Use of Medications for Treating Anxiety or Depression among Testicular Cancer Survivors: A Multi-Institutional Study

Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1129-1138. doi: 10.1158/1055-9965.EPI-20-1762. Epub 2021 Apr 13.

Abstract

Background: This study examined sociodemographic factors, cisplatin-related adverse health outcomes (AHO), and cumulative burden of morbidity (CBMPt) scores associated with medication use for anxiety and/or depression in testicular cancer survivors (TCS).

Methods: A total of 1,802 TCS who completed cisplatin-based chemotherapy ≥12 months previously completed questionnaires regarding sociodemographic features and cisplatin-related AHOs [hearing impairment, tinnitus, peripheral sensory neuropathy (PSN), and kidney disease]. 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. No cisplatin-related AHOs 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. In the multivariable model, higher CBMPt scores were significantly associated with medication use for anxiety and/or depression (P < 0.0001). In addition, tinnitus (P = 0.0009), PSN (P = 0.02), and having health insurance (P = 0.05) were significantly associated with greater use of these medications, whereas being employed (P = 0.0005) and vigorous physical activity (P = 0.01) were significantly associated with diminished use.

Conclusions: 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 of these medications.

Impact: Healthcare providers should encourage TCS to increase physical activity to improve both physical and mental health. Rehabilitation programs should assess work-related skills and provide career development counseling/training.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Anti-Anxiety Agents / therapeutic use*
  • Antidepressive Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Anxiety / diagnosis
  • Anxiety / drug therapy
  • Anxiety / epidemiology*
  • Anxiety / psychology
  • Cancer Survivors / psychology
  • Cancer Survivors / statistics & numerical data
  • Child
  • Cisplatin / adverse effects
  • Depression / diagnosis
  • Depression / drug therapy
  • Depression / epidemiology*
  • Depression / psychology
  • Drug Prescriptions / statistics & numerical data
  • Hearing Loss / chemically induced
  • Hearing Loss / epidemiology
  • Hearing Loss / psychology
  • Humans
  • Kidney Diseases / chemically induced
  • Kidney Diseases / epidemiology
  • Kidney Diseases / psychology
  • Male
  • Middle Aged
  • Risk Factors
  • Self Report / statistics & numerical data
  • Testicular Neoplasms / drug therapy*
  • Testicular Neoplasms / mortality
  • Testicular Neoplasms / psychology
  • Tinnitus / chemically induced
  • Tinnitus / epidemiology
  • Tinnitus / psychology
  • Young Adult

Substances

  • Anti-Anxiety Agents
  • Antidepressive Agents
  • Cisplatin