To explore ongoing symptoms, unmet needs, psychological wellbeing, self-efficacy and overall health status in prostate cancer survivors.
An invitation to participate in a postal questionnaire survey was sent to 546 men, diagnosed with prostate cancer 9 - 24 months previously at two UK cancer centres. The study group comprised men who had been subject to a range of treatments: surgery, radiotherapy, hormone therapy and active surveillance. The questionnaire included measures of prostate-related quality of life (EPIC-26); unmet needs (SCNS SF34); anxiety and depression (HADS), self-efficacy (modified Self-efficacy Scale), health status (EQ-5D) and satisfaction with care (questions developed for study). A single reminder was sent to non-responders after three weeks. Data were analysed by age, co-morbidities, and treatment group.
316 men completed questionnaires (64.1% response rate). Overall satisfaction with follow-up care was high, but was lower for psychosocial than physical aspects of care. Urinary, bowel, and sexual functioning was reported as a moderate/big problem in the last month for 15.2% (n = 48), 5.1% (n = 16), and 36.5% (n = 105) men, respectively. The most commonly reported moderate/high unmet needs related to changes in sexual feelings/relationships, managing fear of recurrence/uncertainty, and concerns about the worries of significant others. It was found that 17% of men (n = 51/307) reported potentially moderate to severe levels of anxiety and 10.2% reported moderate to severe levels of depression (n = 32/308). The presence of problematic side-effects was associated with higher psychological morbidity, poorer self-efficacy, greater unmet needs, and poorer overall health status.
While some men report relatively few problems following prostate cancer treatment, this study highlights important physical and psycho-social issues for a significant minority of prostate cancer survivors. Strategies for identifying those men with on-going problems, alongside new interventions and models of care, tailored to individual needs, are needed to improve quality of life. This article is protected by copyright. All rights reserved.