Predictors for negative intrusive thoughts after prostate cancer diagnosis — ASN Events

Predictors for negative intrusive thoughts after prostate cancer diagnosis (#267)

Thordis Thorsteinsdottir 1 , Heiddis Valdimarsdottir 2 3 , Johan Stranne 4 , Ulrica Wilderang 1 , Eva Haglind 1 , Gunnar Steineck 5
  1. Sahlgrenska Academy of the University of Gothenburg, Gothenburg, SWE, Sweden
  2. Department of Oncological Sciences, Mount Sinai School of Medicine, New York, USA
  3. Department of Psychology, Reykjavik University, Reykjavik, Iceland
  4. Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
  5. Division of Clinical Cancer Epidemiology, Department of Oncology–Pathology, Karolinska Insitutet, Stockholm, Sweden

Objective: Men’s reactions to prostate cancer diagnosis, such as intrusive thoughts, may affect their treatment decision and constitute a target for psychological interventions. The aim was to determine if low preparedness for potential side effects of surgery and pessimistic attitudes towards cure were related to higher prevalence of intrusive thoughts among men undergoing radical prostatectomy.

Methods: A total of 971 men with clinically localized prostate cancer were enrolled from September 1, 2008 to August 31, 2009 at the 14 urological departments participating in the LAPPRO trial. Of this group, 833 (86%) men answered two consecutive study-specific questionnaires before and three months after surgery.Questions were stated before surgery on health background and care-related factors seen as possible predictors, and on the outcome, negative intrusive thoughts, before and three months after surgery. The associations between the variables were analyzed statistically by log-binominal and multivariate approach.

Results: The following factors were independently associated with negative intrusive thoughts before surgery: uncertainty of cure [prevalence ratio (PR) 1.9, 95% confidence interval (CI) 1.5 to 2.3], not being prepared for urinary [PR 1.31, CI 1.1 to 1.6], or sexual bother [PR 1.3, CI 1.1 to 1.6]. Reporting negative intrusive thoughts before surgery was the strongest predictor for reporting such thoughts three months after surgery [adjusted odds ratio 3.6, CI 2.4 to 5.4].

Conclusion: Responsive communication before radical prostatectomy, especially for vulnerable individuals, about prospects for cure and surgery-induced urinary or sexual dysfunction could alleviate negative intrusive thoughts and thereby influence men’s psychological well-being after surgery.