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J Cancer Surviv. 2016 Apr;10(2):223-33. doi: 10.1007/s11764-015-0468-5. Epub 2015 Jul 16.

The prevalence, severity, and correlates of psychological distress and impaired health-related quality of life following treatment for testicular cancer: a survivorship study.

Author information

1
Psycho-Oncology Co-operative Research Group (PoCoG), Chris O'Brien Lifehouse (C39Z), University of Sydney, Sydney, NSW, 2006, Australia. allan.smith@sydney.edu.au.
2
Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia. allan.smith@sydney.edu.au.
3
Psycho-Oncology Co-operative Research Group (PoCoG), Chris O'Brien Lifehouse (C39Z), University of Sydney, Sydney, NSW, 2006, Australia.
4
Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia.
5
Improving Palliative Care through Clinical Trials (ImPaCCT), South Western Sydney Clinical School, The University of New South Wales, and Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
6
Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.
7
Chris O'Brien Lifehouse and University of Sydney, Sydney, NSW, Australia.
8
Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC, Australia.
9
Chris O'Brien Lifehouse, Sydney, NSW, Australia.
10
Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, NSW, Australia.
11
Prince of Wales Hospital, Sydney, NSW, Australia.
12
CanSpeak, Sydney, NSW, Australia.
13
Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia.
14
Liverpool Hospital, Sydney, NSW, Australia.
15
Central Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.

Abstract

PURPOSE:

This study aimed to establish the prevalence, severity, and correlates of psychological distress and impaired generic health-related quality of life (HRQOL) in testicular cancer (TC) survivors.

METHODS:

Men who had completed active anti-cancer treatment for TC between 6 months and 5 years previously showing no evidence of recurrence were recruited from 14 Australian cancer centers from September 2009 to February 2011. Participants completed a self-report questionnaire measuring demographic, disease, and treatment information, psychological distress (i.e., depression, anxiety, and stress; DASS21), generic health-related quality of life (HRQOL; SF-36v2), TC-specific HRQOL (EORTC QLQ-TC26), coping (MAC), social support (DUFSS), and unmet needs (CaSUN).

RESULTS:

Of 486 eligible TC survivors, 244 (50.2%) completed the questionnaire. Compared with normative data, TC survivors reported: small but statistically significant increases in mean levels of anxiety and depression; a greater prevalence of moderate to extremely severe anxiety (19%) and depression (20%); and significant deficits to mostly mental aspects of generic HRQOL. The most problematic TC-specific HRQOL issues (e.g., fear of recurrence) were also more mental than physical. In multiple regression analyses, the strongest correlates of psychological distress and impaired generic HRQOL were psychosocial (e.g., helpless/hopeless coping and lower social support) rather than disease or treatment factors.

CONCLUSIONS:

Generally, TC survivors appear to experience mild psychological distress and HRQOL impairments, while a vulnerable subgroup experience more severe morbidity.

IMPLICATIONS FOR CANCER SURVIVORS:

There is a need to identify TC survivors at risk of poorer outcomes and for interventions to target the areas of greatest impairment (i.e., psychological distress and mental HRQOL).

KEYWORDS:

Health-related quality of life; Oncology; Psychological distress; Survivorship; Testicular cancer

PMID:
26178326
DOI:
10.1007/s11764-015-0468-5
[Indexed for MEDLINE]

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