TY - JOUR
T1 - Identifying classes of the pain, fatigue, and depression symptom cluster in long-term prostate cancer survivors—results from the multi-regional Prostate Cancer Survivorship Study in Switzerland (PROCAS)
AU - Adam, Salome
AU - Thong, Melissa S. Y.
AU - Martin-Diener, Eva
AU - Camey, Bertrand
AU - Egger Hayoz, C. line
AU - Konzelmann, Isabelle
AU - Mousavi, Seyed Mohsen
AU - Herrmann, Christian
AU - Rohrmann, Sabine
AU - Wanner, Miriam
AU - Staehelin, Katharina
AU - Strebel, R. to T.
AU - Randazzo, Marco
AU - John, Hubert
AU - Schmid, Hans-Peter
AU - Feller, Anita
AU - Arndt, Volker
N1 - Funding Information: We thank the Swiss Society of Urology, Europa Uomo Switzerland, and the Cancer League Switzerland for the participation and support of the study. Special thanks to all urologists involved for their participation, especially to Dr. Aron Cohen (K?snacht), Dr. med. Thomas Luginb?hl (Uster), Dr. med. Jean-Luc Fehr (Z?rich), Dr. med. Ladislav Prikler (B?lach), Dr. med. Dirk Wilbert (Glarus), Dr. med. Friedrich von Toggenburg (Buchs), Dr. med. Thomas Warzinek (Sargans), Dr. med. Stefan Preusser (Wetzikon), Dr. med. Christophe L. Hugonnet (Bulle), Dr. med. Joseph Eigenmann (Fribourg), and Dr. med. Rolf Gerber (Bern). The code that supports the findings of this study is available on request from the corresponding author. Funding Information: Open Access funding enabled and organized by Projekt DEAL. The PROCAS study was financially supported by Swiss Bridge. Salome Adam was financially supported by the Béatrice Ederer-Weber Foundation. The funding source was neither involved in the collection, interpretation, and analysis of the data, nor in the decision for the writing of this manuscript. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/11
Y1 - 2021/11
N2 - Purpose: Aside from urological and sexual problems, long-term (≥5 years after initial diagnosis) prostate cancer (PC) survivors might suffer from pain, fatigue, and depression. These concurrent symptoms can form a cluster. In this study, we aimed to investigate classes of this symptom cluster in long-term PC survivors, to classify PC survivors accordingly, and to explore associations between classes of this cluster and health-related quality of life (HRQoL). Methods: Six hundred fifty-three stage T1-T3N0M0 survivors were identified from the Prostate Cancer Survivorship in Switzerland (PROCAS) study. Fatigue was assessed with the EORTC QLQ-FA12, depressive symptoms with the MHI-5, and pain with the EORTC QLQ-C30 questionnaire. Latent class analysis was used to derive cluster classes. Factors associated with the derived classes were determined using multinomial logistic regression analysis. Results: Three classes were identified: class 1 (61.4%) – “low pain, low physical and emotional fatigue, moderate depressive symptoms”; class 2 (15.1%) – “low physical fatigue and pain, moderate emotional fatigue, high depressive symptoms”; class 3 (23.5%) – high scores for all symptoms. Survivors in classes 2 and 3 were more likely to be physically inactive, report a history of depression or some other specific comorbidity, be treated with radiation therapy, and have worse HRQoL outcomes compared to class 1. Conclusion: Three distinct classes of the pain, fatigue, and depression cluster were identified, which are associated with treatment, comorbidities, lifestyle factors, and HRQoL outcomes. Improving classification of PC survivors according to severity of multiple symptoms could assist in developing interventions tailored to survivors’ needs.
AB - Purpose: Aside from urological and sexual problems, long-term (≥5 years after initial diagnosis) prostate cancer (PC) survivors might suffer from pain, fatigue, and depression. These concurrent symptoms can form a cluster. In this study, we aimed to investigate classes of this symptom cluster in long-term PC survivors, to classify PC survivors accordingly, and to explore associations between classes of this cluster and health-related quality of life (HRQoL). Methods: Six hundred fifty-three stage T1-T3N0M0 survivors were identified from the Prostate Cancer Survivorship in Switzerland (PROCAS) study. Fatigue was assessed with the EORTC QLQ-FA12, depressive symptoms with the MHI-5, and pain with the EORTC QLQ-C30 questionnaire. Latent class analysis was used to derive cluster classes. Factors associated with the derived classes were determined using multinomial logistic regression analysis. Results: Three classes were identified: class 1 (61.4%) – “low pain, low physical and emotional fatigue, moderate depressive symptoms”; class 2 (15.1%) – “low physical fatigue and pain, moderate emotional fatigue, high depressive symptoms”; class 3 (23.5%) – high scores for all symptoms. Survivors in classes 2 and 3 were more likely to be physically inactive, report a history of depression or some other specific comorbidity, be treated with radiation therapy, and have worse HRQoL outcomes compared to class 1. Conclusion: Three distinct classes of the pain, fatigue, and depression cluster were identified, which are associated with treatment, comorbidities, lifestyle factors, and HRQoL outcomes. Improving classification of PC survivors according to severity of multiple symptoms could assist in developing interventions tailored to survivors’ needs.
KW - Classes
KW - Depression
KW - Fatigue
KW - Pain
KW - Prostate cancer
KW - Symptom cluster
UR - http://www.scopus.com/inward/record.url?scp=85104599344&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00520-021-06132-w
DO - https://doi.org/10.1007/s00520-021-06132-w
M3 - Article
C2 - 33847829
SN - 0941-4355
VL - 29
SP - 6259
EP - 6269
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 11
ER -