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Supportive Care in Cancer

, Volume 27, Issue 12, pp 4461–4467 | Cite as

Mood outcomes of a behavioral treatment for urinary incontinence in prostate cancer survivors

  • Amy Y. ZhangEmail author
  • Stephen Ganocy
  • Alex Z. Fu
  • Denise Kresevic
  • Lee Ponsky
  • Gerald Strauss
  • Donald R. Bodner
  • Hui Zhu
Original Article
  • 108 Downloads

Abstract

Purpose

This study aimed to assess whether prostate cancer survivors who received a behavioral intervention to urinary incontinence had experienced a significant mood improvement.

Methods

One hundred fifty-three prostate cancer survivors with persistent incontinence were included in this secondary data analysis. They were randomly assigned to usual care or interventions that provided pelvic floor muscle exercises and self-management skills. All subjects had measures of anxiety, depression, and anger at baseline, 3 months (post-intervention), and 6 months (follow-up). Negative binomial regression analysis was performed to examine the group status, daily leakage frequency at 3 months, and their interactions at 3 months as predictors for mood outcomes at 6 months, controlling for demographic and medical variables.

Results

The main effect of daily leakage frequency at 3 months significantly predicted anxiety at 6 months (p < .01). The group main effect on any mood outcomes at 6 months was not statistically significant. The interaction between the group and 3-month leakage had a significant effect on anxiety; intervention subjects achieving a significant leakage reduction at 3 months exhibited significantly less anxiety at 6 months than other subjects (p = .04). Age, employment status, and receiving surgery at baseline were significantly associated with less anxiety, depression, and anger at 6 months.

Conclusions

Reduced urinary incontinence significantly predicted less anxiety, especially among the intervention subjects. The findings suggest a significant association between a behavioral therapy of urinary incontinence and anxiety reduction in prostate cancer survivors.

Keywords

Behavioral intervention Anxiety Cancer care Prostate cancer Psychosocial studies 

Notes

Authors’ contributions

All the authors have contributed to this article through research participation, data collection or data analysis, and manuscript production.

Funding information

The study was supported by the National Institutes of Health/National Cancer Institute (R01CA127493; PI: Zhang). Cleveland Clinic, University Hospitals Cleveland Medical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, and the MetroHealth System, which are all affiliated with Case Western Reserve University, provided support for patient access.

Compliance with ethical standards

Conflict of interest

The authors declare that they do not have a financial relation with the funding agency NIH except for honoraria received when performing grant reviews. The authors have full control of the primary data that is available for the journal’s review if requested.

Ethical compliance

Informed consent was obtained from all individual participants included in the study. This study has not been published and is not under consideration for publication elsewhere. All authors have contributed to this article through research participation, data collection or data analysis, and manuscript production. They provided financial disclosure under the Conflict of Interest.

References

  1. 1.
    Kollberg KS, Wilderäng U, Thorsteinsdottir T, Hugosson J, Wiklund P, Bjartell A, Carlsson S, Stranne J, Haglind E, Steineck G (2017) How badly did it hit? Self-assessed emotional shock upon prostate cancer diagnosis and psychological well-being: a follow-up at 3, 12, and 24 months after surgery. Acta Oncol 56:984–990CrossRefGoogle Scholar
  2. 2.
    Lane A, Metcalfe C, Young GJ, Peters TJ, Blazeby J, Avery KN, Dedman D, Down L, Mason MD, Neal DE, Hamdy FC, Donovan JL, ProtecT Study group (2016) Patient-reported outcomes in the ProtecT randomized trial of clinically localized prostate cancer treatments: study design, and baseline urinary, bowel and sexual function and quality of life. BJU Int 118(6):869–879CrossRefGoogle Scholar
  3. 3.
    Korfage IJ, Essink-Bot ML, Janssens ACJW, Schröder FH, de Koning HJ (2006) Anxiety and depression after prostate cancer diagnosis and treatment: 5-year follow-up. Br J Cancer 94:1093–1098CrossRefGoogle Scholar
  4. 4.
    Sharp L, O’Leary E, Kinnear H, Gavin A, Drummond FJ (2016) Cancer-related symptoms predict psychological wellbeing among prostate cancer survivors: results from the PiCTure study. Psycho-Oncology 25:282–291CrossRefGoogle Scholar
  5. 5.
    Watson E, Shinkins B, Frith E, Neal D, Hamdy F, Walter F, Weller D, Wilkinson C, Faithfull S, Wolstenholme J, Sooriakumaran P, Kastner C, Campbell C, Neal R, Butcher H, Matthews M, Perera R, Rose P (2016) Symptoms, unmet needs, psychological well-being and health status in survivors of prostate cancer: implications for redesigning follow-up. BJU Int 117:E10–E19CrossRefGoogle Scholar
  6. 6.
    Meissner VH, Herkommer K, Marten-Mittag B, Gschwend JE, Dinkel A (2017) Prostate cancer-related anxiety in long-term survivors after radical prostatectomy. J Cancer Surviv 11(6):800–807CrossRefGoogle Scholar
  7. 7.
    ACS (2017) Cancer Facts & Figures. American Cancer Society, Inc., AtlantaGoogle Scholar
  8. 8.
    Penson DF, McLerran D, Feng Z, Li L, Albertsen PC, Gilliland FD, Hamilton A, Hoffman RM, Stephenson RA, Potosky AL, Stanford JL (2005) 5-year urinary and sexual outcomes after radical prostatectomy: results from the prostate cancer outcomes study. J Urol 173:1701–17055CrossRefGoogle Scholar
  9. 9.
    Fontaine E, Izadifar V, Barthelemy Y, Desgrippes A, Beurton D (2000) Urinary continence following radical prostatectomy assessed by a self-administered questionnaire. Eur Urol 37:223–227CrossRefGoogle Scholar
  10. 10.
    Potosky AL, Davis WW, Hoffman RM, Stanford JL, Stephenson RA, Penson DF, Harlan LC (2004) Five-year outcomes after prostatectomy or radiotherapy for prostate cancer: the prostate cancer outcomes study. J Natl Cancer Inst 96:1358–1367CrossRefGoogle Scholar
  11. 11.
    Butler L, Downe-Wamboldt B, Marsh S, Bell D, Jarvi K (2000) Behind the scenes: partners’ perceptions of quality of life post radical prostatectomy. Urol Nurs 20:254–258PubMedGoogle Scholar
  12. 12.
    Paterson J (2000) Stigma associated with postprostatectomy urinary incontinence. J Wound Ostomy Continence Nurs 27:168–173PubMedGoogle Scholar
  13. 13.
    Palmer MH, Fogarty LA, Somerfield MR, Powel LL (2003) Incontinence after prostatectomy: coping with incontinence after prostate cancer surgery. Oncol Nurs Forum 30:229–238CrossRefGoogle Scholar
  14. 14.
    Rondorf-Klym LM, Colling J (2003) Quality of life after radical prostatectomy. Oncol Nurs Forum 30:E24–E32CrossRefGoogle Scholar
  15. 15.
    Lim AJ, Brandon AH, Fiedler J, Brickman AL, Boyer CI, Raub WA Jr, Soloway MS (1995) Quality of life: radical prostatectomy versus radiation therapy for prostate cancer. J Urol 154:1420–1425CrossRefGoogle Scholar
  16. 16.
    Heyman EN, Rosner TT (1996) Prostate cancer: an intimate view from patients and wives. Urol Nurs 16:37–44PubMedGoogle Scholar
  17. 17.
    Wallerstedt A, Carlsson S, Nilsson AE, Johansson E, Nyberg T, Steineck G, Wiklund NP (2012) Pad use and patient reported bother from urinary leakage after radical prostatectomy. J Urol 187:196–200CrossRefGoogle Scholar
  18. 18.
    Ravi P, Karakiewicz PI, Roghmann F, Gandaglia G, Choueiri TK, Menon M, McKay RR, Nguyen PL, Sammon JD, Sukumar S, Varda B, Chang SL, Kibel AS, Sun M, Trinh Q-D (2014) Mental health outcomes in elderly men with prostate cancer. Urol Oncol 32(8):1333–1340CrossRefGoogle Scholar
  19. 19.
    KÖhler N, Friedrich M, Gansera L, Holze S, Thiel R, Roth S, Rebmann U, Stolzenburg JU, Truss MC, Fahlenkamp D, Scholz HJ, Brahler E (2014) Psychological distress and adjustment to disease in patients before and after radical prostatectomy. Results of a prospective multi-centre study. Eur J Cancer Care 23:795–802CrossRefGoogle Scholar
  20. 20.
    Martin AD, Nakamura LY, Nunez RN, Wolter CE, Humphreys MR, Castle EP (2011) Incontinence after radical prostatectomy: a patient centered analysis and implications for preoperative counseling. J Urol 186(1):204–208CrossRefGoogle Scholar
  21. 21.
    Sciarra A, Gentilucci A, Salciccia S, Von Heland M, Ricciuti GP, Marzio V, Pierella F, Musio D, Tombolini V, Frantellizzi V, Pasquini M, Maraone A, Guandalini A, Maggi M (2018) Psychological and functional effect of different primary treatments for prostate cancer: a comparative prospective analysis. Urol Oncol 36(7):340.e7–340.e21CrossRefGoogle Scholar
  22. 22.
    Sharpley CF, Bitsika V, Christie DRH, Bradford R, Steigler A, Denham JW (2017) Psychological resilience aspects that mediate the depressive effects of urinary incontinence in prostate cancer survivors 10 years after treatment with radiation and hormone ablation. J Psychosoc Oncol 35(4):438–450CrossRefGoogle Scholar
  23. 23.
    Zenger M, Lehmann-Laue A, Stolzenburg JU, Schwalenberg T, Ried A, Hinz A (2010) The relationship of quality of life and distress in prostate cancer patients compared to the general population. GMS Psychosoc Med 7:Doc02.  https://doi.org/10.3205/psm000064 CrossRefPubMedGoogle Scholar
  24. 24.
    Holm HV, Fosså SD, Hedlund H, Dahl AA (2013) Study of generic quality of life in patients operated on for post-prostatectomy incontinence. Int J Urol 20(9):889–895CrossRefGoogle Scholar
  25. 25.
    Dess RT, Jackson WC, Suy S, Soni PD, Lee JY, Abugharib AE, Zumsteg ZS, Feng FY, Hamstra DA, Collins SP, Spratt DE (2017) Predictors of multidomain decline in health-related quality of life after stereotactic body radiation therapy (SBRT) for prostate cancer. Cancer 123(9):1635–1642CrossRefGoogle Scholar
  26. 26.
    Parahoo K, McDonough S, McCaughan E, Noyes J, Semple C, Halstead EJ, Neuberger MM, Philipp P (2015) Psychosocial interventions for men with prostate cancer: a Cochrane systematic review. BJU Int 116:174–183CrossRefGoogle Scholar
  27. 27.
    Resel-Folkersma L, Salinas-Casado J, Moreno-Sierra J (2014) Post-prostatectomy stress urinary incontinence: a review of contemporary surgical treatments. Rev Clin Gerontol 24:191–204CrossRefGoogle Scholar
  28. 28.
    Anderson CA, Omar MI, Campbell SE, Hunter KF, Cody JD, Glazener CMA (2015) Conservative management for postprostatectomy urinary incontinence. Cochrane Database Syst Rev 2015(1):CD001843.  https://doi.org/10.1002/14651858.CD001843.pub5
  29. 29.
    Segerstrom SC (2012) The Oxford handbook of psychoneuroimmunology. Oxford University Press, New YorkCrossRefGoogle Scholar
  30. 30.
    Zhang AY, Bodner DR, Fu AZ, Ganzler DD, Klein E, Kresevic D, Moore S, Ponsky L, Purdum M, Strauss G, Zhu H (2015) Effects of patient-centered interventions on persistent urinary incontinence after prostate cancer treatment: a randomized controlled trial. J Urol 194:1675–1681CrossRefGoogle Scholar
  31. 31.
    Donovan JL, Peters TJ, Abrams P, Brookes ST, de aa Rosette JJ, Schafer W (2000) Scoring the short form ICSmaleSF questionnaire. International Continence Society. J Urol 164:1948–1955CrossRefGoogle Scholar
  32. 32.
    Pfeiffer E, Johnson TM, Chiofolo RC (1981) Functional assessment of elderly subjects in four service settings. J Am Geriatr Soc 29:433–437CrossRefGoogle Scholar
  33. 33.
    Conlon M, Anderson GC (1990) Three methods of random assignment: comparison of balance achieved on potentially confounding variables. Nurs Res 39:376–379CrossRefGoogle Scholar
  34. 34.
    Hu F, Hu Y, Ma Z, Rosenberger WF (2014) Adaptive randomization for balancing over covariates. WIREs Comput Stat 6:288–303CrossRefGoogle Scholar
  35. 35.
    Nezu AM (1998) Helping cancer patients cope: a problem-solving approach. American Psychological Association, Washington, DCCrossRefGoogle Scholar
  36. 36.
    McNair DM, Lorr M, Droppleman LF (1992) EdITS Manual for the Profile of Mood States (POMS) (revised ed.). Educational and Testing Service, San DiegoGoogle Scholar
  37. 37.
    Shacam S (1983) A shortened version of the profile of mood states. J Pers Assess 47:305–306CrossRefGoogle Scholar
  38. 38.
    Brown JS, McNaughton KS, Wyman JF, Burgio KL, Harkaway R, Bergner D, Altman DS, Kaufman J, Kaufman K, Girman CJ (2003) Measurement characteristics of a voiding diary for use by men and women with overactive bladder. Urology 61:802–809CrossRefGoogle Scholar
  39. 39.
    Dmochowski RR, Sanders SW, Appell RA, Nitti VW, Davila GW (2005) Bladder-health diaries: an assessment of 3-day vs 7-day entries. BJU Int 96:1049–1054CrossRefGoogle Scholar
  40. 40.
    Charlson M, Szatrowski TP, Peterson J, Gold J (1994) Validation of a combined comorbidity index. J Clin Epidemiol 47:1245–1251CrossRefGoogle Scholar
  41. 41.
    Thorsteinsdottir T, Hedelin M, Stranne J, Valdimarsdóttir H, Wilderäng U, Haglind E, Steineck G (2013) Intrusive thoughts and quality of life among men with prostate cancer before and three months after surgery. Health Qual Life Outcomes 11:154–165CrossRefGoogle Scholar
  42. 42.
    Peh CX, Liu J, Bishop GD, Chan HY, Chua SM, Kua EH, Mahendran R (2016) Emotion regulation and emotional distress: the mediating role of hope on reappraisal and anxiety/depression in newly diagnosed cancer patients. Psycho-Oncology 26:1191–1197CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of NursingCase Western Reserve UniversityClevelandUSA
  2. 2.Cancer Prevention and Control ProgramGeorgetown University Medical CenterWashingtonUSA
  3. 3.Department of Veterans Affairs Medical CenterLouis Stokes ClevelandClevelandUSA
  4. 4.School of Medicine; University Hospitals Cleveland Medical Center, Department of UrologyCase Western Reserve UniversityClevelandUSA

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