Associate Professor Icahn School of Medicine at Mount Sinai
Introduction: The significant impact of bladder cancer and treatment on patient quality of life and emotional wellbeing has been documented. Increasing evidence from cancer research emphasize the importance of examining patients supportive care needs and social support as factors that could influence their emotional adjustment. The purpose of the study was to assess the prevalence and demographic and clinical predictors of psychological distress among bladder cancer patients and its associations with patient reported supportive care needs and perceived availability of social support.
Methods: A cross-sectional design was used to investigate the study questions. Bladder cancer patients were recruited from the Bladder Cancer Advocacy Network (BCAN) to complete a questionnaire that included the Hospital Anxiety and Depression Scale (HADS), bladder cancer patient need survey (BCNAS-32), and the social provisions scale (SPS). The inclusion criteria restricted our sample to include bladder cancer patients who were English speakers, aged 18-85 years, and were able and willing to provide informed consent. Patients who had metastatic disease, cancer recurrence, or other primary cancers at the time of assessment were excluded from the study
Results: About 159 bladder cancer patients participated in the study. The mean age was 62±9.4 years and 51% were male. About 37% reported cancer stage I, 25% reported cancer stage II, and 55% reported cancer stage III. Almost two-third (62%) of patients received cystectomy and urinary diversion. Patients reported elevated levels of psychological distress (Mean±SD:14.3±12.15) and psychological distress was significantly associated with younger age and lower educational levels (p < .05). Univariate regression analyses revealed significant associations between psychological distress (HADS total score), HADS depression and anxiety subscales, patient age, physical functioning/daily living needs, sexuality needs, and perceived social support with higher distress, anxiety, and depression scores associated with younger age, higher unmet needs, and lower levels of social support. Multivariate regression analyses, showed similar findings confirming the associations depicted by the univariate regression analyses.
Conclusions: Bladder cancer patients experience significant psychological distress and distress levels could be increased by increased patient supportive care needs and lack of social support. Patient focused interventions could be tailored to address these issues with the goal to improve patient quality of life and emotional adjustment.
Source of Funding: National Cancer Institute-1R03CA165768-01A1
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