Factors associated with use of medications for anxiety and depression in testicular cancer survivors after cisplatin-based chemotherapy.

Authors

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Shirin Ardeshirrouhanifard

Indiana University School of Medicine, Indianapolis, IN

Shirin Ardeshirrouhanifard , Paul C Dinh Jr., Patrick O. Monahan , Sophie Fosså , Robert A Huddart , Chunkit Fung , Yiqing Song , Darren R. Feldman , Robert James Hamilton , David J. Vaughn , Neil E. Martin , Christian K. Kollmannsberger , Lifang Hou , Lawrence Einhorn , Kurt Kroenke , Lois B. Travis

Organizations

Indiana University School of Medicine, Indianapolis, IN, National Advisory Unit on Late Effects After Cancer Treatment, Oslo, Norway, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, Indiana University Richard M Fairbanks School of Public Health, Indianapolis, IN, Memorial Sloan Kettering Cancer Center, New York, NY, Division of Urologic Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, Department of Medicine, University of Pennsylvania, Philadelphia, PA, Dana Farber Cancer Institute, Boston, MA, Division of Medical Oncology, University of British Columbia, Vancouver, BC, Canada, Feinberg School of Medicine, Northwestern University, Chicago, IL, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, Regenstrief Institute, Indianapolis, IN

Research Funding

U.S. National Institutes of Health
U.S. National Institutes of Health

Background: Cancer survivors are at increased risk of anxiety and depression that can affect health-related quality of life. There is no study to date that has examined the characteristics of testicular cancer survivors (TCS) taking medications for anxiety or depression since pharmacological interventions are typically reserved for more severe cases of these disorders. In this study, we aimed to examine sociodemographic factors, cisplatin-related adverse health outcomes (AHOs), and cumulative burden of morbidity (CBMPt) scores associated with medication use for anxiety and/or depression in TCS. Methods: A total of 1,802 TCS who completed CBCT ≥12 months previously completed validated questionnaires regarding sociodemographic features and cisplatin-related AHOs (hearing impairment, tinnitus, peripheral sensory neuropathy (PSN), kidney disease). Patients were recognized as users of medications for anxiety and/or depression if they used pharmacological classes of these medications and also indicated that the reason for use was for anxiety or depression. Individual AHOs were graded 0-to-4 based on severity according to NCI Common Terminology Criteria for Adverse Events version 4.03. A CBMPt score encompassed the number and severity of cisplatin-related AHOs. Multivariable logistic regression models assessed the relationship of individual AHOs and CBMPt with medication use for anxiety and/or depression. Results: A total of 151 TCS (8.4%) used medications for anxiety and/or depression. Any grade of HL, tinnitus, PSN, and kidney disease were reported by 37.9%, 39.5%, 55.2%, and 2.4% of 1,802 participants, respectively. No cisplatin-related AHO were reported by 511 (28.4%) participants, whereas 622 (34.5%), 334 (18.5%), 287 (15.9%), and 48 (2.7%), respectively, had very low, low, medium, and high CBMPt scores. Higher CBMPt scores were significantly associated with greater medication use for anxiety and/or depression (CBMPt scores of low (OR = 2.96, 95%CI, 1.67-5.24), medium (OR = 3.47, 95%CI, 1.95-6.18), and high (OR = 3.18, 95%CI, 1.22-8.3). A multivariable model including individual AHOs indicated that tinnitus (P= 0.0009), PSN (P= 0.02), and having health insurance (OR = 2.15, 95%CI, 1.01-4.56) were associated with significantly greater use of these medications; whereas being employed (OR = 0.39, 95%CI, 0.23-0.66) and vigorous physical activity (OR = 0.63, 95%CI,0.44-0.89) were associated with significantly diminished use. Conclusions: We found that TCS with higher CBMPt scores had a higher probability of using medications for anxiety and/or depression and conversely, those who were employed and physically active tended to have reduced use. These findings deserve further investigation in longitudinal studies. In the interim, healthcare providers should be aware of these associations in formulating survivorship care plans.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Genitourinary Cancer—Prostate, Testicular, and Penile

Track

Genitourinary Cancer—Prostate, Testicular, and Penile

Sub Track

Germ Cell/Testicular Cancer

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 5025)

DOI

10.1200/JCO.2021.39.15_suppl.5025

Abstract #

5025

Poster Bd #

Online Only

Abstract Disclosures

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