Fear of recurrence in long-term testicular cancer survivors.
OBJECTIVE
To explore fear of recurrence (FoR) in long-term testicular cancer survivors (TCSs) since FoR hardly has been examined in TCSs.


METHODS
In a cross-sectional questionnaire study, 1336 TCSs at a mean of 11.4 years (SD 4.2) after diagnosis gave information about their medical and social situation, and completed measures on mental distress, fatigue, quality of life, coping, self-esteem and neuroticism. FoR during the last week was explored with one question, with the response categories rated on a 4-point Likert scale. Nine percent of the TCSs had a structured psychiatric interview.


RESULTS
Twenty-four percent of the TCSs reported 'quite a bit' FoR and 7% reported 'very much' FoR during the last week. The FoR question showed moderate correlations (0.22-0.51) with established psychological measures. The level of FoR was significantly positively correlated with mental distress, fatigue and neuroticism and significantly negatively correlated with quality of life, self-esteem and coping. In univariate analyses, neurotoxic side effects and somatic symptoms, but not treatment modality, were significantly associated with level of FoR. In a multivariate analysis, a medium educational level, increasing levels of traumatic cancer-related stress symptoms and of neuroticism were significantly associated with rising FoR. Among those who had a psychiatric interview, the presence of at least one current mental disorder was significantly associated with FoR.


CONCLUSIONS
High levels of FoR in long-term TCSs are not uncommon. Levels of mental and somatic problems are associated with the levels of FoR. Clinical consequences of these findings for TCSs are discussed.
Department of Clinical Cancer Research, The Norwegian Radiumhospital, Rikshospitalet University Hospital, Oslo, Norway. tone.skaali@radiumhospitalet.no
Tone
T
Skaali
Sophie D
SD
Fosså
Roy
R
Bremnes
Olav
O
Dahl
Carl Fredrik
CF
Haaland
Erik Rønneberg
ER
Hauge
Olbjørn
O
Klepp
Jan
J
Oldenburg
Erik
E
Wist
Alv A
AA
Dahl
D000223:Adaptation, Psychological; D000328:Adult; D003430:Cross-Sectional Studies; D003674:Defense Mechanisms; D005221:Fatigue / Q000523:psychology; D005239:Fear; D005500:Follow-Up Studies; D018237:Germinoma / Q000523:psychology* / Q000628:therapy; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D009497:Neurotic Disorders / Q000523:psychology; D010555:Personality Inventory; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D012649:Self Concept; D018239:Seminoma / Q000523:psychology* / Q000628:therapy; D012803:Sick Role; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013736:Testicular Neoplasms / Q000523:psychology* / Q000628:therapy