Objective Limited research has investigated the psychosocial processes that underpin the effect of physical symptoms on fear of cancer recurrence. Additionally, despite evidence of increased vulnerability of marginalized populations to negative outcomes, few studies have examined the unique experience of gay men coping with the cancer process. The goals of this study were to determine whether disease-related self-efficacy and satisfaction with medical care mediated the relationship between greater physical symptoms and worse fear of recurrence among gay or bisexual prostate cancer survivors. Methods Participants were composed of 92 self-identified gay or bisexual men, who had received a diagnosis of prostate cancer in the past 4 years. Participants provided demographic information and completed self-report questionnaires that assessed symptom function, self-efficacy for prostate cancer symptoms, satisfaction with healthcare, and fear of recurrence. Bootstrapping procedures were used to assess for significant mediation. Results Results suggested significant mediation of the relationship between each of bowel, hormonal, and sexual function with fear of recurrence by self-efficacy and satisfaction with healthcare. Mediation was not significantly supported for the association between urinary function and fear of recurrence. Conclusions Findings support the explanatory effects of self-efficacy for symptom management and satisfaction with healthcare on the relationship between symptom function and fear of recurrence. These results indicate that psychological processes, specifically psychological factors that hold particular relevance to gay or bisexual men, reflect a potential avenue for intervention to decrease fear of cancer recurrence.

Analysis of the long-term effects of pancreatic cancer screening and genetic testing reveal psychological gains that are maintained at 1-year follow-up. This intervention is particularly effective for younger participants and individuals with greater baseline distress.

Findings support the mediating role of the subjective experience of being an out gay man in the association between anxious attachment and illness intrusiveness. These results suggest that facilitating greater comfort with outness would be beneficial for illness adjustment among gay men with prostate cancer whom have more anxious attachment styles. Copyright © 2015 John Wiley & Sons, Ltd.

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Mediation analyses revealed a significant association between insomnia symptom severity and the cognitive and physical domains of fatigue. Fatigue catastrophizing was the only significant mediator, accounting for 25% of the variance in the relationship between insomnia symptoms and the cognitive fatigue. However, fatigue catastrophizing did not significantly mediate the relationship between insomnia symptoms and physical fatigue, indicating physical and cognitive fatigue may reflect distinct processes in fatigue expression in those with MS.