Obvious but overlooked-Partner important in prostate cancer

  • Partners relieve prostate cancer men’s fear

  • Published date :
    Oct 6, 2009

    MedWire News: Men with prostate cancer have significantly less anxiety about disease recurrence if they have a partner, according to US research.

    However, the study findings also show that men who are in partnerships and have high socioeconomic status have similar physical and mental health to un-partnered men of the same status, and irrespective of whether men with prostate cancer have a partner or not, multiple comorbid conditions appear to significantly worsen mental states and health-related quality of life (HRQoL).

    “Identifying men at increased risk for low HRQoL may help us address the underlying factors associated with psychological distress,” say Jonathan Bergman, from the University of California at Los Angeles, and team in the journal Cancer.

    A total of 476 men with clinically localized prostate cancer participated in the study, which compared clinical characteristics such as treatment type, comorbidities, prostate-specific antigen level, biopsy Gleason score, and clinical T classification between partnered and un-partnered men.

    Disease-specific QoL were taken at baseline, and again at regular intervals up to 48 months after treatment. HRQoL was assessed using the University of California at Los Angeles Prostate Cancer Index, which captures urinary, sexual, and bowel function and bother scores.

    Anxiety related to prostate cancer recurrence was measured using the Memorial Anxiety Scale for Prostate Cancer.

    Among the cohort, 85% of men had a partner and 15% did not.

    Multivariate analysis of baseline HRQoL data showed that men with and without partners had similar physical and mental health. The only difference was that men with partners tended to have less bowel bother and were less fearful of disease recurrence than un-partnered men.

    Taking into account changes in HRQoL from baseline to 12 months did not alter the findings. However, treatment type did have an effect, with men receiving radiation (whether brachytherapy or external-beam radiotherapy) having significantly worse physical HRQoL, with the exception of sexual function and bother, than men undergoing radical prostatectomy.

    HRQoL scores were also greatly affected by comorbidities such as hypertension, hypercholesterolemia, diabetes mellitus, and peripheral vascular disease. Sexual bother was among those factors most severely affected by these comorbidities, along with sexual function and fear of recurrence.

    The researchers note that this finding “suggests a potential avenue for improvement in prostate cancer care, namely placing specific emphasis on interventions to improve mental health and other HRQoL impairments in men with multiple comorbidities.”

    They conclude: “The reasons partnership status influenced HRQoL less dramatically in our cohort than in previously described undeserved men are not fully understood, although greater financial resources may partly offset reliance on a partner.”

    As I have researched topics to comment on, it has become clear to me how often the wife or partner is overlooked in the prostate cancer discussion. I now take several moments with the newly diagnosed cancer “couple” to talk only about the female’s role and the importance of the male to be communicative. I now make it clear that what the male will be going through, not only the cure concerns, particularly the voiding issues and sexual issues , will be difficult for the couple. That is why daily I add something to my wife/partner page of the blog.

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