abstract
Introduction
In colorectal, cervical, and breast cancers, oncologic follow-up can exacerbate or
alleviate patient stress about disease recurrence. Such patient experiences are less
well defined for urologic malignancies. We developed a cross-sectional prospective
survey study to assess kidney (Kid), prostate (Pros), and bladder (Bld) cancer patient
perceptions of oncologic follow-up following surgical treatment.
Patients and Methods
Patients with pTanyNanyM0 Kid, Pros, and Bld cancer presenting at least 60 days following
primary surgical treatment of their cancer were eligible. Receipt of adjuvant therapy
or disease recurrence were exclusion criteria. Questionnaires assessing attitudes
towards follow-up and stress-reducing strategies were administered prior to revealing
testing results. Analysis was performed according to cancer type and level of recurrence
risk, with pathologic stage used a proxy for recurrence risk.
Results
Three hundred thirty-seven patients were prospectively surveyed from 2018 to 2020:
127 (38%) Kid, 134 (40%) Pros, and 76 (23%) Bld. Patients showed satisfaction with
provided strategies to combat recurrence anxiety (Kid 86%, Pros 81%, Bld 85%). However,
approximately 16% of patients reported wanting, but not receiving, strategies for
fear reduction. Most patients reported diagnostic tests were “Not at All” burdensome
(Kid 86%, Pros 94%, Bld 82%) and disagree that fewer tests would alleviate anxiety
(Kid 89%, Pros 91%, Bld 84%). The majority reported an increased sense of worry if
there were no cancer follow-ups (Kid 84%, Pros 80%, Kid 81%), and preferred their
specialist to their family physician to direct such care (Kid 89%, Pros 91%, Bld 95%).
When stratified by recurrence risk, no significant differences existed across cancers
in patients’ attitudes toward follow-up. However, Pros cancer patients showed a difference
in fear of recurrence (“Not at All” worried about recurrence ≤T2 38%, ≥T3, 19%; P= .04).
Conclusion
Urology patients appear satisfied with their oncologic follow-up. Sixteen percent
of patients sought additional strategies to combat fear, indicating opportunity for
improvement.
Keywords
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Article info
Publication history
Published online: January 27, 2022
Accepted:
January 17,
2022
Received in revised form:
January 9,
2022
Received:
November 14,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
