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Trial Lecture – time and place
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Adjudication committee
- First opponent: Professor Andreas Røder, University of Copenhagen, Denmark
- Second opponent: Professor Hege Haugnes, UiT - The Arctic University of Norway, Tromsø
- Third member and chair of the evaluation committee: Professor Viktor Berge, University of Oslo
Chair of the Defence
Associate Professor Stig Müller, University of Oslo
Principal Supervisor
Erik Skaaheim Haug, Sykehuset i Vestfold
Summary
Prostate cancer is the most common cancer form among men in Norway and is typically diagnosed in an early phase with a good prognosis. Although radical treatments may offer a potential cure, they come with significant adverse effects and have often limited long-term prognostic benefit. This dilemma makes valid knowledge about the negative effects of treatments particularly important. The present thesis explores the lives of men with non-metastatic prostate cancer with a special focus on the role of psychological factors. The overall aim is to generate new knowledge to enhance patient counselling, both for newly diagnosed men and for those undergoing follow-up after treatment.
The thesis comprises three papers, which are based on both cross-sectional and prospective questionnaire-based studies.
The first paper investigates the work life in a sample of men previously treated with radical prostatectomy or in active surveillance. The study found little differences in work status and work ability between the two treatment groups. Rather, non cancer-related factors, such as older age, chronic fatigue and elevated levels of anxiety and depression, were associated with a reduction in work ability, while treatment method was not.
In the second paper, we studied the fear of recurrence in the same group of men as in paper I. We found that fear of recurrence was common, particularly among younger patients with certain psychological traits. Unsurprisingly, fear of recurrence was prevalent after radical prostatectomy with signs of recurrent disease. However, it was almost as high in the active surveillance group, despite their very low risk of dying of prostate cancer.
In the third paper, we prospectively examined the relationship between levels of anxiety and depression at the time of prostate biopsy and the adverse effects after radical prostatectomy. Our findings showed that men with higher levels of such psychological distress were more affected by decreases in urinary and sexual function. Additionally, they used more incontinence pads and sexual aids during follow-up.
These findings highlight the relevance of psychological factors when making treatment decisions and during follow-up care for men with non-metastatic prostate cancer. Further studies should focus on identifying these men and develop supportive interventions in clinical practice.
Additional information
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