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The association of cancer-specific anxiety with disease aggressiveness in men on active surveillance of prostate cancer.

Publication ,  Journal Article
Naha, U; Freedland, SJ; Abern, MR; Moreira, DM
Published in: Prostate Cancer Prostatic Dis
June 2021

BACKGROUND: Active surveillance (AS) provides appropriate prostate cancer (PCa)-specific survival while minimizing morbidity, but underlying worry of PCa can generate anxiety. The aim of the study is to evaluate anxiety levels in men on AS and how anxiety relates to disease characteristics and treatment decision-making. METHODS: A retrospective analysis was conducted using all 302 subjects from the Reduction by Dutasteride of clinical progression Events in Expectant Management (REDEEM) study. Prostate biopsies were obtained at 18 and 36 months. Anxiety was measured at baseline and 3, 6, 12, 18, and 36 months post-randomization using the MAX-PC (Memorial general anxiety scale for PCa) questionnaire. Univariable and multivariable analysis of the association of disease aggressiveness (PSA levels, percentage of positive cores, and maximum core involvement) and anxiety levels were performed. Cox regression was used to analyze time to progression to discontinuation of active surveillance as a function of baseline anxiety. RESULTS: Overall, MAX-PC scores decreased from moderate at baseline with slight increases after receiving PSA results at 18 months, followed by more decline. Percentage of positive cores was associated with baseline anxiety (P = 0.02). The association remained when controlling for age, race, number of cores sampled, body mass index, prostate volume, and maximum core length (P = 0.003). In univariable and multivariable analysis, baseline anxiety was not significantly associated with time to progression to discontinuation of active surveillance. CONCLUSIONS: In evaluating the natural history of anxiety levels among patients with prostate cancer undergoing active surveillance, there was a decline of anxiety levels over time, with increases after receiving PSA results. Moreover, we found that disease aggressiveness measured by percentage of positive biopsy cores was associated with baseline levels of anxiety. However, anxiety had no impact on clinical or therapeutic progression.

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Published In

Prostate Cancer Prostatic Dis

DOI

EISSN

1476-5608

Publication Date

June 2021

Volume

24

Issue

2

Start / End Page

335 / 340

Location

England

Related Subject Headings

  • Watchful Waiting
  • Urology & Nephrology
  • Surveys and Questionnaires
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prognosis
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
 

Citation

APA
Chicago
ICMJE
MLA
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Naha, U., Freedland, S. J., Abern, M. R., & Moreira, D. M. (2021). The association of cancer-specific anxiety with disease aggressiveness in men on active surveillance of prostate cancer. Prostate Cancer Prostatic Dis, 24(2), 335–340. https://doi.org/10.1038/s41391-020-00279-z
Naha, Ushasi, Stephen J. Freedland, Michael R. Abern, and Daniel M. Moreira. “The association of cancer-specific anxiety with disease aggressiveness in men on active surveillance of prostate cancer.Prostate Cancer Prostatic Dis 24, no. 2 (June 2021): 335–40. https://doi.org/10.1038/s41391-020-00279-z.
Naha U, Freedland SJ, Abern MR, Moreira DM. The association of cancer-specific anxiety with disease aggressiveness in men on active surveillance of prostate cancer. Prostate Cancer Prostatic Dis. 2021 Jun;24(2):335–40.
Naha, Ushasi, et al. “The association of cancer-specific anxiety with disease aggressiveness in men on active surveillance of prostate cancer.Prostate Cancer Prostatic Dis, vol. 24, no. 2, June 2021, pp. 335–40. Pubmed, doi:10.1038/s41391-020-00279-z.
Naha U, Freedland SJ, Abern MR, Moreira DM. The association of cancer-specific anxiety with disease aggressiveness in men on active surveillance of prostate cancer. Prostate Cancer Prostatic Dis. 2021 Jun;24(2):335–340.

Published In

Prostate Cancer Prostatic Dis

DOI

EISSN

1476-5608

Publication Date

June 2021

Volume

24

Issue

2

Start / End Page

335 / 340

Location

England

Related Subject Headings

  • Watchful Waiting
  • Urology & Nephrology
  • Surveys and Questionnaires
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prognosis
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies