Ilie Gabriela, MacDonald Morgan, Bell David, Rendon Ricardo, Langille Gavin, Bailly Gregory, Mason Ross, Bowes David, Wilke Derek, Patil Nikhilesh, Lawen Joseph, Grantmyre John, Thompson Robert, MacDonald Cody, O'Malley Padraic, Pan Larry, Bagnell Scott, Campbell Holly, Acker Matthew, Massaro Peter, Padmore Dave, Rutledge Robert D H
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada.
Urol Pract. 2020 Sep;7(5):384-390. doi: 10.1097/UPJ.0000000000000104. Epub 2019 Oct 4.
Although survival rates are highest among prostate cancer survivors compared to any other forms of cancer, nearly 60% suffer from mental distress. Here we examine urinary function and psychosocial stressors and their association with poor mental health in a younger group of prostate cancer survivors who have undergone curative treatment.
The study includes 128 men (47 to 70 years old) who received active treatment for prostate cancer, and completed a survivorship online survey between 2017 and 2018. Psychological distress was assessed with Kessler Psychological Distress Scale. International Prostate Symptom Score subscales (incomplete urinary emptying, frequency, intermittency, urgency, weak stream, straining and nocturia) and number of current prostate cancer survivorship stressors were predictors. Multivariate logistic regression was used to fit the model while controlling for months of survivorship since diagnosis, the presence or absence of surgery, radiation or hormone therapy treatment, current medication for depression and demographics.
A total of 19.5% of men scored positive for current mental health issues. Prostate cancer survivors who reported increased number of current survivorship stressors (OR 1.48, 95% CI 1.09-2.01), had higher frequency of urination (OR 2.05, 95% CI 1.15-3.64), history of radiation treatment (OR 7.15, 95% CI 1.02-50.35) and were currently on prescribed medication for depression (OR 33.47, 95% CI 3.80-294.87) had higher odds for screening positive for psychological distress compared with their counterparts.
These results corroborate recent findings showing an intersection between urological oncology and poor mental health during survivorship, and warrant the development of multidisciplinary teams in addressing survivorship issues in this population.
尽管前列腺癌幸存者的生存率高于其他任何癌症形式，但仍有近60%的人遭受精神困扰。在此，我们研究了一组接受根治性治疗的年轻前列腺癌幸存者的泌尿功能、社会心理压力源及其与心理健康不佳的关联。
该研究纳入了128名年龄在47至70岁之间接受过前列腺癌积极治疗并于2017年至2018年间完成生存情况在线调查的男性。采用凯斯勒心理困扰量表评估心理困扰程度。国际前列腺症状评分量表的各个子量表（排尿不尽、尿频、尿流中断、尿急、尿流无力、排尿费力和夜尿）以及当前前列腺癌生存压力源的数量作为预测指标。在控制自诊断以来的生存月数、是否接受手术、放疗或激素治疗、当前是否服用抗抑郁药物以及人口统计学因素的同时，使用多变量逻辑回归来拟合模型。
共有19.5%的男性当前心理健康问题筛查呈阳性。报告当前生存压力源数量增加的前列腺癌幸存者（比值比1.48，95%置信区间1.09 - 2.01）、尿频频率较高的幸存者（比值比2.05，95%置信区间1.15 - 3.64）、有放疗史的幸存者（比值比7.15，95%置信区间1.02 - 50.35）以及当前正在服用抗抑郁药物的幸存者（比值比33.47，95%置信区间3.80 - 294.87），与其他幸存者相比，心理困扰筛查呈阳性的几率更高。
这些结果证实了近期的研究发现，即在生存期间泌尿外科肿瘤学与心理健康不佳之间存在交叉，并且有必要组建多学科团队来解决该人群的生存问题。
