Psychological distress among patients awaiting histopathologic results after prostate biopsy: An unaddressed concern

2021 ◽  
pp. 039156032110498
Author(s):  
Luca Sarchi ◽  
Ahmed Eissa ◽  
Stefano Puliatti ◽  
Marco Amato ◽  
Simone Assumma ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Psychological Distress ◽  
Prostate Biopsy ◽  
Psychological Impact ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Prostate Biopsies ◽  
Psa Testing ◽  
Main Component ◽  
Histopathological Results

Background: Prostate cancer is the most commonly diagnosed neoplasm in men. From the introduction of PSA testing, an increasing number of men undergoes prostate biopsy (PBX). While the physical side effects of PBx have been well investigated, its psychological impact has been under-evaluated. Aim: The aim of our study is to investigate the presence of psychological distress (anxiety and depression) in patients waiting for histopathological results after prostate biopsy (PBx). Methods: From February to April 2019, 51 consecutive patients undergoing prostate biopsies at our institution were included. Age, PSA, DRE, familiarity for prostate cancer, number of previous biopsies, type of anesthesia, number of cores were recorded. All patients filled the Hospital Anxiety and Depression Scale (HADS), a psychometric Likert-scale questionnaire, before receiving the histopathological results of their PBx. Results: The prevalence of psychological distress among patients awaiting histopathologic results is 41% (21/51 patients), with anxiety being the main component of their distress. On multivariate analysis, PSA, family history, and repeat biopsy were significantly associated with anxiety and depression. Conclusion: Patients undergoing PBx experience a burden of psychological distress waiting for histopathologic results, especially anxiety. Appropriate counseling should be offered to patients at high risk of developing psychological distress after PBx. Future goals would include technological improvements to shorten the time between biopsy and definitive results.

scholarly journals Patterns of Prostate-Specific Antigen Testing and Prostate Biopsies During the COVID-19 Pandemic

2021 ◽  
pp. 1028-1033
Author(s):  
Harvey W. Kaufman ◽  
Zhen Chen ◽  
Justin K. Niles ◽  
Jeff Radcliff ◽  
Yuri Fesko
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Diagnostic Testing ◽  
Specific Antigen ◽  
International Classification Of Diseases ◽  
Prostate Biopsies ◽  
Psa Testing ◽  
Classification Of Diseases ◽  
Antigen Testing

PURPOSE This study examined changes in prostate disease screening (prostatic-specific antigen [PSA] testing), prostate biopsy testing, and prostate cancer diagnoses during the COVID-19 pandemic through December 2020. MATERIALS AND METHODS This analysis included test results from men ≥ 40 years, without prior International Classification of Diseases-10 record of prostate cancer since January 2016, who received PSA or prostate biopsy testing at Quest Diagnostics during January 2018-December 2020. Monthly trends were evaluated for three periods: prepandemic (January 2018-February 2020), early-pandemic (March-May 2020), and late-pandemic (June-December 2020). RESULTS Meeting inclusion criteria were 16,365,833 PSA and 48,819 prostate biopsy results. The average monthly number of PSA tests declined from 465,187 prepandemic to 295,786 early-pandemic (36.4% decrease; P = .01) before rebounding to 483,374 (3.9% increase; P = .23) late-pandemic. The monthly average number of PSA results ≥ 50 ng/mL (23,356; 0.14% of all PSA results) dipped from 659 prepandemic to 506 early-pandemic (23.2% decrease; P = .02) and rebounded to 674 late-pandemic (2.3% increase; P = .65). The average monthly number of prostate biopsy results decreased from 1,453 prepandemic to 903 early-pandemic (37.9% decrease; P = .01) before rebounding to 1,190 late-pandemic (18.1% decrease; P = .01). The average monthly number for Gleason score ≥ 8 (6,241; 12.8% of all prostate biopsies) declined from 182 prepandemic to 130 early-pandemic (28.6% decrease; P = .02) and decreased to 161 late-pandemic (11.5% decrease; P = .02). CONCLUSION The findings suggest that a substantial number of prostate screening opportunities and cancer diagnoses have been missed. Efforts are needed to bring such patients back for screening and diagnostic testing and to restore appropriate care for non–COVID-19–related medical conditions.

Psychological Impact of Prostate Biopsy: Physical Symptoms, Anxiety, and Depression

2013 ◽  
Vol 31 (33) ◽  
pp. 4235-4241 ◽  
Author(s):  
Julia Wade ◽  
Derek J. Rosario ◽  
Rhiannon C. Macefield ◽  
Kerry N.L. Avery ◽  
C. Elizabeth Salter ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Psychological Impact ◽  
Specific Antigen ◽  
Depression Scale ◽  
Physical Symptoms ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
A Minor ◽  
To Receive ◽  
Antigen Testing

Purpose To investigate the psychological impact of prostate biopsy, including relationships between physical biopsy-related symptoms and anxiety and depression. Patients and Methods A prospective cohort of 1,147 men, nested within the Prostate Testing for Cancer and Treatment trial and recommended to receive prostate biopsy, completed questionnaires assessing physical and psychological harms after biopsy in the Prostate Biopsy Effects study. Psychological impact was measured using the Hospital Anxiety and Depression Scale, and scores were compared according to experiences of biopsy-related symptoms at biopsy, and at 7 and 35 days afterward, and in relation to biopsy results. Results A total of 1,144 men (99.7%) returned questionnaires at biopsy, with 1,090 (95.0%) and 1,016 (88.6%) responding at 7 and 35 days postbiopsy. Most men experienced biopsy-related symptoms as no problem or a minor problem, and overall levels of anxiety and depression were low and similar to normative levels. Of men receiving a negative biopsy result (n = 471), anxiety was greater in those experiencing problematic biopsy-related symptoms compared with those experiencing nonproblematic symptoms at 7 days for the following symptoms: pain (P < .001), shivers, (P = .020), hematuria (P < .001), hematochezia (P < .001), and hemoejaculate (P < .001). Anxiety was reduced, although symptoms were not, after 35 days. Overall levels of anxiety were low across all time points except at the 35-day assessment among men who had received a cancer diagnosis. Conclusion Problematic postbiopsy symptoms can lead to increased anxiety, distinct from distress related to diagnosis of prostate cancer. Men and doctors need to consider these additional potential harms of biopsy when deciding whether to initiate prostate-specific antigen testing.

Psychological distress in patients undergoing urological surgery: A cross-sectional study

2021 ◽  
pp. 205141582110140
Author(s):  
Nuala Murray ◽  
Charles O’Connor ◽  
Rhona Dempsey ◽  
Sean Liew ◽  
Helen Richards ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Repeated Measures ◽  
Depression Scale ◽  
University Hospital ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Post Surgery ◽  
Oncological Patients

Purpose: The purpose of this study was to evaluate the psychological distress of urological and uro-oncological patients undergoing surgery. Methods: Patients who presented to Mercy University Hospital from October 2019–May 2020 were consecutively recruited. Demographic and clinical characteristics including age, gender, marital status, type of surgery (uro-oncology or general urology), endoscopy or open surgery were gathered. Mood was evaluated using the Hospital Anxiety and Depression Scale prior to admission, prior to discharge and 6 weeks post-surgery. Results: A total of 118 participants (79.7% male) completed the Hospital Anxiety and Depression Scale prior to admission, prior to discharge and at 6 weeks post-surgery. Forty patients (33.9%) underwent uro-oncology-related surgery. At pre-admission 39 patients (33%) fell into a possible-probable clinical category for anxiety and 15 (12.7%) for depression. Older patients had significantly lower anxiety levels than younger patients ( p⩽0.01). There were no differences between patients undergoing uro-oncology or more general urology surgery and levels of anxiety or depression. Repeated measures analysis of variance with age as a covariate indicated no significant differences in Hospital Anxiety and Depression Scale anxiety scores over time. There was a statistically significant reduction in Hospital Anxiety and Depression Scale depression scores over the three assessment time points ( p=0.004). Conclusion: Over one-third of patients were experiencing moderate to severe levels of psychological distress pre-surgery – higher than levels previously reported in uro-oncological patients. Surprisingly, there was no difference in anxiety and depression scores in uro-oncology and urology patients. Psychological distress in both uro-oncology and more general urology patients should be considered in the surgical setting. Level of evidence Moderate

scholarly journals 841 The psychological impact of Foundation Interim Year 1 Placements on Final Year UK Medical Students Transitioning to Foundation Year One During the COVID Era

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Durand-Hill ◽  
D I Ike ◽  
A N Nijhawan ◽  
A B Shah ◽  
A Dawson ◽  
...  
Keyword(s):  
Medical Students ◽  
Perceived Stress ◽  
Psychological Impact ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Stress Scale ◽  
The Uk

Abstract Introduction During the COVID pandemic, the 2019-2020 cohort of final year students were invited to participate in Foundation interim Year 1 placements (FiY1). FiY1 aimed to ease transition to Foundation Year 1 doctor (FY1). We assessed the psychological impact of FiY1 on final year medical students. Method A cross-sectional survey was distributed to final year medical students in the UK between June 4th and July 4th, 2020. The survey contained the following domains: participant demographics, rationale for FiY1 participation, a checklist of the key safety principles for FiY1s, the Hospital Anxiety and Depression Scale and the Perceived Stress scale-4. Results 107 final years responded to the survey. 72.0% (n = 77) of final year students surveyed were working as FiY1s. Final year students participating in FiY1 postings had reduced rates of anxiety (29.9% vs 43.4%, P = 0.186), depression (5.2% vs 20.0%, P = 0.018) and lower perceived stress levels (5.0 vs 7.2, P &lt; 0.001). 19.5% (15/77) FiY1s reported working beyond their competency, 27.3% (22/77) felt unsupervised, but 94.8% (73/77) of FiY1s felt the post prepared them for FY1. Conclusions Students participating in FiY1 postings felt less stressed and depressed than those not participating in the scheme and the majority felt it was preparing them for FY1.

scholarly journals Cancer Detection Rates of Systematic and Targeted Prostate Biopsies after Biparametric MRI

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Maudy C. W. Gayet ◽  
Anouk A. M. A. van der Aa ◽  
Harrie P. Beerlage ◽  
Bart Ph Schrier ◽  
Maaike Gielens ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rates ◽  
Prostate Biopsies ◽  
Significant Difference ◽  
Significant Pathology ◽  
Study Population ◽  
Clinically Significant ◽  
Control Study

Objective. To compare prostate cancer detection rates (CDRs) and pathology results with targeted prostate biopsy (TB) and systematic prostate biopsy (SB) in biopsy-naive men. Methods. An in-patient control study of 82 men undergoing SB and subsequent TB in case of positive prostate MRI between 2015 and 2017 in the Jeroen Bosch Hospital, the Netherlands. Results. Prostate cancer (PCa) was detected in 54.9% with 70.7% agreement between TB and SB. Significant PCa (Gleason score ≥7) was detected in 24.4%. The CDR with TB and SB was 35.4% and 48.8%, respectively (p=0.052). The CDR of significant prostate cancer with TB and SB was both 20.7%. Clinically significant pathology upgrading occurred in 7.3% by adding TB to SB and 22.0% by adding SB to TB. Conclusions. There is no statistically significant difference between CDRs of SB and TB. Both SB and TB miss significant PCas. Moreover, pathology upgrading occurred more often by adding SB to TB than vice versa. This indicates that the omission of SB in this study population might not be justified.

scholarly journals Independent Validation of a Diagnostic Noninvasive 3-MicroRNA Ratio Model (uCaP) for Prostate Cancer in Cell-Free Urine

2019 ◽  
Vol 65 (4) ◽  
pp. 540-548 ◽  
Author(s):  
Jacob Fredsøe ◽  
Anne K I Rasmussen ◽  
Emma B Laursen ◽  
Yunpeng Cai ◽  
Kenneth A Howard ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Area Under The Curve ◽  
Extracellular Vesicle ◽  
Urine Samples ◽  
Ratio Model ◽  
Psa Testing ◽  
Diagnostic Potential

Abstract BACKGROUND Detection of prostate cancer (PC) based on serum prostate-specific antigen (PSA) testing leads to many unnecessary prostate biopsies, overdiagnosis, and overtreatment of clinically insignificant tumors. Thus, novel and more accurate molecular biomarkers are required. METHODS Using reverse transcription quantitative PCR, we measured the concentrations of 45 preselected microRNAs (miRNAs) in extracellular vesicle-enriched cell-free urine samples from 4 independent patient cohorts from Spain and Denmark, including 758 patients with clinically localized PC, 289 noncancer controls with benign prostatic hyperplasia (BPH), and 233 patients undergoing initial transrectal ultrasound (TRUS)-guided prostate biopsy owing to PC suspicion (101 with benign and 132 with malignant outcome). Diagnostic potential was assessed by ROC and decision curve analysis. RESULTS We identified and successfully validated 8 upregulated and 21 downregulated miRNAs in urine from PC patients. Furthermore, we validated a previously identified 3-miRNA diagnostic ratio model, uCaP (miR-222–3p*miR-24–3p/miR-30c-5p). High uCaP scores were distinctive of PC in urine samples from BPH vs PC patients in 3 independent cohorts [area under the curve (AUC) = 0.84, 0.71, 0.72]. Additionally, uCaP predicted TRUS biopsy results with greater accuracy than PSA (AUC uCaP = 0.644; AUC PSA = 0.527) for patients within the diagnostic gray zone (PSA ≤ 10 ng/mL). CONCLUSIONS We successfully validated a urine-based diagnostic 3-miRNA signature for PC (uCaP) in 3 independent patient cohorts from 2 countries. In the future, the simple and noninvasive uCaP test may be used to help more accurately select patients for prostate biopsy. Prospective clinical validation is warranted.

Perspectives on psychological distress in cancer patients: Comparison between expected, perceived and actual disturbances in a clinic from Argentina

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18515-18515
Author(s):  
F. Torrente ◽  
D. Gercovich ◽  
H. Hirsch ◽  
P. Margiolakis ◽  
E. Gil Deza ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Cancer Patients ◽  
Mental Health Treatment ◽  
Depression Scale ◽  
High Rate ◽  
Anxiety And Depression ◽  
Cutoff Score ◽  
Waiting Room ◽  
Psychological Assistance

18515 Background: Psychological distress is a widespread phenomenon in cancer patients (pts.) Notwithstanding, its recognition and the threshold criteria for referral to a specialized unit are still problematic in clinical practice. Correspondingly, the aim of this study was to explore how much psychological distress (PD) is expected by the oncologists, how much distress is actually present in these pts., and finally how many of them are detected as having significant problems and referred to the mental health unit (MHU). Methods: Three sources of data were compared for the purpose of this study. Firstly, a survey to the practicing oncologists (n =18) was carried out in order to establish the rate of PD expected by them. Secondly, a consecutive sample of 259 pts. was evaluated in the waiting room with the Hospital Anxiety and Depression Scale (HADS) for establishing an estimation of the actual rate of PD in this population. Finally, 115 pts. from the MHU were studied for determining the rate and the accuracy of the referral made by the oncologists. Results: Sixty one percent of the surveyed oncologists considered that 75% or more of their pts would need psychological assistance. The waiting room sample evaluated with the HADS showed that 74.9% of patients surpassed the cutoff score (11 points) for either anxiety or depression, or both. Despite this, less than 5% of the total population of the clinic was referred to the MHU. From this sample, 38.3% of the pts. scored below the cutoff line. The proportion of pts. who exceeded the cutoff score for depression was significantly higher in the MHU sample. Conclusions: Most of the oncologists expect a high rate of PD in their patients, and even overestimate it. Actual rates of anxiety and depression were also high. On the contrary, the rate of referral to specialized mental health treatment was extremely low and the pts. referred were not necessarily highly disturbed. Depression is probably better recognized than anxiety by oncologists. In conclusion, both quantitative and qualitative problems were detected in the referral to the MHU, regardless the awareness of the oncologists about PD. No significant financial relationships to disclose.

Association of fatigue and psychological distress with quality of life in patients with a previous venous thromboembolic event

2009 ◽  
Vol 102 (12) ◽  
pp. 1219-1226 ◽  
Author(s):  
Paul Lukas ◽  
René Krummenacher ◽  
Franziska Biasiutti ◽  
Stefan Begré ◽  
Hansjörg Znoj ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychological Distress ◽  
Thromboembolic Event ◽  
Short Form ◽  
Depression Scale ◽  
Venous Thromboembolic Event ◽  
Anxiety And Depression ◽  
Blood Collection ◽  
Venous Thromboembolic

SummaryHealth-related quality of life (QoL) has been associated with several social and medical conditions in patients with deep vein thrombosis (DVT) and pulmonary embolism (PE).To the best of our knowledge,there is no study investigating the relationship of QoL with psychological variables in this patient population.We assumed as a hypothesis an association between heightened levels of fatigue and psychological distress, as well as decreased QoL in patients with an objectively diagnosed venous thromboembolic event. Study participants were 205 consecutively enrolled out-patients (47.4 years, 54.6% men) with DVT and/or PE. Approximately 10 days before blood collection for thrombophilia work-up, QoL, fatigue, and psychological distress were assessed using the Short Form Health Survey (SF-12), the Multidimensional Fatigue Symptom Inventory Short Form (MFSI-SF) as well as the Hospitality Anxiety and Depression scale (HADS). After controlling for demographic and medical factors, fatigue (p<0.01) but not psychological distress (p>0.05) was negatively associated with physical QoL, explaining 11.0% of the variance. Fatigue (p<0.001) and psychological distress (p<0.001) were significant predictors of mental QoL,explaining an additional 36.2% and 3.6% of the variance. Further analyses revealed that all subscales of the HADS (e.g. anxiety and depression) and of the MFSI-SF (e.g. general fatigue, physical fatigue, emotional fatigue, mental fatigue and vigor) were significant predictors of mental QoL. MFSI-SF subscales also predicted physical QoL. The findings suggest that fatigue and psychological distress substantially predict QoL in patients with a previous venous thromboembolic event above and beyond demographic factors.

Meaning of life, representation of death, and their association with psychological distress

2017 ◽  
Vol 16 (5) ◽  
pp. 511-519 ◽  
Author(s):  
Ines Testoni ◽  
Giulia Sansonetto ◽  
Lucia Ronconi ◽  
Maddalena Rodelli ◽  
Gloria Baracco ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Path Analysis ◽  
Cancer Patients ◽  
Meaning In Life ◽  
Religious Orientation ◽  
Depression Scale ◽  
Meaning Of Life ◽  
Anxiety And Depression ◽  
Cross Sectional ◽  
Healthy Participants

AbstractObjective:This paper presents a two-phase cross-sectional study aimed at examining the possible mitigating role of perceived meaning of life and representation of death on psychological distress, anxiety, and depression.Method:The first phase involved 219 healthy participants, while the second encompassed 30 cancer patients. Each participant completed the Personal Meaning Profile (PMP), the Testoni Death Representation Scale (TDRS), the Hospital Anxiety and Depression Scale (HADS), and the Distress Thermometer (DT). The primary analyses comprised (1) correlation analyses between the overall scores of each of the instruments and (2) path analysis to assess the indirect effect of the PMP on DT score through anxiety and depression as determined by the HADS.Results:The path analysis showed that the PMP was inversely correlated with depression and anxiety, which, in turn, mediated the effect on distress. Inverse correlations were found between several dimensions of the PMP, the DT, and the HADS–Anxiety and HADS–Depression subscales, in both healthy participants and cancer patients. Religious orientation (faith in God) was related to a stronger sense of meaning in life and the ontological representation of death as a passage, rather than annihilation.Significance of Results:Our findings support the hypothesis that participants who represent death as a passage and have a strong perception of the meaning of life tend to report lower levels of distress, anxiety, and depression. We recommend that perceived meaning of life and representation of death be more specifically examined in the cancer and palliative care settings.

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