e17013 Background: Mood disorders are prevalent in cancer patients in general and in bladder cancer specifically. New psychiatric diagnoses post-bladder cancer treatment are associated with decreased survival. Bladder cancer management is cost- and labor-intensive from a healthcare and social standpoint. Tools such as Enhanced Recovery After Surgery (ERAS) pathways have been developed to lower this burden of care, but focus entirely on physiologic parameters without addressing the psycho-social burden of bladder cancer or its treatment. Data is lacking regarding prevalence of mood disorders in bladder cancer patients, especially those with non-muscle-invasive disease, their caregivers, and regarding the relationship between patient and caregiver mood disorders. Methods: A cross-sectional dyadic study of 96 bladder cancer patients and their self-designated primary caregivers. Study utilized retrospective chart review and separate telephone interviews of patient and caregiver. Patients must have received initial diagnosis or proven recurrence within the past 24 and 12 months, respectively, and have no metastatic disease. Surveys included Patient Health Questionnaire 9 (PHQ-9) for depression, General Anxiety Disorder-7 (GAD-7) for anxiety, Short Form Health Survey (SF-12) for health-related quality of life, and a financial toxicity measure. Pearson correlation and regression models were used for analysis. Results: 49% (9.3% moderate to severe, 40.2% mild) of bladder cancer patients and 33% of caregivers (7.2% moderate to severe, 24.8% mild) had symptoms of depression. Patients’ PHQ-9 scores were moderately correlated with their caregiver, r = 0.49 (95% CI 0.32,0.63 p < 0.001). GAD-7 scores were not correlated between patient and caregiver r = 0.08 (95% CI 0.12,0.28 p = 0.45). Both patient (r = -0.31, 95%CI -0.48,-0.10 p < 0.004) and caregiver (r = -0.41, 95%CI -0.58,-0.22 p < 0.001) incomes were inversely associated with depression symptoms. Results were similar when stratified by non-muscle-invasive and muscle-invasive status. Conclusions: Depression is common among bladder cancer patients and their caregivers and these symptoms are correlated between patient and their caregiver. This correlation did not appear to hold true with respect to anxiety. Financial situation may play a role as increasing income was negatively correlated with depression symptoms. Patient and caregiver may both experience adverse psycho-social consequences from bladder cancer and treatments and pose a joint opportunity for intervention to lower burden of care.
Advances in bladder cancer management