Perceived Positive and Negative Life Changes in Testicular Cancer Survivors

Abstract

Background and objectives: Despite a generally good prognosis, testicular cancer can be a life-altering event. We explored perceived positive and negative life changes after testicular cancer in terms of frequency, demographic and disease-related predictors, and associations with depression and anxiety. Materials and methods: All testicular cancer survivors receiving follow-up care at two specialized outpatient treatment facilities were approached at follow-up visits or via mail. We assessed a total of N = 164 patients (66% participation rate, mean time since diagnosis: 11.6 years, SD = 7.4) by the Posttraumatic Growth Inventory (PTGI, modified version assessing positive and negative changes for each of 21 items), Patient-Health-Questionnaire-9 (PHQ-9), and Generalized-Anxiety-Disorder-Scale-7 (GAD-7). We conducted controlled multivariate regression analyses. Results: Most survivors (87%) reported at least one positive change (mean number: 7.2, SD = 5.0, possible range: 0–21). The most frequent perceived positive changes were greater appreciation of life (62%), changed priorities in life (62%), and ability rely on others (51%). At least one negative change was perceived by 33% (mean number of changes: 1.1, SD = 2.5). Negative changes were most frequent for decreases in self-reliance (14%), personal strength (11%), and ability to express emotions (9%). A higher socioeconomic status was associated with more positive changes (β = 0.25, 95% CI 0.08 to 0.42); no other association with demographic and disease-related predictors emerged. While positive life changes were not associated with depression (β = −0.05, 95% CI −0.17 to 0.07) and anxiety (β = 0.00, 95% CI −0.13 to 0.13), more negative life changes were significantly associated with higher depression (β = 0.15, 95% CI −0.03 to 0.27) and anxiety (β = 0.23, 95% CI 0.11 to 0.36). There was no significant interaction of positive and negative changes on depression or anxiety. Conclusions: Although positive life changes after testicular cancer are common, a significant number of survivors perceive negative changes in life domains that have been primarily investigated in terms of personal growth. Early identification of and psychosocial support for patients who perceive predominantly negative changes may contribute to prevention of prolonged symptoms of anxiety and depression.

Identifying the unmet supportive care needs of individuals affected by testicular cancer: a systematic review

“…Symptom burden: Memorial Symptom Assessment Scale—Short Form (MSAS-SF). Vehling et al, [ 55 ] (same study as above) Germany. Investigate and establish the presence of anxiety and depression in TCS and analyse the influence of correlates.…”

Predictors of Posttraumatic Growth in Cancer Patients Post Treatment

“…We agree with Taku et al (2021) that the positive and negative consequences of trauma, or the changes resulting from experiencing trauma, are not just the opposite ends of one dimension. Vehling et al (2021) modified the PTGI in their research, with each item asking patients to comment on whether they experienced positive or negative change in that domain. They found that the level of positive change was not related to depression or anxiety experience.…”

Prevalence and risk factors of loneliness among patients with hematological malignancies

“…The occurrence of cancers is a major negative life event. [24] The diagnosis of malignancy and the pain of the cancer itself constitute a strong reminder of the possibility of death, which can easily lead to adverse psychological problems in patients. [25] Notably, when evaluating the relationship between sociodemographic factors and loneliness in patients with hematological malignancies, we found that occupation, family earning, living areas, and times of hospitalization were significantly related to loneliness.…”

“…The occurrence of cancers is a major negative life event. [24] The diagnosis of malignancy and the pain of the cancer itself constitute a strong reminder of the possibility of death, which can easily lead to adverse psychological problems in patients. [25]…”

“…As a result, the mean total scores were 36.25 (SD, 10.22) with a mean single-item score of 1.81 (SD, 0.51). Based on the Perry classification of loneliness [low (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), moderate (35-49), moderately high (50-64), and severe (65-80) degrees of loneliness]. All patients with hematological malignancies also suffered from various degrees of loneliness, 71.34% of patients had a loneliness score greater than 35 among them.…”