The roles of stress and social support in prostate cancer mortality

Abstract

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. Materials and 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.

Keywords:

• Oncology
• perceived stress
• prostate cancer
• quality of life
• social support

Acknowledgements

We would like to thank the Swedish Cancer Foundation, the Swedish Council for Working Life and Social Research, and the Fulbright US Student Program for financial support. Thank you to all of the participants in the PROCAP Study and the research nurses who extracted the clinical follow-up data. Thank you to Robert Szulkin for helping to program the progression variables. Finally, we would like to acknowledge that this project was made possible by the continuous work of the NPCR steering group: Pär Stattin (chairman), Anders Widmark, Lars Egevad, Magnus Törnblom, Stefan Carlsson, Jan Adolfsson, Anna Bill-Axelson, Jan-Erik Johanssson, Ove Andrén, Mats Lambe, Erik Holmberg, David Robinson, Bill Pettersson, Jonas Hugosson, Jan-Erik Damber, Ola Bratt, Göran Ahlgren, Karin Hellström and Maria Nyberg.

Funding

Supported by funds from the Swedish Cancer Foundation, the Swedish Council for Health, Working Life, and Social Research (FAS), and the Fulbright US Student Program.

Declaration of interest: The authors have no conflicts of interest to disclose.