The roles of stress and social support in prostate cancer mortality.
OBJECTIVE
This study aimed to evaluate the association between perceived stress, social support, disease progression and mortality in a nationwide population-based cohort of men with prostate cancer.


METHODS
The study surveyed 4105 Swedish men treated for clinically localized prostate cancer regarding stress, grief, sleep habits and social support. Associations between these factors and mortality were assessed using multivariate Cox regression analysis.


RESULTS
Men with the highest levels of perceived stress had a statistically significantly increased rate of prostate cancer-specific mortality compared with men with low stress levels (hazard ratio 1.66, 95% confidence interval 1.05-2.63). Men with high stress levels also had a high frequency of grieving and sleep loss. They also had fewer people with whom to share their emotional problems and felt an inability to share most of their problems with partners, friends and family.


CONCLUSIONS
This study contributes to the growing field of psychosocial quality of life research in men with prostate cancer. The findings show a significant association between prostate cancer-specific mortality and perceived stress in patients initially diagnosed with localized, non-metastatic prostate cancer. Significant associations between perceived stress and various psychosocial factors were also seen. The findings of this study could prove useful to target interventions to improve quality of life in men with prostate cancer.
a 1 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm, Sweden.|b 2 Department of Internal Medicine, Temple University Hospital , Philadelphia, PA, USA.
Michael
M
Jan
a 1 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm, Sweden.
Stephanie E
SE
Bonn
a 1 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm, Sweden.
Arvid
A
Sjölander
a 1 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm, Sweden.
Fredrik
F
Wiklund
c 3 Department of Surgery and Preoperative Sciences, Urology, Umeå University , Umeå, Sweden.
Pär
P
Stattin
d 4 Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , Gothenburg, Sweden.
Erik
E
Holmberg
a 1 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm, Sweden.
Henrik
H
Grönberg
a 1 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm, Sweden.
Katarina
K
Bälter
D000368:Aged; D015331:Cohort Studies; D018450:Disease Progression; D006117:Grief; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000150:complications / Q000401:mortality / Q000523:psychology*; D012893:Sleep Wake Disorders / Q000150:complications / Q000523:psychology*; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
Oncology; perceived stress; prostate cancer; quality of life; social support