Objective and subjective predictors of cancer-related stress symptoms in testicular cancer survivors.
OBJECTIVE
(1) To investigate cancer-related stress symptoms among testicular cancer survivors (TCSs), (2) to gain insight into the relationship of sociodemographic and cancer-related variables with cancer-related stress symptoms and (3) to assess whether objective and subjective aspects of cancer diagnosis and treatment can be associated with ongoing distress after cancer.


METHODS
Three hundred and fifty-four TCSs were enrolled in this study and completed the Impact of Events Scale (IES). Thirty TCSs were also selected for interviews: 15 with no and 15 with high levels of cancer-related stress symptoms.


RESULTS
Thirteen percent of the TCSs reported experiencing cancer-related stress symptoms. Single TCSs, those with less education, and those who were not employed for wages reported higher levels of stress. Cancer-related variables appeared to play almost no role. Information obtained through interviews suggested that subjective perceptions were more strongly associated with cancer-related stress symptoms than were actual medical histories. Perceptions about the impact of the illness on current life and fear of the future were particularly decisive factors in the presence or absence of cancer-related stress symptoms.


CONCLUSIONS
It would be beneficial to ask TCSs during follow-up about their thoughts concerning the threats posed by testicular cancer and its effects for their current and future lives, as such perceptions do not necessarily coincide with actual medical histories or current state of health.


CONCLUSIONS
TCSs who feel that their lives continue to be threatened by their experiences with testicular cancer should be referred for psychosocial intervention.
Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, The Netherlands.
Joke
J
Fleer
Dirk
D
Sleijfer
Harald
H
Hoekstra
Marrit
M
Tuinman
Ed
E
Klip
Josette
J
Hoekstra-Weebers
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D004522:Educational Status; D005239:Fear; D006801:Humans; D008016:Life Change Events; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009426:Netherlands; D015404:Nursing Methodology Research; D011779:Q-Sort; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013736:Testicular Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy