The Impact of Cancer Status on Anxiety in Prostate Cancer Patients: A Network Analysis

Prostate cancer (PCa) patients often also suffer from comorbid anxiety, which can impede treatment efficacy as well as be intrinsically unpleasant. Identification of the associations between particular symptoms of anxiety that are most likely to occur at different points in the PCa diagnosis-treatment journey can inform anxiety treatment choices and potentially influence their overall treatment outcomes. Although simple correlational analyses and ANOVA models of data analysis have been used to address this issue, the possibility of confounds due to the inter-relationships between other anxiety symptoms argues for the use of network analysis, which calculates each symptom-symptom connection while also taking into account the entire range of symptom relationships. Responses to the GAD-10 self-report scale for Generalised Anxiety Disorder were collected from 415 PCa patients who were grouped according to whether (1) their PCa was just diagnosed and undergoing initial treatment; (2) their cancer was in remission; or (3) their cancer was recurring after initial treatment. The results of the network analysis indicated several areas where clinically relevant differences were present between the three PCa groups, but caution was applied to the results of statistical tests due to unequal sample sizes. Individual GAD symptom-symptom association differences are discussed in terms of their implications for directed and individualised anxiety-management treatment models.