Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan, Italy.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Support Care Cancer. 2021 Feb;29(2):645-651. doi: 10.1007/s00520-020-05524-8. Epub 2020 May 18.
To investigate whether prostate cancer (PCa) patients' coping strategies (i.e., fighting spirit, anxious preoccupation, fatalism, helplessness/hopelessness, and avoidance) significantly change during the first 3-year follow-up period of active surveillance (AS).
Altogether, 104 patients on AS completed the Mini-Mental Adjustment to Cancer (Mini-MAC) at baseline (T0), at 10 and 12 months after diagnostic biopsy (T1 and T2, respectively) and then at 24- (T3) and 36-month (T4) follow-up. Paired samples T test was used to detect statistically significant changes over time. Changes ≥ 1 point (or ≤ - 1) were hypothesized to be clinically relevant.
During the first 3 years on AS, men experienced decreased anxiety, avoidance thoughts/behaviors, and fight-against-cancer attitudes, and these changes were found to be statistically significant. When considering clinically significant changes between inclusion in AS (T0) and 3-year follow-up (T4), avoidance decreased in 19% of patients.
Most patients were observed to have adopted functional coping strategies at baseline, which were maintained through the first 3 years on AS. Overall, men on AS may perceive increasing control over their cancer and comfort with the AS protocol over time and experience slight decreases in anxious preoccupation, cancer-related avoidance thoughts and behaviors, and fight-against-cancer reactions. For those men who find it difficult to cope with AS, psychological monitoring and interventions could be helpful throughout the monitoring journey.
探究前列腺癌（PCa）患者在主动监测（AS）的最初 3 年随访期间，其应对策略（即求生意志、焦虑关注、宿命论、无助/无望和回避）是否会发生显著变化。
共有 104 名接受 AS 的患者在基线（T0）、诊断性活检后 10 个月（T1）和 12 个月（T2）以及 24 个月（T3）和 36 个月（T4）随访时完成了简易心理调整癌症量表（Mini-MAC）。采用配对样本 t 检验检测随时间的统计学显著变化。变化≥1 点（或≤-1）被假设为具有临床意义。
在 AS 的最初 3 年内，男性经历了焦虑、回避思维/行为以及抗癌态度的降低，这些变化具有统计学意义。当考虑 AS 纳入（T0）和 3 年随访（T4）之间的临床显著变化时，19%的患者回避行为减少。
大多数患者在基线时被观察到采用了功能性应对策略，这些策略在 AS 的最初 3 年内得以维持。总体而言，随着时间的推移，接受 AS 的男性可能会逐渐感知到对自身癌症的控制增加，并对 AS 方案感到舒适，同时经历焦虑关注、癌症相关回避思维和行为以及抗癌反应的轻微下降。对于那些难以应对 AS 的男性，在整个监测过程中，心理监测和干预可能会有所帮助。
