Aspects of posttraumatic stress disorder in long-term testicular cancer survivors: cross-sectional and longitudinal findings

PURPOSE - The purpose of this research is to study the prevalence of posttraumatic stress disorder (PTSD) and variables associated with PTSD in Norwegian long-term testicular cancer survivors (TCSs) both cross-sectionally and longitudinally.

METHODS - At a mean of 11 years after diagnosis, 1418 TCSs responded to a mailed questionnaire, and at a mean of 19 years after diagnosis, 1046 of them responded again to a modified questionnaire. Posttraumatic symptoms related to testicular cancer were self-rated with the Impact of Event Scale (IES) at the 11-year study only. An IES total score ≥35 defined Full PTSD, and a score 26-34 identified Partial PTSD, and the combination of Full and Partial PTSD defined Probable PTSD.

RESULTS - At the 11-year study, 4.5 % had Full PTSD, 6.4 % had Partial PTSD, and 10.9 % Probable had PTSD. At both studies, socio-demographic variables, somatic health, anxiety/depression, chronic fatigue, and neurotoxic adverse effects were significantly associated with Probable PTSD in bivariate analyses. Probable anxiety disorder, poor self-rated health, and neurotoxicity remained significant with Probable PTSD in multivariate analyses at the 11-year study. In bivariate analyses, probable PTSD at that time significantly predicted socio-demographic variables, somatic health, anxiety/depression, chronic fatigue, and neurotoxicity among participants of the 19-year study, but only probable anxiety disorder remained significant in multivariable analysis.

CONCLUSIONS - In spite of excellent prognosis, 10.9 % of long-term testicular cancer survivors had Probable PTSD at a mean of 11 years after diagnosis. Probable PTSD was significantly associated with a broad range of problems both at that time and was predictive of considerable problems at a mean of 19 year postdiagnosis.

IMPLICATIONS FOR CANCER SURVIVORS - Among long-term testicular cancer survivors, 10.9 % have Probable PTSD with many associated problems, and therefore health personnel should explore stress symptoms at follow-up since efficient treatments are available.

Journal of cancer survivorship : research and practice. 2016 Feb 26 [Epub ahead of print]

Alv A Dahl, Marie Østby-Deglum, Jan Oldenburg, Roy Bremnes, Olav Dahl, Olbjørn Klepp, Erik Wist, Sophie D Fosså

National Advisory Unit for Long-Term Adverse Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, P.O. Box 4953, Nydalen, N-0424, Oslo, Norway.   Faculty of Medicine, University of Southern Denmark, Odense, Denmark., Department of Oncology, Akershus University Hospital, Lørenskog, Norway., Department of Oncology, University Hospital of Northern Norway, University of Northern Norway, Tromsø, Norway., Department of Oncology, Haukeland University Hospital, University of Bergen, Bergen, Norway., Department of Oncology, Saint Olav's Hospital, National University for Science and Technology, Trondheim, Norway., University of Oslo, Oslo, Norway., National Advisory Unit for Long-Term Adverse Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, P.O. Box 4953, Nydalen, N-0424, Oslo, Norway.