Fear of Recurrence, Symptom Burden, and Health-Related Quality of Life in Men With Prostate Cancer

OBJECTIVES To examine the contributions of fear of recurrence and the more commonly examined treatment-related symptoms to the health-related quality of life (HRQOL) of men treated for localized prostate cancer. METHODS A total of 730 men with localized disease were identified from the Cancer of the Prostate Strategic Urologic Research Endeavor, a national, prospective study of men with prostate cancer. Pre- to post-treatment changes in fear of recurrence, treatment-specific symptoms and burden, comorbidities at diagnosis, number of new symptoms, and post-treatment HRQOL data were analyzed. RESULTS Linear regression, adjusted for clinical and demographic characteristics, showed that improved fear of recurrence (P <0.01), higher number of post-treatment symptoms (P <0.01), and improved bowel function (P <0.01) significantly predicted better mental health scores. For physical health, improved urinary bother (P <0.01) and lower number of post-treatment symptoms (P <0.01) were associated with better physical health. CONCLUSION Understanding men's fears about cancer recurrence and how these fears influence physical and mental health are important components of providing care to this growing population. UROLOGY 72: 1269-1273, 2008. (C) 2008 Elsevier Inc.