Anxiety and health‐related quality of life (HRQL) in patients undergoing active surveillance of prostate cancer in an Australian centre

Abstract

Objective To assess anxiety, health‐related quality of life (HRQL) and understanding of active surveillance (AS) in a cohort of patients enrolled in AS of prostate cancer in an Australian setting. Patients and Methods Survey of 61 men currently enrolled in AS for prostate cancer, which included validated measures of sexual function using the International Index of Erectile Function (IIEF‐5), voiding using the International Prostate Symptom Severity Score (IPSS) and the Memorial Anxiety Scale for Prostate Cancer (MAX‐PC), a measure of prostate cancer specific anxiety. Three novel questions to assess patients' Understanding of AS (UAS). IIEF‐5 and IPSS scores obtained through the present survey were compared with patients' scores at initiation of AS. Results In all, 47 of 61 (77%) patients responded to the survey. There was no significant difference in patients' IIEF‐5 and IPSS scores at commencement of AS compared with the survey results. Our patients' on AS MAX‐PC scores were consistent with other published cohorts and did not suggest high rates of clinically significant anxiety amongst this cohort. Most (89%) of the patients' responses to the UAS indicated a correct understanding of AS. Conclusion Our patients on AS maintained their HRQL with low levels of anxiety, which did not differ from those reported in other groups of men with prostate cancer and most had an appropriate understanding of AS. This study represents one of the first Australasian investigations on HRQL and anxiety in men on AS of prostate cancer.

How Does Active Surveillance for Prostate Cancer Affect Quality of Life? A Systematic Review

“…There was a low frequency of general and disease-specific anxiety in all five AS studies that assessed anxiety (usually in the range of 4-15%) [19,21,22,24,27]. Two studies also highlighted that anxiety scores of AS patients were comparable to those of radical prostatectomy patients [19,21].…”

“…More generally, since the values scored by both men and their partners were within the normal range of the general population, the authors concluded that anxiety for these individuals was not clinically relevant. Similarly, Wilcox et al [27] underlined that the level of anxiety relating specifically to PCa in a cohort of Australian patients on AS was below the defined threshold of clinical relevance.…”

Active surveillance in Canadian men with low-grade prostate cancer

“…8 Active surveillance consists of close observation via a regimen of periodic PSA measurements, digital rectal examinations and serial prostate biopsies, with the goal of offering curative therapy in the event of disease progression or reclassification. Evidence suggests that active surveillance for low-grade prostate cancer is a safe and feasible management option that is well tolerated by patients 9,10 and does not substantially compromise oncologic outcomes. 11,12 Although a variety of selection criteria for active surveillance exist, most patients with a diagnosis of low-grade (Gleason score 6) cancer may be candidates.…”

Disease-specific and patient-reported outcomes under active surveillance

“…Anderson et al [25] found that trait anxiety and fear of recurrence were significant predictors for both PCa-related and total HRQoL. Wilcox et al [26] reported on 47 active surveillance patients who had completed HRQoL measures in an Australasian setting. Their results did not differ from those reported in other groups of men on active surveillance.…”