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

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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 × 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 × 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.

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Acknowledgements

CaPSURE™ is supported by TAP Pharmaceutical Products (Lake Forest, IL). This research was additionally funded by National Institutes of Health/National Cancer Institute University of California—San Francisco SPORE Special Program of Research Excellence P50 C89520. Dr. Hart is supported by grant K08MH068257 from the National Institute of Mental Health. This material is the result of work supported with resources and the use of facilities at the Houston Center for Quality of Care and Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center. Dr. Latini is supported by Mentored Research Scholar Grant 06-083-01-CPPB from the American Cancer Society. The current CaPSURE™ Investigators are: Peter R. Carroll, M.D. (University of California, San Francisco, San Francisco, CA), James S. Cochran, M.D. (Urology Clinics of North Texas, Dallas, TX), Christopher J. Kane, M.D. (Veterans Administration Medical Center, San Francisco, CA), Donald P. Finnerty, M.D. (PAPP Clinic, Newnan, GA), Eugene V. Kramolowsky, M.D. (The Virginia Urology Center, Richmond, VA), Robert M. Segaul, M.D. (Urology Associates of West Broward Belle Terre, Sunrise, FL), Paul Sieber, M.D. (Urological Associates of Lancaster, Lancaster, PA), Stanley A. Brosman, M.D. (Pacific Clinical Research, Santa Monica, CA), Lynn W. Conrad, M.D. (Urology Center of the South, PC, Memphis, TN), Joseph N. Macaluso, Jr., M.D. (Urologic Institute of New Orleans, Gretna, LA), Michael Flanagan, M.D. (Urology Specialists, Waterbury, CT), Jeffrey K. Cohen, M.D. (Triangle Urology Group, Pittsburgh, PA), Jerrold Sharkey, M.D. (Urology Health Center, New Port Richey, FL), Thomas W. Coleman, M.D. (Mobile Urology Group, Mobile, AL), Elliott C. Silbar, M.D. (Clinic of Urology, Milwaukee, WI), Paul S. Ray, DO (Cook County Hospital, Chicago, IL), David Noyes, M.D. (Berkshire Urological Associates, P.C., Pittsfield, MA), Mohammed Mostafavi, M.D. (Urology Group of Western New England, Springfield, MA), Louis Keeler, III, M.D. (Center for Urologic Care, Voorhees, NJ), James Gottesman, M.D. (Seattle Urological, Seattle, WA), Bhupendra M. Tolia, M.D. (Associated Advanced Adult and Pediatric Urology, Bronx, NY), W. Lamar Weems, M.D. (Mississippi Urology, Jackson, MS), Glen Wells, M.D. (Alabama Urology, Birmingham, AL), Richard J. Kahnoski, M.D. (Michigan Medical, Grand Rapids, MI), Sheldon J. Freedman, M.D. (Las Vegas, NV), Randil Clark, M.D. (North Idaho Urology, Coeur D’Alene, ID), Daniel W. Lin, M.D (Veterans Administration Puget Sound HCS, Seattle, WA), Mark Austenfeld, M.D. (Kansas City Urology Care, Kansas City, MO), Henri P. Lanctin, M.D. (Adult and Pediatric Urology, St. Cloud, MN), J. Brantley Thrasher, M.D. (University of Kansas, Kansas City, KS), and David W. Bowyer, M.D. (Snake River Urology, Twin Falls, ID). Former CaPSURE investigators are: John Forrest, M.D. (1995–1999, Urologic Specialists of Oklahoma, Tulsa, OK), William Schmeid, M.D. (1995–1999, Metro Urology, Jeffersonville, IN), Glen Brunk, M.D. (1995–1999, Urology of Indiana, Indianapolis, IN), Jay Young, M.D. (1995–2001, South Orange County Medical Research Center, Laguna Woods, CA), Gary Katz, M.D. (1996–2000, Medical College of Virginia and Veterans Administration Medical Center, Richmond, VA), Stacy J. Childs, M.D. (1999–2000, Cheyenne Urological, Cheyenne, WY), Kevin Tomera, M.D. (1999–2001, Alaska Urological Associates, Anchorage, AK), Clayton Hudnall, M.D. (1995–2002, Urology San Antonio Research, San Antonio, TX), and David Penson, M.D., MPH (2000–2003, Veterans Administration Puget Sound HCS, Seattle, WA).

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Authors and Affiliations

  1. Department of Psychology, Ryerson University, Toronto, ON, Canada

    Stacey L. Hart

  2. Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada

    Stacey L. Hart

  3. Scott Department of Urology and the Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA

    David M. Latini

  4. The Houston Center for Quality of Care and Utilization Studies, VA Medical Center, 2002 Holcombe Blvd., Houston, TX, 77030, USA

    David M. Latini

  5. Department of Urology, University of California San Francisco, Box 1695, San Francisco, CA, 94143, USA

    Janet E. Cowan & Peter R. Carroll

  6. Programs in Urologic Oncology and Genitourinary Cancer Epidemiology and Population Science, Comprehensive Cancer Center, University of California San Francisco, Box 1695, San Francisco, CA, 94143, USA

    Janet E. Cowan & Peter R. Carroll

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  1. Stacey L. Hart
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  2. David M. Latini
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  3. Janet E. Cowan
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  4. Peter R. Carroll
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CaPSURE™ Investigators

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Correspondence to Stacey L. Hart.

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Hart, S.L., Latini, D.M., Cowan, J.E. et al. Fear of recurrence, treatment satisfaction, and quality of life after radical prostatectomy for prostate cancer. Support Care Cancer 16, 161–169 (2008). https://doi.org/10.1007/s00520-007-0296-x

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  • DOI: https://doi.org/10.1007/s00520-007-0296-x

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