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The prevalence, severity, and correlates of psychological distress and impaired health-related quality of life following treatment for testicular cancer: a survivorship study

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Abstract

Purpose

This study aimed to establish the prevalence, severity, and correlates of psychological distress and impaired generic health-related quality of life (HRQOL) in testicular cancer (TC) survivors.

Methods

Men who had completed active anti-cancer treatment for TC between 6 months and 5 years previously showing no evidence of recurrence were recruited from 14 Australian cancer centers from September 2009 to February 2011. Participants completed a self-report questionnaire measuring demographic, disease, and treatment information, psychological distress (i.e., depression, anxiety, and stress; DASS21), generic health-related quality of life (HRQOL; SF-36v2), TC-specific HRQOL (EORTC QLQ-TC26), coping (MAC), social support (DUFSS), and unmet needs (CaSUN).

Results

Of 486 eligible TC survivors, 244 (50.2 %) completed the questionnaire. Compared with normative data, TC survivors reported: small but statistically significant increases in mean levels of anxiety and depression; a greater prevalence of moderate to extremely severe anxiety (19 %) and depression (20 %); and significant deficits to mostly mental aspects of generic HRQOL. The most problematic TC-specific HRQOL issues (e.g., fear of recurrence) were also more mental than physical. In multiple regression analyses, the strongest correlates of psychological distress and impaired generic HRQOL were psychosocial (e.g., helpless/hopeless coping and lower social support) rather than disease or treatment factors.

Conclusions

Generally, TC survivors appear to experience mild psychological distress and HRQOL impairments, while a vulnerable subgroup experience more severe morbidity.

Implications for Cancer Survivors

There is a need to identify TC survivors at risk of poorer outcomes and for interventions to target the areas of greatest impairment (i.e., psychological distress and mental HRQOL).

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Acknowledgments

This study was co-funded by beyondblue and Cancer Australia (grant number 507961). Dr Allan “Ben” Smith was supported by an Australian Rotary Health Ian Scott Scholarship. Professor Butow holds a NHMRC Senior Principal Research Fellowship, and Professor King is supported by the Australian Government through Cancer Australia. The study was conducted by PoCoG in collaboration with ANZUP. The authors would like to thank all the men who participated in the study, as well as investigators and trials staff at the following hospitals: Border Medical Oncology, Canberra, Concord Repatriation General, Flinders Medical Centre, Liverpool, Princess Alexandra, Peter MacCallum Cancer Centre, Prince of Wales, Royal Adelaide, Royal North Shore, Royal Prince Alfred, St George, Tweed and Westmead.

Conflicts of interest

The authors declare that they have no competing interests.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

Author information

Authors and Affiliations

  1. Psycho-Oncology Co-operative Research Group (PoCoG), Chris O’Brien Lifehouse (C39Z), University of Sydney, Sydney, NSW, 2006, Australia

    Allan “Ben” Smith, Phyllis Butow & Madeleine T. King

  2. Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia

    Allan “Ben” Smith, Peter Grimison, Guy C. Toner, Martin R Stockler, Elizabeth Hovey, John Stubbs & Madeleine T. King

  3. Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia

    Ian Olver

  4. Improving Palliative Care through Clinical Trials (ImPaCCT), South Western Sydney Clinical School, The University of New South Wales, and Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia

    Tim Luckett

  5. Chris O’Brien Lifehouse and University of Sydney, Sydney, NSW, Australia

    Peter Grimison

  6. Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC, Australia

    Guy C. Toner

  7. Chris O’Brien Lifehouse, Sydney, NSW, Australia

    Martin R Stockler, George Hruby & Keith Cox

  8. Prince of Wales Hospital, Sydney, NSW, Australia

    Elizabeth Hovey

  9. CanSpeak, Sydney, NSW, Australia

    John Stubbs

  10. Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia

    Sandra Turner & Howard Gurney

  11. Liverpool Hospital, Sydney, NSW, Australia

    Mahmood Alam

  12. Central Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia

    Madeleine T. King

  13. Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, NSW, Australia

    Martin R Stockler & George Hruby

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  1. Allan “Ben” Smith
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  2. Phyllis Butow
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  15. Madeleine T. King
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Corresponding author

Correspondence to Allan “Ben” Smith.

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Smith, A.“., Butow, P., Olver, I. et al. The prevalence, severity, and correlates of psychological distress and impaired health-related quality of life following treatment for testicular cancer: a survivorship study. J Cancer Surviv 10, 223–233 (2016). https://doi.org/10.1007/s11764-015-0468-5

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  • DOI: https://doi.org/10.1007/s11764-015-0468-5

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