Cancer-related symptoms, mental well-being, and psychological distress in men diagnosed with prostate cancer treated with androgen deprivation therapy

Sarah Wilding, Amy Downing, Penny Wright, Peter J Selby, Eila Watson, Richard Wagland, David Donnelly, Luke Hounsome, Hugh Butcher, Malcolm Mason, Ann Henry, Anna Gavin, Adam W Glaser

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9 Citations (Scopus)
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Abstract

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.
Original languageEnglish
JournalQuality of Life Research
Early online date21 May 2019
DOIs
Publication statusPublished - 01 Oct 2019

Keywords

  • Androgen deprivation therapy
  • Cancer-related symptoms
  • Mental well-being
  • Patient-reported outcome measures
  • Prostate cancer
  • Psychological distress

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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