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Does active surveillance for men with localized prostate cancer carry psychological morbidity?

Burnet, KL; Parker, C; Dearnaley, D; Brewin, CR; Watson, M; (2007) Does active surveillance for men with localized prostate cancer carry psychological morbidity? BJU INT , 100 (3) 540 - 543. 10.1111/j.1464-410X.2007.07009.x.

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Abstract

To investigate, in a cross-sectional study, the prevalence of anxiety and depression in patients with localised prostate cancer managed by active surveillance, compared with those receiving immediate treatment, as active surveillance is a relatively new approach to managing this disease, designed to avoid 'unnecessary' treatment, but it is unclear whether the approach contributes to psychological distress, given that men are living with untreated cancer.A consecutive series of 764 patients with prostate cancer were approached in outpatient clinics. Of these, 329 men with localized disease (cT1/2, N0/NX, M0/MX) meeting the study entry criteria, completed the Hospital Anxiety and Depression Scale (HADS); 100 were on active surveillance, 81 were currently receiving radical treatment (radiotherapy + neoadjuvant hormone therapy) and 148 had previously received radical radiotherapy.Overall, 16% (51/329) of patients met the HADS criteria for anxiety and 6% (20/329) for depression. Analyses indicated that higher anxiety scores were significantly associated with younger age (P < 0.01) and a longer interval since diagnosis (P < 0.01), but not with management by active surveillance (P = 0.38). Higher depression scores were significantly associated with a longer interval since diagnosis (P < 0.05), but not with management by active surveillance (P = 0.83).Active surveillance for managing localized prostate cancer was not associated with greater psychological distress than more immediate treatment for prostate cancer.

Type: Article
Title: Does active surveillance for men with localized prostate cancer carry psychological morbidity?
DOI: 10.1111/j.1464-410X.2007.07009.x
Keywords: anxiety, depression, coping, active surveillance, localized prostate cancer, QUALITY-OF-LIFE, HOSPITAL ANXIETY, DEPRESSION SCALE, THE-LITERATURE, CARCINOMA, SUPPORT, SAMPLE, HADS
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: http://discovery.ucl.ac.uk/id/eprint/125456
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