Time after surgery, symptoms and well‐being in survivors of urinary bladder cancer

• Published in: BJU international Vol. 91; no. 4; pp. 325 - 330
• Main Authors: Henningsohn, L., Wijkström, H., Pedersen, J., Ahlstrand, C., Aus, G., Bergmark, K., Onelöv, E., Steineck, G.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.03.2003; Blackwell
• Subjects: Adult; Aged; Aged, 80 and over; anxiety; Anxiety - etiology; Biological and medical sciences; bladder cancer; cystectomy; Cystectomy - adverse effects; Cystectomy - psychology; depression; Depression - etiology; Female; Health Status; Humans; Male; Medical sciences; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Nephrology. Urinary tract diseases; Postoperative Complications - etiology; postoperative symptoms; response shift; Sickness Impact Profile; Survivors; Time Factors; Tumors of the urinary system; Urinary Bladder Neoplasms - psychology; Urinary Bladder Neoplasms - surgery; Urinary tract. Prostate gland; well‐being; Mood disorder; Human; well-being; Urinary system disease; Ureterostomy; Depression; Urinary tract disease; Malignant tumor; Statistical study; response shift; Quality of life; Symptomatology; Cystectomy; Functional recovery; Treatment; postoperative symptoms; Urinary bladder; Surgery; bladder cancer; Bladder disease; Anxiety; Psychological well being
• ISSN: 1464-4096; 1464-410X; 1464-410X
• DOI: 10.1046/j.1464-410X.2003.04101.x

OBJECTIVE To evaluate how an increasing burden of symptoms influences well‐being, anxiety and depression at different intervals after a radical cystectomy with urostomy for bladder cancer, as this therapy can induce long‐term distressful symptoms. PATIENTS AND METHODS Patients with bladder cancer undergoing radical cystectomy in Stockholm between 1969 and 1995 were matched with 434 controls from the normal population; all 404 patients operated on between 1985 and 1995 at three other hospitals in Sweden were invited to enter the study. The final analysis included 306 patients and 310 controls, all assessed for symptoms and well‐being. RESULTS A low or moderate level of well‐being was reported by 35% of the patients having none or one of the symptoms studied, by 39% with two symptoms, by 45% with three symptoms and by 66% of those with four or more symptoms. The values, irrespective of symptom burden, were 45% after 2–5 years of follow‐up, 58% after 6–10 years and 38% at>10 years after surgery. The total symptom burden also influenced the risk of anxiety and depression. Symptom prevalence remained largely unaffected by the duration of follow‐up, except for defecation urgency. CONCLUSIONS The number of long‐term symptoms after radical surgery with a urostomy for urinary bladder cancer affects the risk of anxiety, depression and low or moderate well‐being.