Impact of prostate cancer testing: an evaluation of the emotional consequences of a negative biopsy result

Macefield, Rhiannon; Metcalfe, Chris; Lane, J. Athene; Donovan, JL; Avery, Kerry; Blazeby, Jane M; Down, L; Neal, David E.; Hamdy, Freddie C.; Vedhara, Kavita

doi:10.1038/sj.bjc.6605648

Cited by 83 publications

(73 citation statements)

References 31 publications

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“…This was not suprising and also consistent with the literature. 3,16 An important finding of our study was the difference of effect of video-based education on patient anxiety post-information STAI-S scores between the 2 groups. While the post-information STAI-S scores remained stable in patients who received only written information (Group 2) (p = 0.89), there was a significant decrease of post-information STAI-S scores in patients who received both written and video education (Group 1) (p = 0.01).…”

Section: Discussionmentioning

confidence: 90%

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The effect of video-based education on patient anxiety in men undergoing transrectal prostate biopsy

Tarhan

Çakmak

Ünal

et al. 2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(11-12):e894-900. http://dx.doi.org/10.5489/cuaj.2208 Published online December 15, 2014. Abstract Introduction:We assess the effect of video-based education on patient anxiety during transrectal prostate biopsy. Methods: A total of 246 patients who underwent transrectal prostate biopsy were prospectively enrolled in the study. Group 1 included 123 patients who received both written and video-based education, while Group 2 included 123 patients who received only written instructions regarding prostate biopsies. State-Trait Anxiety Inventory (STAI) was used to assess state and trait anxiety (STAI-S/T) After completing the STAI-S and STAI-T questionnaires, all patients in Group 1 received written information and video-based education and they again completed STAI-S before the biopsy. On the contrary, after completing the STAI-S and STAI-T questionnaires, the patients in Group 2 received only written information and then they completed the STAI-S before the biopsy. Moreover, a visual analog scale (VAS) was used to assess pain scores during digital rectal examination, probe insertion, periprostatic local anesthesic infiltration, and biopsy. Results: No difference was noted between 2 groups regarding VAS scores. Comparing the 2 groups on baseline anxiety, we found that trait anxiety scores (STAI-T) were similar (p = 0.238). Preinformation STAI-S scores were similar in both groups (p = 0.889) and they both indicated high anxiety levels (score ≥42). While postinformation STAI-S scores remained high in Group 2, post-information STAI-S scores significantly decreased in Group 1 (p = 0.01). Conclusions: Undergoing a prostate biopsy is stressful and may cause anxiety for patients. Video-based education about the procedure can diminish patient anxiety.

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Section: Discussionmentioning

confidence: 90%

“…3 About 20% of men undergoing to prostate biopsy felt anxious and/or highly stressed prior to the biopsy. 16 Pain, evaluation for possible malignancy and rectal route used by the probe are some possible reasons of the anxiety. Providing a detailed description of the diagnostic method or surgical procedure is one way to reduce anxiety.…”

Section: Discussionmentioning

confidence: 99%

The effect of video-based education on patient anxiety in men undergoing transrectal prostate biopsy

Tarhan

Çakmak

Ünal

et al. 2014

CUAJ

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“…Zisman et al 43 found that undergoing a prostate biopsy can have an impact on the patient's well-being due to causing pain and anxiety. Macefield et al 44 reported that although most men coped well with undergoing a biopsy, a minority experienced elevated distress at the time of biopsy and after receiving a negative result. The authors stress that men should be informed of the risk of distress that is related to diagnostic uncertainty before consenting to PSA testing and possibly undergoing a biopsy.…”

Section: Shared Decision Makingmentioning

confidence: 99%

PSA-based prostate cancer screening: the role of active surveillance and informed and shared decision making

Venderbos¹,

Roobol²

2011

Asian J Androl

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Since the first publication describing the identification of prostate-specific antigen (PSA) in the 1960s, much progress has been made. The PSA test changed from being initially a monitoring tool to being also used as a diagnostic tool. Over time, the test has been heavily debated due to its lack of sensitivity and specificity. However, up to now the PSA test is still the only biomarker for the detection and monitoring of prostate cancer. PSA-based screening for prostate cancer is associated with a high proportion of unnecessary testing and overdiagnosis with subsequent overtreatment. In the early years of screening for prostate cancer, high rates of uptake were very important. However, over time the opinion on PSA-based screening has shifted towards the notion of informed choice. Nowadays, it is thought to be unethical to screen men without them being aware of the pros and cons of PSA testing, as well as the fact that an informed choice is related to better patient outcomes. Now, as the results of three major screening studies have been presented and the downsides of screening are becoming better understood, informed choice is becoming more relevant.

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“…Psychologically, anxiety frequently co-occurs with biopsies and psa screening [19][20][21] . Macefield and collaborators 22 reported that approximately 20% of screened men experienced high levels of tension and anxiety at the time of biopsy, as well as clinically significant distress. Prostate-specific antigen tests were also positively associated with anger, depression, and confusion in a smaller proportion of men participating in pca screening 22 .…”

Section: Introductionmentioning

confidence: 99%

“…Macefield and collaborators 22 reported that approximately 20% of screened men experienced high levels of tension and anxiety at the time of biopsy, as well as clinically significant distress. Prostate-specific antigen tests were also positively associated with anger, depression, and confusion in a smaller proportion of men participating in pca screening 22 . Considering that most patients with elevated psa and hgpin actually have benign conditions that will not progress to pca, there are reasons to believe that those patients might undergo unnecessary psychological distress as a result of screening.…”

Section: Introductionmentioning

confidence: 99%

Risk Perception and Psychological Morbidity in Men at Elevated Risk for Prostate Cancer

et al. 2015

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Objective As prostate-specific antigen (psa) makes prostate cancer (pca) screening more accessible, more men are being identified with conditions that indicate high risk for developing pca, such as elevated psa and high-grade intraepithelial neoplasia (hgpin). In the present study, we assessed psychological well-being and risk perception in individuals with those high-risk conditions.Methods A questionnaire consisting of a psychological symptom survey, a trait risk-aversion survey, and a cancerspecific risk perception survey was administered to 168 patients with early-stage localized pca and 69 patients at high risk for pca (n = 16 hgpin, n = 53 psa > 4 ng/mL). Analysis of variance was used to examine differences in psychological well-being and appraisal of risk between the groups. ResultsCompared with the pca group, the high-risk group perceived their risk of dying from something other than pca to be significantly lower (p = 0.007). However, pca patients reported significantly more clinically important psychological symptoms. ConclusionsThe identification of prostate conditions that predict progression to cancer might not result in the psychological symptoms commonly experienced by pca patients, but does appear to be related to a distorted perception of the disease's mortal risk. Patients with pca experience reduced psychological well-being, but better understand the risks of pca recurrence and death. Education on the risks and outcomes of pca can help at-risk men to view health assessments with reduced worry.

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Impact of prostate cancer testing: an evaluation of the emotional consequences of a negative biopsy result

Cited by 83 publications

References 31 publications

The effect of video-based education on patient anxiety in men undergoing transrectal prostate biopsy

The effect of video-based education on patient anxiety in men undergoing transrectal prostate biopsy

PSA-based prostate cancer screening: the role of active surveillance and informed and shared decision making

Risk Perception and Psychological Morbidity in Men at Elevated Risk for Prostate Cancer

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