The quality of life of patients on active surveillance: two years follow-up

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Introduction. Research showed that most patients did not report psychological burden; nonetheless, longer term follow-up is still needed. The aim of this study was to investigate the changes in quality of life (QoL) over the first two years on AS.
Patients and Methods. Between Nov 2007 and Jan 2013, 208 patients completed questionnaires at enrolment in the AS protocol (T0). Evaluations after 10 months (T1) from diagnostic biopsy, 12 months (after the first re-biopsy- T2) and 24 months (T3) were completed by 156, 109 and 62
patients, respectively. Validated self-report questionnaires were administered, including: a) Functional Assessment of Cancer Therapy – Prostate Version, measuring physical wellbeing, social wellbeing, emotional wellbeing, functional wellbeing; b) Mini Mental Adjustment to Cancer: fighting spirit, helplessness/hopelessness, fatalism, anxious preoccupation and avoidance. Repeated measure analyses of variance (ANOVA) were performed to test changes over time.
Results. The mean age of study population at T0 was 66.2 years. ANOVAs showed the following significant changes over time: social wellbeing decreased from T0 to T3 (p = 0.001); emotional wellbeing increased between both T0 and T2 (p = 0.016) as well as T0 and T3 (p = 0.001). Anxious preoccupation and avoidance significantly decreased from T0 and T2 (p = 0.0001 and p = 0.035, respectively).
Conclusion. Patients on AS reported high levels of physical and psychological wellbeing throughout the first two years. QoL was not impaired by the idea of living with an untreated cancer. It is particularly interesting that anxious preoccupation, i.e.worry about disease progression, decreased over the first year on AS and then remained stable. The decrease in the perception of social wellbeing could be related to the fact that support from family/friends is likely to be higher in the period immediately following the diagnosis.
Acknowledgements to Foundations I. Monzino and ProADAMO.

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