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Cancer-related symptoms, mental well-being, and psychological distress in men diagnosed with prostate cancer treated with androgen deprivation therapy.
Quality of Life Research ( IF 3.5 ) Pub Date : 2019-05-23 , DOI: 10.1007/s11136-019-02212-x
Sarah Wilding 1, 2, 3 , Amy Downing 1, 2 , Penny Wright 1 , Peter Selby 1 , Eila Watson 4 , Richard Wagland 5 , David W Donnelly 6 , Luke Hounsome 7 , Hugh Butcher 1 , Malcolm Mason 8 , Ann Henry 1 , Anna Gavin 6 , Adam W Glaser 1, 2
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PURPOSE There are known associations between treatment of prostate cancer (PCa) involving Androgen Deprivation Therapy (ADT) and psychological and physical side effects. We investigate the associations between cancer-related symptoms, health-related quality of life (HRQL), and poor psychological outcomes in men whose treatment for PCa involved ADT. METHODS A cross-sectional postal questionnaire was administered to UK men 18-42 months post diagnosis of PCa. Men completed items on functional outcomes using the Expanded Prostate Cancer Index Composite (EPIC-26), EuroQol-5D (EQ-5D), and the European Organisation for Research and Treatment of Cancer (EORTC) Fatigue subscale. Psychological outcomes (mental well-being and psychological distress) were assessed using the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) and the Kessler 6-item scale (K6), respectively. Associations between explanatory variables and psychological outcomes were assessed using stepped logistic regression. RESULTS 13,097 men treated with ADT completed a questionnaire. A minority of men reported poor mental well-being (15.5%) or severe psychological distress (6.6%). After controlling for sociodemographic and clinical variables, reporting clinically significant fatigue was strongly associated with severe psychological distress (OR 9.92; 95% CI 7.63 to 12.89) and poor well-being (OR 3.86; 95% CI 3.38 to 4.42). All cancer-related symptoms and HRQL variables were associated with both psychological outcomes. CONCLUSIONS While the majority of men treated with ADT did not report poor psychological outcomes, a small proportion reported severe problems. Clinically significant fatigue was demonstrated as a possible indicator of poor outcomes. Healthcare systems need to have clear protocols in place which specifically and routinely target psychological distress and fatigue.

中文翻译:

经雄激素剥夺治疗的被诊断患有前列腺癌的男性的癌症相关症状,心理健康和心理困扰。

目的在涉及雄激素剥夺疗法(ADT)的前列腺癌(PCa)治疗与心理和生理副作用之间存在已知的关联。我们调查了PCa治疗涉及ADT的男性中与癌症相关的症状,与健康相关的生活质量(HRQL)和不良的心理结果之间的关联。方法对英国男性诊断为PCa后18-42个月进行横断面邮寄问卷调查。男性使用扩展的前列腺癌指数综合指数(EPIC-26),EuroQol-5D(EQ-5D)和欧洲癌症研究与治疗组织(EORTC)疲劳分量表完成了有关功能结局的项目。分别使用短沃里克-爱丁堡心理健康量表(SWEMWBS)和凯斯勒6项量表(K6)评估心理结局(心理健康和心理困扰)。使用逐步逻辑回归评估解释变量与心理结果之间的关联。结果13097例接受ADT治疗的男性完成了问卷调查。少数男性报告其心理健康状况不佳(15.5%)或严重的心理困扰(6.6%)。在控制了社会人口统计学和临床​​变量后,报告临床上明显的疲劳与严重的心理困扰(OR 9.92; 95%CI 7.63至12.89)和健康状况不佳(OR 3.86; 95%CI 3.38至4.42)密切相关。所有与癌症相关的症状和HRQL变量均与两种心理预后相关。结论虽然大多数接受ADT治疗的男性并未报告较差的心理结果,但一小部分则报告了严重的问题。临床上明显的疲劳被证明是不良预后的可能指标。医疗保健系统需要有明确的协议,专门针对性地和常规地针对心理困扰和疲劳。
更新日期:2019-05-21
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