title: Time after surgery, symptoms and well-being in survivors of urinary bladder cancer.
abstract: OBJECTIVE
  To evaluate how an increasing burden of symptoms influences well-being, anxiety and depression at different intervals after a radical cystectomy with urostomy for bladder cancer, as this therapy can induce long-term distressful symptoms.
  
  
  METHODS
  Patients with bladder cancer undergoing radical cystectomy in Stockholm between 1969 and 1995 were matched with 434 controls from the normal population; all 404 patients operated on between 1985 and 1995 at three other hospitals in Sweden were invited to enter the study. The final analysis included 306 patients and 310 controls, all assessed for symptoms and well-being.
  
  
  RESULTS
  A low or moderate level of well-being was reported by 35% of the patients having none or one of the symptoms studied, by 39% with two symptoms, by 45% with three symptoms and by 66% of those with four or more symptoms. The values, irrespective of symptom burden, were 45% after 2-5 years of follow-up, 58% after 6-10 years and 38% at>10 years after surgery. The total symptom burden also influenced the risk of anxiety and depression. Symptom prevalence remained largely unaffected by the duration of follow-up, except for defecation urgency.
  
  
  CONCLUSIONS
  The number of long-term symptoms after radical surgery with a urostomy for urinary bladder cancer affects the risk of anxiety, depression and low or moderate well-being.
authors.affiliation: Clinical Cancer Epidemiology, Radiumhemmet, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Henningsohn
authors.forename: H
authors.initials: H
authors.lastname: Wijkström
authors.forename: J
authors.initials: J
authors.lastname: Pedersen
authors.forename: C
authors.initials: C
authors.lastname: Ahlstrand
authors.forename: G
authors.initials: G
authors.lastname: Aus
authors.forename: K
authors.initials: K
authors.lastname: Bergmark
authors.forename: E
authors.initials: E
authors.lastname: Onelöv
authors.forename: G
authors.initials: G
authors.lastname: Steineck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D015653:Cystectomy / Q000009:adverse effects* / Q000523:psychology; D003863:Depression / Q000209:etiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D018434:Sickness Impact Profile; D017741:Survivors; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000523:psychology / Q000601:surgery*