FACING UNTREATED PROSTATE CANCER ON ACTIVE SURVEILLANCE: WHO IS AT RISK FOR INCREASED ANXIETY?

Introduction. “Living with untreated prostate cancer (PCa)” may cause distress in men on Active Surveillance (AS). We aimed to evaluate PCa-related anxiety (anx) over the first 2 years on AS. Patients and Methods. Between 2007-2014, 207 patients (pts) progressively completed the Memorial Anxiety Scale for Prostate Cancer (MAX-PC), a self-report tool providing 4 indexes: PCa anx, PSA anx, fear of recurrence, MAX-PC total score. Assessment was conducted at entrance in AS protocol (T0), 2 months before first re-biopsy from diagnostic one (T1), after re-biopsy (T2) and 1 year after re-biopsy (T3). Cronbach’s α was calculated to estimate internal consistency for each index. Descriptive analyses were performed. Wilcoxon test was used to detect statistically significant changes over time. Results. Mean age of sample at diagnosis was 64 years (SD=7; 42-79 yrs). Figure 1 shows results of descriptive analyses. The majority of pts had low scores in all the subscales and the MAX-PC total index (skewness>0). Cronbach’s α was ≥ 0.70 for all indexes, indicating good internal consistency. Wilcoxon test showed statistically significant reductions in MAX-PC total score (61% of pts, p=0,0006) and PCa anx (58% of pts, p=0,0012) between T1 and T2. Conclusions. This is the first study to report on PCa-related anx over the first 2 years on AS, which emerged as favourably low. Internal consistency analyses showed that MAX-PC is reliable tool to assess anxiety in men on AS despite it was developed for patients undergoing radical prostatectomy. Further research is needed to confirm its validity in the population of AS pts. In particular for “fear of recurrence”, originally designed to measure worry for cancer relapse after radical treatment. Yet, items seem to be properly applicable to fear for disease progression. The concurrence of decrease in anx with the first re-biopsy highlights a potentially reassuring role of the AS monitoring scheme.