Fear of recurrence, treatment satisfaction, and quality of life after radical prostatectomy for prostate cancer

Abstract

Goals of work: Fear of cancer recurrence (FOR) is common in prostate cancer patients, but little research has examined the impact of FOR on quality of life (QOL) or the mechanism by which these fears become intensified. The objective of this study was to examine treatment satisfaction (TS) as a moderator of the relationship between FOR and QOL.

Patients and methods: Data were drawn from the CaPSURE database, a 12,000-man national observational prostate cancer registry. Three hundred and thirty-three patients who underwent radical prostatectomy (RP) to treat their prostate cancer completed self-report measures. TS was measured 0-6 months post-RP with a nine-item scale developed for this study, FOR was measured 6-12 months post-RP with a previously validated five-item scale, and QOL was measured 12-18 months post-RP with the Short Form 36.

Main results: After controlling for age, education, number of comorbid medical conditions, and cancer severity, lower FOR (B = -0.12, p < 0.0001), higher TS (B = 0.09, p < 0.001), and the interaction of TS x FOR (B = 0.87, p < 0.05) significantly predicted higher mental health QOL scores. Furthermore, lower FOR (B = -0.08, p < 0.01), and the interaction of TS x FOR (B = -1.11, p < 0.01) significantly predicted higher physical health QOL scores.

Conclusions: TS levels mitigated the impact of high FOR on lower levels of QOL. Specifically, patients who reported lower TS and greater FOR endorsed significantly lower levels of QOL compared to other patients in the sample.