Uncertainty, post-traumatic stress, and quality of life in non-muscle-invasive bladder cancer survivors.

Abstract

e16027 Background: More than 74,000 people are diagnosed with bladder cancer every year in the US, and approximately 75% of them have non-muscle-invasive bladder cancer (NMIBC). Having a NMIBC with high recurrence rates and frequent surveillance cystoscopies followed by repeated treatment can be a source of uncertainty and post-traumatic stress disorder (PTSD) symptoms affecting survivor’s quality of life (QOL). This study was to explore the impact of cancer, cancer treatment, and surveillance procedures on uncertainty, PTSD symptoms, and QOL in patients with NMIBC. Methods: NMIBC patients, diagnosed between 2010 – 2014, were eligible for this study. Of the 5979 NMIBC population identified through North Carolina Central Cancer Registry and met the criteria, 2000 patients were randomly selected. Data were collected by postal mail survey from October to December, 2016. The Mishel Uncertainty in Illness Scale-Survivor (MUIS-S), the PTSD Checklist for DSM-5 (PCL-5), the EORTC QLQ-C30, and QLQ-NMIBC24 were used to measure uncertainty, post-traumatic stress, and QOL, respectively. Descriptive statistics, partial correlations, ANOVA, and t-test were performed. Results: 396 NMIBC survivors returned their surveys (response rate 22%). Subjects averaged 3.5 years post-diagnosis and 72.8 years of age; the majority were male (71.7%) and white (94.4%). The mean score for uncertainty was 53.3±12.0, which means moderate uncertainty. Subjects who scored at or above 33 for PCL-5 were 4.3%, which indicates having PTSD. The mean scores for QOL dimensions (global health status, function, and symptom) were 73.3±21.9, 84.6±18.5, 15.5±17.1, respectively (possible range 0-100, higher score of global health and function = better, higher score of symptom = worse). There were significant correlations between uncertainty, PTSD symptoms, and all QOL dimensions (all p < 0.001). Conclusions: Higher levels of uncertainty and PTSD symptoms were inversely related with QOL. Thus, future work should continue to explore the antecedents of uncertainty and PTSD symptoms and to identify the relationships among antecedents, uncertainty, PTSD symptoms, and QOL for intervention studies in high risk NMIBC survivors.