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Quality of Life Research
Published in: Quality of Life Research 10/2019

Open Access 01-10-2019 | Prostate Cancer

Cancer-related symptoms, mental well-being, and psychological distress in men diagnosed with prostate cancer treated with androgen deprivation therapy

Authors: Sarah Wilding, Amy Downing, Penny Wright, Peter Selby, Eila Watson, Richard Wagland, David W. Donnelly, Luke Hounsome, Hugh Butcher, Malcolm Mason, Ann Henry, Anna Gavin, Adam W. Glaser

Published in: Quality of Life Research | Issue 10/2019

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Abstract

Purpose

There are known associations between treatment of prostate cancer (PCa) involving Androgen Deprivation Therapy (ADT) and psychological and physical side effects. We investigate the associations between cancer-related symptoms, health-related quality of life (HRQL), and poor psychological outcomes in men whose treatment for PCa involved ADT.

Methods

A cross-sectional postal questionnaire was administered to UK men 18–42 months post diagnosis of PCa. Men completed items on functional outcomes using the Expanded Prostate Cancer Index Composite (EPIC-26), EuroQol-5D (EQ-5D), and the European Organisation for Research and Treatment of Cancer (EORTC) Fatigue subscale. Psychological outcomes (mental well-being and psychological distress) were assessed using the Short Warwick–Edinburgh Mental Well-being Scale (SWEMWBS) and the Kessler 6-item scale (K6), respectively. Associations between explanatory variables and psychological outcomes were assessed using stepped logistic regression.

Results

13,097 men treated with ADT completed a questionnaire. A minority of men reported poor mental well-being (15.5%) or severe psychological distress (6.6%). After controlling for sociodemographic and clinical variables, reporting clinically significant fatigue was strongly associated with severe psychological distress (OR 9.92; 95% CI 7.63 to 12.89) and poor well-being (OR 3.86; 95% CI 3.38 to 4.42). All cancer-related symptoms and HRQL variables were associated with both psychological outcomes.

Conclusions

While the majority of men treated with ADT did not report poor psychological outcomes, a small proportion reported severe problems. Clinically significant fatigue was demonstrated as a possible indicator of poor outcomes. Healthcare systems need to have clear protocols in place which specifically and routinely target psychological distress and fatigue.
Appendix
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Metadata
Title
Cancer-related symptoms, mental well-being, and psychological distress in men diagnosed with prostate cancer treated with androgen deprivation therapy
Authors
Sarah Wilding
Amy Downing
Penny Wright
Peter Selby
Eila Watson
Richard Wagland
David W. Donnelly
Luke Hounsome
Hugh Butcher
Malcolm Mason
Ann Henry
Anna Gavin
Adam W. Glaser
Publication date
01-10-2019
Publisher
Springer International Publishing
Published in
Quality of Life Research / Issue 10/2019
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-019-02212-x

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