Pham Hannah, Torres Harrison, Sharma Pranav
Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX.
Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX.
Urol Oncol. 2019 Feb;37(2):97-107. doi: 10.1016/j.urolonc.2018.12.006. Epub 2018 Dec 21.
Although the majority of bladder cancer literature has been dedicated to optimizing oncological outcomes and focuses on physical prognostic criteria such as nutritional and performance status, emerging data has suggested that both pre- and post-treatment mental health may play as important a role in patient outcomes as physical health. In this review, we summarize the literature regarding the prognostic implications of mental illness on bladder cancer patients and review how both the diagnosis and treatment of bladder cancer can affect mental health across various disease states. Literature review via a modified, nonsystematic analysis was performed from 2000 to 2018 in PubMed, Web of Science, EMBASE, SCOPUS, and OVID. Search terms included "bladder cancer," "non-muscle-invasive bladder cancer," "muscle-invasive bladder cancer," "mental health," "psychological distress," "depression," and "suicide." Articles were limited to English-language, peer-reviewed, original research. A total of 87 publications were reviewed that met our initial inclusion criteria, and 19 relevant publications were incorporated in our review. Eleven studies were prospective and 8 were retrospective. Two articles included non-muscle-invasive bladder cancer patients, 11 included muscle-invasive bladder cancer patients, and 6 incorporated bladder cancer patients across all disease stages. Mental health issues, such as depression and anxiety, often coexist with a diagnosis of bladder cancer with a worse prognosis associated with greater psychological burden. Bladder cancer patients also have an increased risk of suicide especially in older, unmarried, male patients with more advanced disease states. Poor mental health can impact treatment outcomes such as postsurgical complication rates as well as survival-related outcomes similar to physical health. While awareness of the importance of mental health in bladder cancer patients is growing, further studies are needed to assess the role of interventions such as cognitive behavioral therapy or pharmacotherapy in order to optimize treatment.
尽管大多数膀胱癌文献都致力于优化肿瘤学治疗效果，并侧重于身体预后标准，如营养状况和体能状态，但新出现的数据表明，治疗前和治疗后的心理健康在患者治疗效果中可能与身体健康起着同样重要的作用。在本综述中，我们总结了关于精神疾病对膀胱癌患者预后影响的文献，并回顾了膀胱癌的诊断和治疗如何在不同疾病状态下影响心理健康。通过在PubMed、科学网、EMBASE、SCOPUS和OVID数据库中进行2000年至2018年的改良非系统分析进行文献综述。检索词包括“膀胱癌”、“非肌层浸润性膀胱癌”、“肌层浸润性膀胱癌”、“心理健康”、“心理困扰”、“抑郁”和“自杀”。文章限于英文、同行评审的原创研究。共审查了87篇符合我们初始纳入标准的出版物，19篇相关出版物纳入了我们的综述。11项研究为前瞻性研究，8项为回顾性研究。2篇文章纳入了非肌层浸润性膀胱癌患者，11篇纳入了肌层浸润性膀胱癌患者，6篇纳入了所有疾病阶段的膀胱癌患者。心理健康问题，如抑郁和焦虑，常常与膀胱癌诊断并存，心理负担越大，预后越差。膀胱癌患者自杀风险也增加，尤其是年龄较大、未婚、患有更晚期疾病的男性患者。心理健康不佳会影响治疗效果，如术后并发症发生率以及与生存相关的结果，与身体健康情况类似。虽然对膀胱癌患者心理健康重要性的认识在不断提高，但仍需要进一步研究来评估认知行为疗法或药物疗法等干预措施的作用，以优化治疗。
