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. 2016 Mar;117(3):469-77.
doi: 10.1111/bju.13099. Epub 2015 Apr 21.

Relationship between illness uncertainty, anxiety, fear of progression and quality of life in men with favourable-risk prostate cancer undergoing active surveillance

Patricia A Parker  1 , John W Davis  1 , David M Latini  2 , George Baum  1 , Xuemei Wang  1 , John F Ward  1 , Deborah Kuban  1 , Steven J Frank  1 , Andrew K Lee  1 , Christopher J Logothetis  1 , Jeri Kim  1
Affiliations

Relationship between illness uncertainty, anxiety, fear of progression and quality of life in men with favourable-risk prostate cancer undergoing active surveillance

Patricia A Parker et al. BJU Int. 2016 Mar.

Abstract

Objectives: To evaluate prospectively the associations between illness uncertainty, anxiety, fear of progression and general and disease-specific quality of life (QoL) in men with favourable-risk prostate cancer undergoing active surveillance (AS).

Patients and methods: After meeting stringent enrollment criteria for an AS cohort study at a single tertiary care cancer centre, 180 men with favourable-risk prostate cancer completed questionnaires at the time of enrollment and every 6 months for up to 30 months. Questionnaires assessed illness uncertainty, anxiety, prostate-specific QoL (using the Expanded Prostate Cancer Index Composite [EPIC] scale) and general QoL (using the 12-time short-form health survey [SF-12]) and fear of progression. We used linear mixed-model analyses and multilevel mediation analyses.

Results: Sexual scores on the EPIC scale significantly declined over time (P < 0.05). Illness uncertainty was a significant predictor of all EPIC summary scores, SF-12 physical component summary (PCS) scores, mental component summary (MCS) scores and fear of progression scores (all P < 0.05), after controlling for demographic and clinicopathological factors. Anxiety predicted all EPIC summary, MCS and fear of progression scores (all P < 0.05) but not PCS scores (P = 0.08). Scores on PCS, MCS, EPIC summary scales (except sexual scale), and fear of progression did not change significantly over the study period (all P > 0.10).

Conclusion: Over the 2.5-year follow-up, QoL remained stable; only sexual function scores significantly declined. Illness uncertainty and anxiety were significant predictors of general and prostate-specific QoL and fear of progression. Interventions to reduce uncertainty and anxiety may enhance QoL for men with prostate cancer on AS.

Keywords: active surveillance; anxiety; fear; prostate cancer; quality of life; watchful waiting.

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Conflict of interest statement

AUTHORS’ DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

The authors indicated no potential conflicts of interest.

Figures

Fig. 1
Fig. 1
Expanded Prostate Index Composite Sexual quality of life summary scores from baseline to 30 months in 6-month intervals.
See this image and copyright information in PMC

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