The association of cancer-specific anxiety with disease aggressiveness in men on active surveillance of prostate cancer

ABSTRACT BACKGROUND Active surveillance (AS) provides appropriate prostate cancer (PCa)-specific survival while minimizing morbidity, but underlying worry of PCa can generate anxiety. The

aim of the study is to evaluate anxiety levels in men on AS and how anxiety relates to disease characteristics and treatment decision-making. METHODS A retrospective analysis was conducted

using all 302 subjects from the Reduction by Dutasteride of clinical progression Events in Expectant Management (REDEEM) study. Prostate biopsies were obtained at 18 and 36 months. Anxiety

was measured at baseline and 3, 6, 12, 18, and 36 months post-randomization using the MAX-PC (Memorial general anxiety scale for PCa) questionnaire. Univariable and multivariable analysis of

the association of disease aggressiveness (PSA levels, percentage of positive cores, and maximum core involvement) and anxiety levels were performed. Cox regression was used to analyze time

to progression to discontinuation of active surveillance as a function of baseline anxiety. RESULTS Overall, MAX-PC scores decreased from moderate at baseline with slight increases after

receiving PSA results at 18 months, followed by more decline. Percentage of positive cores was associated with baseline anxiety (_P_ = 0.02). The association remained when controlling for

age, race, number of cores sampled, body mass index, prostate volume, and maximum core length (_P_ = 0.003). In univariable and multivariable analysis, baseline anxiety was not significantly

associated with time to progression to discontinuation of active surveillance. CONCLUSIONS In evaluating the natural history of anxiety levels among patients with prostate cancer undergoing

active surveillance, there was a decline of anxiety levels over time, with increases after receiving PSA results. Moreover, we found that disease aggressiveness measured by percentage of

positive biopsy cores was associated with baseline levels of anxiety. However, anxiety had no impact on clinical or therapeutic progression. Access through your institution Buy or subscribe

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IMPACT OF ACTIVE SURVEILLANCE FOR PROSTATE CANCER ON THE RISK OF DEPRESSION AND ANXIETY Article Open access 28 July 2022 THE EFFECTIVENESS OF PSYCHOLOGICAL INTERVENTION FOR DEPRESSION,

ANXIETY, AND DISTRESS IN PROSTATE CANCER: A SYSTEMATIC REVIEW OF LITERATURE Article 09 March 2021 COMPARISON OF PROCEDURAL ANXIETY AND PAIN ASSOCIATED WITH CONVENTIONAL TRANSRECTAL

ULTRASOUND PROSTATE BIOPSY TO MAGNETIC RESONANCE IMAGING-ULTRASOUND FUSION-GUIDED BIOPSY: A PROSPECTIVE COHORT TRIAL Article 25 November 2023 CODE AVAILABILITY All computer code used to

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AFFILIATIONS * Department of Urology, University of Illinois College of Medicine, Chicago, IL, USA Ushasi Naha, Michael R. Abern & Daniel M. Moreira * Division of Urology, Department of

Surgery and the Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA Stephen J. Freedland * Urology Section, Veterans Affairs Medical Center,

Durham, NC, USA Stephen J. Freedland Authors * Ushasi Naha View author publications You can also search for this author inPubMed Google Scholar * Stephen J. Freedland View author

publications You can also search for this author inPubMed Google Scholar * Michael R. Abern View author publications You can also search for this author inPubMed Google Scholar * Daniel M.

Moreira View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Daniel M. Moreira. ETHICS DECLARATIONS CONFLICT OF

INTEREST The authors declare that they have no conflict of interest. ADDITIONAL INFORMATION PUBLISHER’S NOTE Springer Nature remains neutral with regard to jurisdictional claims in published

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FIGURE LEGENDS RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Naha, U., Freedland, S.J., Abern, M.R. _et al._ The association of cancer-specific anxiety

with disease aggressiveness in men on active surveillance of prostate cancer. _Prostate Cancer Prostatic Dis_ 24, 335–340 (2021). https://doi.org/10.1038/s41391-020-00279-z Download

citation * Received: 14 May 2020 * Revised: 13 August 2020 * Accepted: 27 August 2020 * Published: 08 September 2020 * Issue Date: June 2021 * DOI: https://doi.org/10.1038/s41391-020-00279-z

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