title: Anxiety level of early- and late-stage prostate cancer patients.
abstract: OBJECTIVE
  Anxiety can worsen prostate cancer patients' decision making and quality of life. Early identification of anxiety disorders is thus very important for excellent prostate cancer treatment. This study aimed to determine the levels of anxiety in patients with early-stage prostate cancer compared with advanced-stage disease.
  
  
  METHODS
  This cross-sectional study was performed at the Department of Urology, 'Cipto Mangunkusumo' Hospital, Faculty of Medicine, University of Indonesia. The subjects were early-stage prostate cancer patients and advanced-stage prostate cancer patients with bone metastatic lesions proved by bone scan. Comparative analysis was done to analyze anxiety scores assessed by use of an 11-item modified Memorial Anxiety Scale for Prostate Cancer (MAX-PC) questionnaire. We also assessed the relationship of the MAX-PC score with age, prostate-specific antigen (PSA) value, number of bone metastases, and pain. Data were analyzed by using SPSS ver. 17 (SPSS Inc.).
  
  
  RESULTS
  There were 34 subjects with early-stage prostate cancer and 34 subjects with advanced-stage prostate cancer. We found that the mean anxiety score was significantly lower (P=0.0001) in the early-stage prostate cancer group (8.32±3.65) than in the advanced-stage prostate cancer group (12.61±4.56). Nine subjects had a pathological MAX-PC score (≥16), of whom 1 subject had early-stage disease and 8 subjects had advanced-stage disease. Furthermore, there were significant positive correlations (P<0.001) between MAX-PC score and visual analogue scale pain score (r=0.633), PSA value (r=0.263), and number of bone metastatic lesions (r=0.464). However, the correlation between age and anxiety score was not significant (P=0.170).
  
  
  CONCLUSIONS
  The MAX-PC anxiety score was significantly associated with the stage of prostate cancer. Furthermore, visual analogue scale pain score, PSA value, and number of bone metastatic lesions can also affect the MAX-PC anxiety score.
authors.affiliation: Departments of Urology, Cipto Mangunkusumo Hospital, Faculty of Medicine University of Indonesia, Jakarta, Indonesia.
authors.forename: Charles
authors.initials: C
authors.lastname: Johanes
authors.affiliation: Departments of Urology, Cipto Mangunkusumo Hospital, Faculty of Medicine University of Indonesia, Jakarta, Indonesia.
authors.forename: Richard Arie
authors.initials: RA
authors.lastname: Monoarfa
authors.forename: Raden Irawati
authors.initials: RI
authors.lastname: Ismail
authors.affiliation: Departments of Urology, Cipto Mangunkusumo Hospital, Faculty of Medicine University of Indonesia, Jakarta, Indonesia.
authors.forename: Rainy
authors.initials: R
authors.lastname: Umbas
keywords: Anxiety disorders; Neoplasm staging; Pain measurement; Prostatic neoplasms