Psychological stress in long-term testicular cancer survivors: a Danish nationwide cohort study

Kreiberg, Michael; Bandak, Mikkel; Lauritsen, Jakob; Andersen, Klaus Kaae; Skøtt, Julie Wang; Johansen, Christoffer; Agerbæk, Mads; Holm, Niels V.; Lau, Cathrine Juel; Daugaard, Gedske

doi:10.1007/s11764-019-00835-0

Cited by 13 publications

(18 citation statements)

References 30 publications

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“… 30 Study assessment time points varied from an average of 3 to 19 years post-diagnosis, or 6 months to 11.9 years post-treatment. Only two studies 28 , 31 had a comparison group of non-TC survivors.…”

Section: Resultsmentioning

confidence: 99%

“…31 These authors also found that TC survivors had a higher prevalence of distress than the general men population until the age of 70 (after this age, the general population becomes the more distressed). 31 Distress was also found to be related to Cognitive-Emotional Regulation (R2=37%) in one study. 33 Cancer Management and Research 2021:13…”

Section: Correlates Of Distressmentioning

confidence: 90%

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An Updated Systematic Review of Quantitative Studies Assessing Anxiety, Depression, Fear of Cancer Recurrence or Psychological Distress in Testicular Cancer Survivors

Rincones¹,

Smith²,

Naher³

et al. 2021

CMAR

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Purpose: A diagnosis of testicular cancer (TC) at a relatively young age can have a dramatic impact on the psychological well-being of those affected. The aim of this review was to synthesize recent evidence to provide an updated account of the prevalence, severity and correlates of anxiety, depression, fear of cancer recurrence (FCR) and distress in TC survivors. Patients and Methods: A systematic literature review was conducted from September 2017 until June 2020 using electronic databases including Embase, MEDLINE, PsycINFO, Scopus and Web of Science. Study eligibility and quality were independently assessed by two reviewers. Narrative synthesis was used to depict the severity (mean/median scores), prevalence (proportions above standard clinical thresholds) and correlates of study outcomes. Results: A total of 988 articles were identified for screening after duplicate removal. Fiftysix full-text articles were screened, and eight articles met the inclusion criteria. The reported prevalence of the outcomes varied across studies (clinical levels of anxiety ranged from 6.9% to 21.1%, depression varied from 4.7% to 7%, distress was found between 25% and 41.4%, prevalence of FCR was not reported). Few studies compared TC survivors with other populations. Correlates of poorer psychological outcomes included younger age, relationship status, employment status, poorer sexual functioning, impaired masculinity and coping strategies. Conclusion: Anxiety seems to be the most common issue for TC survivors. Men who are single or unemployed appear most at risk of poorer psychological outcomes, which seem associated with impaired masculinity and sexual function. More research is needed to identify TC survivors most likely to need one of the increasing number of psychological interventions being developed for TC survivors.

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Section: Resultsmentioning

confidence: 99%

Section: Correlates Of Distressmentioning

confidence: 90%

An Updated Systematic Review of Quantitative Studies Assessing Anxiety, Depression, Fear of Cancer Recurrence or Psychological Distress in Testicular Cancer Survivors

Rincones¹,

Smith²,

Naher³

et al. 2021

CMAR

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“…Cancer survivors were also shown to have a higher level of psychological disorders, e.g. depression or anxiety disorders (Kreiberg et al 2020). These comorbidities impose a significant impact on the health-related quality of life after treatment.…”

Section: Discussionmentioning

confidence: 99%

Testicular cancer follow-up costs in Germany from 2000 to 2015

Michaeli

2021

J Cancer Res Clin Oncol

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Purpose Advances in testicular cancer screening and therapy increased 10-year survival to 97% despite a rising incidence; eventually expanding the population of survivors requiring follow-up. We analyzed 10-year follow-up costs after testicular cancer treatment in Germany during 2000, 2008, and 2015. Methods Testicular cancer follow-up guidelines were extracted from the European Association of Urology. Per patient costs were estimated with a micro-costing approach considering direct and indirect medical expenses derived from expert interviews, literature research, and official scales of tariffs. Three perspectives covering costs for patients, providers, and insurers were included to estimate societal costs. Cost progression was compared across cancer histology, stage, stakeholders, resource use, and follow-up years. Results Mean 10-year follow-up costs per patient for stage I seminomatous germ-cell tumors (SGCT) on surveillance declined from EUR 11,995 in 2000 to EUR 4,430 in 2015 (p < 0.001). Advanced SGCT spending shrank from EUR 13,866 to EUR 9,724 (p < 0.001). In contrast, expenditure for stage II SGCT increased from EUR 7,159 to EUR 9,724 (p < 0.001). While insurers covered 32% of costs in 2000, only 13% of costs were reimbursed in 2015 (p < 0.001). 70% of SGCT follow-up resources were consumed by medical imaging (x-ray, CT, ultrasound, FDG-PET). Spending was unevenly distributed across follow-up years (years 1–2: 50%, years 3–5: 39%, years 5–10: 11%). Conclusions The increasing prevalence of testicular cancer survivors caused German statutory insurers to cut per patient cost by up to 80% by budgeting services and decreasing reimbursement rates. The economic burden was gradually redistributed to patients and providers.

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“…Therefore, psycho-oncological support should routinely address these issues during follow-up care, when patients may have more resources to talk about more complex issues and emotions such as embarrassment. Even more so because high levels of distress, mainly anxiety and fear of cancer recurrence, are reported for testicular cancer survivors [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Primary Chemotherapy in a 47-Year-Old Patient with Giant Ulcerative and Necrotizing Nonseminomatous Testicular Germ Cell Tumor

et al. 2021

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Testicular cancer is a rare disease; however, cure rates are high for all tumor stages. Mostly, the disease is diagnosed in an early (local) stage. We report the case of a 47-year-old male patient with a giant nonseminomatous germ cell tumor. At the time of diagnosis, the patient demonstrated a necrotizing and ulcerating growing mass in the left scrotum with an approximate size of 22 × 18 cm. According to the prognostic classification of the International Germ Cell Cancer Collaborative Group (IGCCCG 1997), the patient exhibited a high-risk profile due to alpha-fetoprotein >10,000 ng/mL and lactate dehydrogenase >10× the upper limit of normal in serum. Primary orchiectomy was infeasible due to the tumor’s size, the patient’s poor general condition and initial intensive care unit treatment. Primary systemic chemotherapy was applied. After 3 cycles of cisplatin, etoposide and bleomycin, along with 1 cycle of cisplatin, etoposide and ifosfamide, tumor resection with histomorphological examination showed a complete pathological response. Despite the delayed initiation of the therapy, primary chemotherapy was completed timely and showed promising results. Reasons for the late hospitalization were personal responsibilities regarding his family. Better awareness and knowledge of testicular cancer among young men might prevent the here reported delay of medical consultation and avoid testicular tumors of such enormous size. Psychosocial assessment and distress management is important as an integral part of comprehensive care of testicular cancer patients.

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Psychological stress in long-term testicular cancer survivors: a Danish nationwide cohort study

Cited by 13 publications

References 30 publications

An Updated Systematic Review of Quantitative Studies Assessing Anxiety, Depression, Fear of Cancer Recurrence or Psychological Distress in Testicular Cancer Survivors

An Updated Systematic Review of Quantitative Studies Assessing Anxiety, Depression, Fear of Cancer Recurrence or Psychological Distress in Testicular Cancer Survivors

Testicular cancer follow-up costs in Germany from 2000 to 2015

Primary Chemotherapy in a 47-Year-Old Patient with Giant Ulcerative and Necrotizing Nonseminomatous Testicular Germ Cell Tumor

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