Adult urologyProspective study of men's psychological and decision-related adjustment after treatment for localized prostate cancer
Section snippets
Material and methods
The participants were men newly diagnosed with localized prostate cancer recruited during a 20-month period from 1999 to 2001 from two hospital urology clinics and four urologists' private practices in Queensland, Australia for a study into men's decision making about cancer treatment.9 The inclusion criteria were newly diagnosed localized prostate cancer, considering treatment with curative intent; ability to read and speak English; no previous history of head injury or dementia; no concurrent
Results
The sociodemographic characteristics of the participants are described in Table I. At baseline, younger age was associated with greater levels of intrusion (r = 0.27, P <0.01), fewer sexual symptoms (r = 0.45, P <0.001), and lower sexual bother (r = 0.32, P <0.001). Men who underwent radical prostatectomy were younger (mean age 58.3 ± 7.9 years) than men who underwent external beam radiotherapy (mean age 64.5 ± 5.3 years; P = 0.002) or watchful waiting (mean age 66.6 ± 7.2 years; P <0.0005).
Comment
In contrast to previous research, we found no differences in men's psychological adjustment and global quality of life on the basis of medical treatment group, either at baseline or with time.20 The levels of psychological distress in these men were greatest close to diagnosis, decreasing significantly 2 months after treatment. Parallel to this, the patterns of adjustment for domain-specific physical effects were similar to previous studies. The symptoms were worse 2 months after treatment,
Conclusions
The treatment received did not affect the psychological or decision-related adjustment at baseline or with time, and psychological distress was not found to be associated with the treatment choice. Men's global quality of life was consistent with community norms for noncancer populations. Psychological distress was greatest close to diagnosis; however, 12 months after treatment, most men reported low distress. With time, a subgroup of men remained highly distressed, suggesting the need to trial
Acknowledgements
To the Queensland Cancer Fund and the Royal Brisbane Hospital and Redcliffe Hospital for their assistance in the undertaking of this study.
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