Psychological reactions to biochemical recurrence after radical prostatectomy in men with localized prostate cancer

摘要

A rising PSA following radical prostatectomy (RP) is a possible indicator of recurrence, which is called biochemical recurrence (BCR), and it may concern patients because it can signal that potentially lethal cancer cells remain in the body. Little is known about the psychological reactions to BCR. The purpose of this study was to describe the relation between BCR and psychological outcomes over time in men with localized prostate cancer who have been treated by RP. One hundred and twenty four men who underwent RP (mean age 62.86 years) were interviewed first within two months after surgery (T1) and then approximately 12 months later (T2). A modified version of Radloffs Center for Epidemiologic Studies Depression Scale (CESD) was used for measuring depressive symptoms. Mishel's Uncertainty in Illness Scale (MUIS) and Horowitz's Impact of Event Scale were used to measure uncertainty (IES), intrusion and avoidance about cancer and its treatment, respectively. Cancer-specific physical symptoms including urinary, bowel, and sexual bother and function were measured using the UCLA Prostate Cancer Index (PCI). Medical records were reviewed to code BCR (PSA ≥ .2 ng/ml).;Twenty five (20.16%) men had BCR. The findings indicated that both groups (men with versus men without BCR) showed significant improvement in all PCI domains, with the exception of sexual bother, by T2. ANCOVA technique revealed that relative to men without BCR, men with BCR had significantly slower declines in depressive symptoms (p < .05), significantly greater increases in the level of intrusive thoughts (p < .05), a marginally greater level of avoidance (p = .1), and equal levels of uncertainty about their illness. In both waves of the study, no statistically significant differences were found in the level of sexual, urinary, or bowel bother and functioning between the two groups.;It is concluded that men with BCR react to their illness and its treatments differently from men without BCR. Some men may benefit from educational or psychological interventions to resolve ruminations and distresses associated with BCR and improve their quality of life.