Psychosocial adjustment to a prostate cancer diagnosis in a cohort of radical prostatectomy patients in Quebec, Canada

• Published in: Psycho-oncology (Chichester, England) Vol. 28; no. 4; pp. 839 - 846
• Main Authors: Wissing, Michel D., Chevalier, Simone, O'Flaherty, Ana, McKercher, Ginette, Aprikian, Saro, Saad, Fred, Carmel, Michel, Lacombe, Louis, Hamel, Marc, Aprikian, Armen
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.04.2019
• Subjects: Adaptation, Psychological; Adjustment; Adult; Aged; Aged, 80 and over; Canada; cancer; Cancer surgery; Communication; Confidence intervals; Coping; coping strategies; Cross-Sectional Studies; Fear & phobias; Humans; Logistic Models; Male; Medical diagnosis; Middle Aged; Music; oncology; Patient communication; Patient Satisfaction - statistics & numerical data; Patients; Physical activity; Physicians; Prostate; Prostate cancer; prostatectomy; Prostatectomy - psychology; prostatic neoplasms; Prostatic Neoplasms - psychology; Prostatic Neoplasms - surgery; psychosocial distress; Psychosocial factors; Quality of life; Quality of Life - psychology; Quebec; Questionnaires; Relaxation; Social Support; Surveys and Questionnaires; Urological surgery; Canada; Quebec; patient communication; prostate cancer; coping strategies; prostatic neoplasms; psychosocial distress; prostatectomy; cancer; oncology
• ISSN: 1057-9249; 1099-1611
• DOI: 10.1002/pon.5031

Objective The psychosocial impact of a prostate cancer diagnosis significantly affects a patient's quality of life. We studied patient communication at the time of diagnosis and its impact on psychosocial adjustment of patients. Methods This is a cross‐sectional data analysis from self‐administered questionnaires in the PROCURE biobank study, consisting of a cohort of patients with localized prostate cancer undergoing radical prostatectomy in Québec (Canada), 2006 to 2013. Odds ratios (OR) and their respective 95% confidence intervals (95% CI) were calculated using binary or ordered logistic regression models. Results Data from 1841 patients were analyzed. The median age of patients was 62 years (range 41‐80 years), the majority was French‐Canadian (68.3%) and married (79.6%). Most patients (90.1%) considered conversations with their treating physician a useful information source. Patients were dissatisfied on the communication when receiving their diagnosis by telephone (OR = 0.19, 95% CI, 0.11‐0.33). Younger patients were also more dissatisfied. Most patients preferred to receive information on prostate cancer (89.5%) and radical prostatectomy (88.0%) at the time of diagnosis, while only 58.8% and 52.4% of patients received this information at this stage. Patients who were dissatisfied with the communication of the diagnosis had more negative responses, such as increased worries and fear (P < 0.05). The five most useful coping mechanisms were physical activity (62.3%), breathing exercises (44.5%), music (32.8%), faith (30.3%), and muscle relaxation (30.1%), but varied by demographics. Conclusions This study highlights the importance of physicians communicating a prostate cancer diagnosis well to their patients. Patients may benefit from individually tailored interventions to facilitate their overall coping.