 2012. We administered the Cancer Worry Scale (CWS) to assess FCR severity (primary outcome measure). Secondary outcomes included distress, quality of life (QOL), post-traumatic symptoms, and multidimensional aspects of FCR. χ(2)-tests, t-tests and Pearson's correlations examined the relationship between FCR and medical/demographic characteristics. MANOVA analyses and χ2-tests identified differences between PCa survivors with high and low FCR. Results Two hundred eighty-three PCa survivors (median age of 70.0 years) completed the questionnaires a median time of 7.1 years after surgery. About a third (36%) of all PCa survivors experienced high FCR. High FCR was associated with lower QOL, more physical problems, higher distress and more post-traumatic stress symptoms. PCa survivors with high FCR reported disease-related triggers (especially medical examinations), felt helpless and experienced problems in social relationships. High FCR was associated with a younger age and having received adjuvant radiotherapy. Conclusions Results illustrate that FCR is a significant problem in PCa survivors. Younger men and those treated with adjuvant radiotherapy are especially at risk. Those with high FCR experience worse QOL and higher symptom burden. Health care providers should pay specific attention to this problem and provide appropriate psychosocial care when needed.
背景 对癌症复发的高度恐惧（FCR）在前列腺癌（PCa）幸存者中是一个研究较少的课题。本研究旨在检测PCa幸存者中与高度FCR相关的患病率、后果及特征。
材料与方法 这项横断面研究纳入了1992年至2012年间被诊断为局限性PCa并接受根治性前列腺切除术治疗的患者。我们采用癌症担忧量表（CWS）来评估FCR的严重程度（主要结局指标）。次要结局包括痛苦、生活质量（QOL）、创伤后症状以及FCR的多维度方面。χ²检验、t检验和Pearson相关性分析用于检验FCR与医学/人口统计学特征之间的关系。多变量方差分析（MANOVA）和χ²检验确定了FCR高和低的PCa幸存者之间的差异。
结果 283名PCa幸存者（中位年龄70.0岁）在术后中位时间7.1年完成了问卷调查。所有PCa幸存者中约三分之一（36%）经历了高度FCR。高度FCR与较低的QOL、更多的身体问题、更高的痛苦和更多的创伤后应激症状相关。FCR高的PCa幸存者报告了与疾病相关的触发因素（尤其是医学检查），感到无助，并在社会关系中遇到问题。高度FCR与较年轻的年龄以及接受辅助放疗有关。
结论 结果表明，FCR在PCa幸存者中是一个重要问题。年轻男性和接受辅助放疗的患者尤其有风险。FCR高的患者生活质量较差，症状负担较重。医疗保健提供者应特别关注这个问题，并在需要时提供适当的心理社会护理。
