Department of Urology, Faculty of Medicine and Health Sciences, 26697Stellenbosch University, Cape Town, South Africa.
Department of Psychiatry, Stellenbosch University and SA MRC Genomics of Brain Disorders Unit, Cape Town, South Africa.
Cancer Control. 2022 Jan-Dec;29:10732748221125561. doi: 10.1177/10732748221125561.
Comorbid depression and anxiety in men with localised prostate cancer (CaP) largely go undiagnosed and untreated and their effects on health-related quality of life (HRQOL) in men with CaP should not be underestimated. We examined the prevalence of depression and anxiety and its association with HRQOL in men about to commence treatment for CaP and the differences between treatment groups, radical prostatectomy (RP) and radiation therapy (RT).
One hundred and seven participants from a longitudinal prospective observational study assessing depression, anxiety and HRQOL in men with localised CaP (DAHCaP), were used in this cross-sectional analysis. Data were collected shortly before participants were scheduled to receive their treatment. The Centre for Epidemiologic Studies Depression Scale (CES-D), the State Trait Anxiety Inventory (STAI), the Memorial Anxiety Scale for Prostate Cancer (MAX-PC), the European Organisation for Research and Treatment in Cancer Quality of Life questionnaire (EORTC QLQ-C30) and (EORTC QLQ-PR25) were used in this analysis.
Symptoms of depression pre-treatment were noted in 39.3%, state anxiety 28%, trait anxiety 31.4% and prostate cancer anxiety in 12.1% of participants. Statistically significant correlations ( ≤ .05) with the CES-D and a cluster of symptoms on the EORTC QLQ-C30 domains for Global Health (r = -.35), fatigue (r = .38), pain (r = .32), dyspnoea (r = .28), insomnia (r = .30) and finance (r = .26) and EORTC QLQ-PR25 domains for urinary symptoms (r = .43), bowel (r = .43) and hormone replacement therapy (HRT) (r = .41) were observed.Statistically significant correlations were also noted between the STAI-S and EORTC QLQ-C30 and EORTC QLQ-PR25. No statistically significant difference was noted between treatments.
More men were depressed than anxious with significant associations with HRQOL prior to commencement of treatment. CaP treatments should focus not only on the prevailing indisposition but include a psychooncological and HRQOL assessment at pre-treatment in high-risk individuals.
患有局限性前列腺癌（CaP）的男性中，抑郁和焦虑共病的情况很大程度上未被诊断和治疗，其对 CaP 男性健康相关生活质量（HRQOL）的影响不应被低估。我们研究了即将接受 CaP 治疗的男性中抑郁和焦虑的患病率及其与 HRQOL 的相关性，以及两种治疗方法（根治性前列腺切除术（RP）和放射治疗（RT）之间的差异。
使用一项前瞻性纵向观察性研究中的 107 名参与者的数据，该研究评估了局限性 CaP 男性的抑郁、焦虑和 HRQOL（DAHCaP），这些参与者用于本次横断面分析。数据收集于参与者计划接受治疗前不久。本分析使用了流行病学研究抑郁量表（CES-D）、状态特质焦虑量表（STAI）、前列腺癌焦虑量表（MAX-PC）、欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C30）和（EORTC QLQ-PR25）。
治疗前有 39.3%的患者出现抑郁症状，28%的患者出现状态焦虑，31.4%的患者出现特质焦虑，12.1%的患者出现前列腺癌焦虑。与 CES-D 呈统计学显著相关（≤.05），与 EORTC QLQ-C30 整体健康（r = -.35）、疲劳（r = -.38）、疼痛（r = -.32）、呼吸困难（r = -.28）、失眠（r = -.30）和财务（r = -.26）以及 EORTC QLQ-PR25 尿症状（r = -.43）、肠（r = -.43）和激素替代治疗（HRT）（r = -.41）相关的症状簇也有统计学显著相关性。STAI-S 与 EORTC QLQ-C30 和 EORTC QLQ-PR25 之间也有统计学显著相关性。两种治疗方法之间无统计学显著差异。
在开始治疗前，更多的男性表现出抑郁，与 HRQOL 有显著相关性。CaP 治疗不仅应关注当前的不适，还应在高危人群中进行治疗前的心理肿瘤学和 HRQOL 评估。
