PSYCHOSOCIAL CONCOMITANTS OF SURVIVAL FROM ADULT ONSET TESTICULAR CANCER

Abstract

This study examines the question of whether newly achieved survival from testicular cancer carries the liability of psychosocial disturbance. Psychosocial disturbance was defined on the following dimensions: (1) psychological symptomatology; (2) social impairment; (3) psychosexual dysfunction; (4) self-esteem; (5) recent adverse life stress; (6) death anxiety; and (7) intrusive and avoidant coping with diagnosis. The study used a controlled design to compare thity testicular cancer survivors to fifteen control subjects with a history of benign genital diagnoses. The cancer group consisted of fifteen survivors with Stage II disease and fifteen survivors with Stage III disease so that the effect of stage of disease could be examined.;The hypotheses of greater psychosocial morbidity in the cancer survivors than the benign subjects was partially confirmed by the significantly greater disturbance scores of the former on clinician ratings of somatic concerns and social functioning and trends toward significance on clinician ratings of depression-anxiety and global disturbance. This hypothesis was also supported by significantly greater disturbance on self-reported somatization, intrusive coping, and avoidant coping, and trends toward greater disturbance of self-reported depression, global distress, and death anxiety in the cancer group. Furthermore, in all except one of the 17 study parameters, the benign group mean disturbance scores were lower than those of the cancer survivors.;The hypothesis of greater psychosocial morbidity in the Stage III versus Stage II cancer survivors was not confirmed. The mean disturbance scores of the two groups were virtually identical.;When the cancer group was dichotomized as poorer versus better adjusters on clinician global rating, the poorer adjusters were characterized by significantly higher disturbance scores or trends toward greater disturbance on ten out of 12 self-report parameters. When the cancer group was dichotomized as poorer versus better copers by their extent of use of both avoidant and intrusive modes of traumatic response, the poorer copers were characterized by significantly higher disturbance scores or trends toward greater disturbance on only half of the self-report parameters.;The results of this study embrace an intermediate position between prior findings of no psychosocial dysfunction in the cancer survivor, among the medical and epidemiological authors, and the claims of psychological traumatization in the cancer survivor, among the clinical psychiatric authors. Even on the parameters where testicular cancer survivors could be significantly distinguished from benign controls, the former showed only mild levels of disturbance, which did not jeopardize their daily functioning. Thus, the study provided evidence of the true mild disturbance that was expected to characterize this population.