An Examination of the Relationship between Mental Distress, Functional and Psychosocial Quality of Life Indicators in a Population Based Sample of Prostate Cancer Survivors Who Received Curative Treatment.

INTRODUCTION: Although survival rates are highest among prostate cancer survivors compared to any other forms of cancer, nearly 60% suffer from mental distress. Here we examine urinary function and psychosocial stressors and their association with poor mental health in a younger group of prostate cancer survivors who have undergone curative treatment. METHODS: The study includes 128 men (47 to 70 years old) who received active treatment for prostate cancer, and completed a survivorship online survey between 2017 and 2018. Psychological distress was assessed with Kessler Psychological Distress Scale. International Prostate Symptom Score subscales (incomplete urinary emptying, frequency, intermittency, urgency, weak stream, straining and nocturia) and number of current prostate cancer survivorship stressors were predictors. Multivariate logistic regression was used to fit the model while controlling for months of survivorship since diagnosis, the presence or absence of surgery, radiation or hormone therapy treatment, current medication for depression and demographics. RESULTS: A total of 19.5% of men scored positive for current mental health issues. Prostate cancer survivors who reported increased number of current survivorship stressors (OR 1.48, 95% CI 1.09-2.01), had higher frequency of urination (OR 2.05, 95% CI 1.15-3.64), history of radiation treatment (OR 7.15, 95% CI 1.02-50.35) and were currently on prescribed medication for depression (OR 33.47, 95% CI 3.80-294.87) had higher odds for screening positive for psychological distress compared with their counterparts. CONCLUSIONS: These results corroborate recent findings showing an intersection between urological oncology and poor mental health during survivorship, and warrant the development of multidisciplinary teams in addressing survivorship issues in this population.

Paratesticular tumor of Müllerian duct origin.

A 65 year old Caucasian male presented with a 4 year history of persistent right epididymal discomfort. There was no history of urinary tract infection, dysuria urethral discharge or trauma. Despite several courses of antibiotics and prolonged use of anti-inflammatory medications, his symptoms were unrelenting and had become unbearable. Past history revealed that he had undergone an uncomplicated transurethral prostatectomy for obstructive benign prostatic hyperplasia 6 years previously and a left inguinal herniorrhaphy 15 years ago. There was no history of estrogen use. Physical examination revealed a normal penis, penile urethra, urethral meatus, testes and left epididymis. There was induration of the right epididymis and the caput was exquisitely tender. Complete blood count and urinalysis were normal and urine culture was negative. A scrotal ultrasound failed to show any abnormality. The patient underwent scrotal exploration and a right epididymectomy. An incidental, soft, 2 cm mass was discovered within the spermatic cord adjacent to the superior aspect of the testicle and this was excised. Histologic examination of the epididymis was unremarkable and the other lesion was shown to be a cystic paratesticular müllerian tumor (Figure 1). The epididymalgia resolved post operatively and he has been asymptomatic with no evidence of recurrence for 4 years.

Cavitary pulmonary metastases in transitional cell carcinoma.

Cavitating metastatic lesions in the lungs as a manifestation of metastatic transitional cell carcinoma (TCC) is rare. We herein present a case of multiple cavitary pulmonary metastases secondary to TCCF of the left ureter and bladder.