Time, symptom burden, androgen deprivation, and self-assessed quality of life after radical prostatectomy or watchful waiting: the Randomized Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) clinical trial.

Background: Quality-of-life outcomes are important in the choice of treatment strategy for men with localized prostate cancer.

Objective: To evaluate how follow-up time, number of physical symptoms, and presence of androgen deprivation affected quality of life among men randomized to radical prostatectomy or watchful waiting.

Design, Setting, And Participants: The study group was composed of all 376 living men included in the Swedish part of the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) between January 1, 1989, and February 29, 1996.

Disclosure of incurable illness to spouses: do they want to know? A Swedish population-based follow-up study.

Purpose: Awareness of the cancer patient's terminal state decreases the risk of psychological morbidity of the bereaved. We wanted to determine whether male spouses of cancer patients who died from their disease had received information that the illness was incurable and to determine their preferences of disclosure.

Participants And Methods: The study included 907 widowers whose wives had died of cancer.

Perceptions of a mental health questionnaire: the ethics of using population-based controls.

Mental health surveys are used extensively in epidemiological research worldwide. The ethical questions that arise regarding their risk of causing psychological distress or other potential harm have not been studied in the general population. We have investigated how study participants serving as controls in a population-based study perceived an anonymous postal questionnaire focusing on mental health and wellbeing.

Guilt after the loss of a husband to cancer: is there a relation with the health care provided?

Background: Feelings of guilt are common after bereavement. We investigated whether feelings of guilt after the loss of a husband to cancer are associated with the health care provided at the time close to and at the moment of death.

Materials And Methods: The study population consisted of 506 widows of men who died of prostate cancer in 1995 or of urinary bladder cancer in 1995 or 1996 at the ages 45-74 years.

One third of patients with radiotherapy-induced nausea consider their antiemetic treatment insufficient.

Objective: To describe the prevalence of nausea and vomiting during radiotherapy and to compare quality of life, psychological and functional status in patients experiencing or not experiencing nausea.

Materials And Methods: A cross-sectional selection of 368 cancer patients treated with radiotherapy answered a questionnaire (=93% answering rate) regarding nausea, vomiting, actual use of and interest in antiemetic treatment, quality of life and psychological and functional status during the preceding week of radiotherapy. Mean age was 60 years and 66% were women.

Events after stillbirth in relation to maternal depressive symptoms: a brief report.

Background: Actions taken after a stillbirth can affect long-term psychological morbidity. Our objective was to study how infant bonding and maternal actions after stillbirth are associated with ensuing depressive symptoms.

Methods: Using the population-based Swedish Medical Birth Register, we identified all 380 Swedish-speaking women who gave birth to singleton stillborn infants in Sweden in 1991.

Predictors for the symptomatic prostate cancer patient's delays in seeking care.

Aim: This study aims to determine the predictors for the symptomatic prostate cancer patient's delays in seeking care.

Methods: We followed a cohort of 931 men with prostate cancer from Stockholm County (Sweden) asking about socio-demographic and information-level characteristics as well as the length of delay in seeking care.

Results: Of the 511 patients who returned a completed questionnaire, 219 (43%) reported having clinical symptoms before prostate cancer was diagnosed.

Long-term outcomes for mothers who have or have not held their stillborn baby.

Objectives: to investigate long-term outcomes of mothers who have or have not held their stillborn baby, and predictors of having held the baby.

Design: postal questionnaires.

Setting: a nation-wide cohort study of mothers who gave birth to a singleton stillborn baby in Sweden in 1991.

The Internet and prostate cancer patients: searching for and finding information.

Objective: To define the characteristics of prostate cancer patients who use the Internet.

Material And Methods: In October 2002, 511 prostate cancer patients from Stockholm-Gotland County completed a postal questionnaire consisting of 146 questions regarding use of the Internet, demographic factors, level of information about the disease and its treatment, quality of life and trade-off possibilities.

Results: The response rate was 86.

Measuring anxiety and depression in the oncology setting using visual-digital scales.

We investigated the feasibility of using single-item visual-digital scales for measuring anxiety and depression for research purposes within the oncology and palliative care setting. Data were retrieved from five nationwide postal questionnaires comprising 3030 individuals (response rate 76%): cancer patients, widows/parents who had lost their husband/child to cancer and population controls. All questionnaires contained the Center for Epidemiological Studies Depression scale (CES-D) and Spielberger's State-Trait Anxiety Inventory (STAI-T) as well as seven-point Visual-Digital Scales (VDS) assessing anxiety and depression.

Parents' intellectual and emotional awareness of their child's impending death to cancer: a population-based long-term follow-up study.

Background: We aimed to study care-related determinants of when parents gain awareness of their child's impending death to cancer, and whether the duration of this awareness affects the parents' long-term morbidity.

Methods: Between August 2001 and October 2001, 449 of 561 (80%) parents who had lost a child due to any malignancy in Sweden between Jan 1, 1992, and Dec 31, 1997 (identified on the Swedish Causes of Death Register), answered a 365-item postal questionnaire designed to ascertain when, before the child's actual death, they had become intellectually and emotionally aware of the child's impending death (awareness time). The primary endpoints were intellectual awareness time (defined as time between intellectual realisation that a disease is fatal and the actual time of death) and emotional awareness time (defined as time between emotional realisation that a disease is fatal and the actual time of death).

Epidemiology of urinary bladder cancer: from tumor development to patient's death.

Urinary bladder cancer (UBC) ranks ninth in worldwide cancer incidence. It is more frequent in men than in women. We review the main established/proposed factors, both environmental and genetic, associated with bladder cancer etiology and prognosis.

Polymorphisms in NQO1 and the clinical course of urinary bladder neoplasms.

Objective: Urinary bladder neoplasms differ considerably in biological potential, and tumor morphology alone cannot predict their clinical behaviors. Polymorphisms in xenobiotic metabolic genes reportedly modulate susceptibility to bladder neoplasms and may affect the clinical course and outcomes of the disease. This study was conducted to determine the effect of polymorphisms in the xenobiotic metabolic genes on the disease course and clinical outcomes of urinary bladder neoplasms.

Polymorphisms in XPD, XPC and the risk of death in patients with urinary bladder neoplasms.

We conducted a follow-up study on 311 patients with urinary bladder neoplasms to investigate the association of polymorphisms in DNA repair and cell growth regulatory genes with the clinical outcomes of this disease. We found that patients carrying the variant allele of XPD (K751Q) polymorphism were at lower risk of death (p = 0.04) than the noncarriers.

Economic conditions and marriage quality of men with prostate cancer.

Objective: To explore the predictors of the quality of marriage of men with prostate cancer, as being diagnosed with prostate cancer affects the quality of life of the man and his partner, and while some aspects are known about the impact of the disease and its treatments on the man's quality of life, less is known about the marriage quality (MQ) in this new situation.

Patients And Methods: We followed 591 men from Stockholm County (Sweden) who had been diagnosed with prostate cancer in 1999, and who were 50-80-years old and alive on 1 October 2002. The men completed a questionnaire asking about their MQ, and several other sociodemographic, medical and economic characteristics.

Erectile function after robotic nerve sparing and semi-sparing of the neurovascular bundles.

We set out to present potency results after bilateral, unilateral, and semi-sparing of the neurovascular bundles after robotic prostatectomy. Two hundred and twenty-five consecutive robotic-assisted laparoscopic radical prostatectomies were performed by one surgeon (NPW) from the start of our robotic program in January 2002 until December 2005. Patient demographics, operative, and postoperative data were prospectively entered into a database.

When death appears best for the child with severe malignancy: a nationwide parental follow-up.

Background: Loss of a child to malignancy is associated with long-term morbidity among surviving parents. This study aims to identify particular sources of stress among parents of children with severe malignancy.

Methods: We attempted to contact all parents in Sweden who lost a child to cancer between 1992 and 1997.

Reliability of assessment of urgency and other symptoms indicating anal sphincter, large bowel or urinary dysfunction.

Objective: The Radiumhemmets Scale of Disease-Specific Symptom Assessment-Prostate Cancer has been used in several studies. However, no test-retest reliability study of it has been conducted concerning the assessment of urinary, anal sphincter or large bowel function. The aim of this study was to evaluate the reliability of items assessing these functions.

Prognostic significance of homozygous deletions and multiple duplications at the CDKN2A (p16INK4a)/ARF (p14ARF) locus in urinary bladder cancer.

Objective: The 9p21 locus is a major target in the pathogenesis of human urinary bladder cancer. This locus harbours the CDKN2A/ARF tumour suppressor gene, which encodes two cell-cycle regulatory proteins: p16INK4a and p14ARF. We studied how homozygous deletions and multiple duplications at this locus affect prognosis and survival in patients with bladder cancer.

Lymphedema and bladder-emptying difficulties after radical hysterectomy for early cervical cancer and among population controls.

The aim of the study was to acquire knowledge that can be used to refine radical hysterectomy to improve quality-of-life outcome. Data were collected in 1996-1997 by means of an anonymous postal questionnaire in a follow-up study of two cohorts (patients and population controls). We attempted to enroll all 332 patients with stage IB-IIA cervical cancer registered in 1991-1992 at the seven departments of gynecological oncology in Sweden and 489 population controls.

Home care of a child dying of a malignancy and parental awareness of a child's impending death.

In this population-based study, we found that parents who are aware that their child will die from a malignancy are more likely to care for their child at home during the child's last month of life compared to parents who are not aware. End-of-life home care was comparable to hospital care for satisfactory pain relief, access to pain relief and access to medications for other physical symptoms. Using an anonymous postal questionnaire, we obtained information from 449 parents in Sweden who had lost a child due to a malignancy between 1992 and 1997, 4 to 9 years before participating in our study.

A hierarchical step-model for causation of bias-evaluating cancer treatment with epidemiological methods.

As epidemiological methods are used increasingly to evaluate the effects of cancer treatment, guidelines for the application of such methods in clinical research settings are necessary. Towards this end, we present a hierarchical step-model for causation of bias, which depicts a real-life study as departing from a perfect setting and proceeding step-wise towards a calculated, often adjusted, effect-parameter. Within this model, a specific error (which influences the effect-measure according to one of four sets of rules) is introduced on one (and only one) of the model's four steps.

Interviewer variability - quality aspects in a case-control study.

Quality assurance and quality control are important for the reliability of case-control studies. Here we describe the procedures used in a previously published study, with emphasis on interviewer variability. To evaluate risk factors for acute pancreatitis, information including previous diagnoses and medication was collected from medical records and by telephone interviews from 462 cases and 1781 controls.

Perceptions of inadequate health care and feelings of guilt in parents after the death of a child to a malignancy: a population-based long-term follow-up.

Background: Parental feelings of guilt can be a serious problem after the death of a child to a malignancy. This study identified predictors of feelings of guilt in parents during the year after a child's death.

Methods: The Swedish Cause of Death Register and Swedish Cancer Register were used to identify all parents in Sweden who had a child who died of a malignancy between 1992-1997.