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The prevalence,severity, and correlates of psychological distress and impaired health-related quality of life following treatment for testicular cancer: a survivorship study
Authors:Allan “Ben” Smith  Phyllis Butow  Ian Olver  Tim Luckett  Peter Grimison  Guy C. Toner  Martin R Stockler  Elizabeth Hovey  John Stubbs  Sandra Turner  George Hruby  Howard Gurney  Mahmood Alam  Keith Cox  Madeleine T. King
Affiliation:1.Psycho-Oncology Co-operative Research Group (PoCoG), Chris O’Brien Lifehouse (C39Z),University of Sydney,Sydney,Australia;2.Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP),Sydney,Australia;3.Sansom Institute for Health Research,University of South Australia,Adelaide,Australia;4.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,Australia;5.Chris O’Brien Lifehouse and University of Sydney,Sydney,Australia;6.Peter MacCallum Cancer Centre and University of Melbourne,Melbourne,Australia;7.Chris O’Brien Lifehouse,Sydney,Australia;8.Prince of Wales Hospital,Sydney,Australia;9.CanSpeak,Sydney,Australia;10.Crown Princess Mary Cancer Centre,Westmead Hospital,Sydney,Australia;11.Liverpool Hospital,Sydney,Australia;12.Central Clinical School, Sydney Medical School,University of Sydney,Sydney,Australia;13.Concord Cancer Centre,Concord Repatriation General Hospital,Sydney,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:
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