Bladder Cancer Treatment May Negatively Impact Patients’ Psychosocial Well-being

Intravesical therapy for patients with non-muscle invasive bladder cancer was found to have an impact on patients’ social, emotional and physical health.

Patients with non-muscle invasive bladder cancer who received intravesical therapy, or therapy within the bladder, may experience an impact on social, emotional and physical wellbeing, according to recent findings.

The patients in the study, which was published in the International Journal of Urological Nursing, received intravesical therapy with either Bacillus Calmette-Guerin (BCG) or Mitomycine (MMC) treatments. The study authors aimed to assess which psychosocial issues patients experienced during these treatments, and what the impacts of these issues were.

“Patients battle to cope with the side effects, for example the emotional stress of getting a day off work, not all employers are willing to allocate sick leave,” the authors wrote. “Coping with work, family, relationship and daily activities can cause a lot of stress for these patients.”

The researchers analyzed data from 80 participants ages 40 to 94 from June 2013 to July 2014 at the urological department of Franciscus Gasthuis hospital in the Netherlands. The patients, mostly male (82%), were either starting or already undergoing treatment with BCG or MMC intravesical therapy. Data was collected through patient questionnaires and analyzed with psychosocial distress and symptom screening tools.

Of the participants, 32% reported that intravesical therapy impacted levels of distress in their daily life, social, emotional and physical wellbeing. The therapy was found to put a strain on 5.3% of patients’ relationships and 16.3% of patients’ sexuality. Additionally, patients reported a negative impact on work (6.3%), finances (2.5%), childcare (3.8%) and transportation (9%). Notably, the patients in the 40-59 age group experienced the most distress (17%), which could be related to the burden of childcare and work-related issues, according to the authors.

The authors also noted that the emotional issues patients reported as providing the most distress were coping with emotions (28%), depression or gloom (28%), concentration (28%), anxiety (28%) and self-confidence (20%). However, participants did not indicate that they found it necessary to consult a mental health professional for these issues.

“Nurses need to be aware of which psychosocial issues patients are confronted with during intravesical therapy and can play an important role in providing the necessary information, guidance and counseling, which is necessary to help the patient maintain an acceptable (quality of life) during treatment,” the authors explained.

They added that nurses play an important role in encouraging patients to engage in physical activity, which could have a positive effect on wellbeing during treatment. They can also refer patients to physiotherapy or rehabilitation programs if necessary or encourage patients to keep up with an exercise diary.

Regardless, “patients have psychosocial issues which need to be addressed,” the authors concluded.

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