Poor Mental Health Prior to Cancer Surgery Linked to Higher Risk of Complications

Pre-surgery bladder cancer patients who self-reported poor mental health ended up suffering from greater health complications in the 30 days following surgery compared to patients with higher self-assessments of mental health, according to a new study published in The Journal of Urology.

The findings show that a patient’s mental health prior to surgery can influence postoperative outcomes. The researchers note that stress may delay both wound healing and the ability to fight off postoperative infections.

The study involved 274 bladder cancer patients undergoing a radical cystectomy (RC), a surgery in which the bladder is removed. This procedure is an effective treatment for locally advanced bladder cancer, but complications occur in as many as two-thirds of patients.

“Prior studies have suggested that poor baseline mental health can lead to more significant postoperative complications possibly due to impaired immune response associated with higher levels of stress,” explained Scott M. Gilbert, M.D., M.S., of the H. Lee Moffitt Cancer Center, Tampa, FL.

“This may delay both wound healing and the ability to fight infection in the postoperative state, for example. Although self-appraisal of overall well-being may mediate physiologic responses to surgery, patient-reported health status has not been extensively studied among bladder cancer patients to date, and its utility in predicting postoperative outcomes, such as complications, has not been previously examined.”

Using the Medical Outcomes Study Short Form (SF-12), patients evaluated their own health and reported the effects that the disease and treatment were having on their overall well-being. The SF-12 is a standardized, validated questionnaire that measures composite scores for physical (PCS) and mental (MCS) components of health.

The study findings show a relevant link between patients with bladder cancer who reported low mental health status and high grade complications after surgery. In 274 patients who had undergone RC and had completed the survey, the composite scores for mental health were statistically significantly lower in those who had a high grade 30-day complication rate. The composite scores for physical health were not found to be lower, however.

“Recognition of poor preoperative mental health may represent a potential signal warranting more proactive recognition and assessment preoperatively,” Gilbert said.

Source: Elsevier Health Sciences

Woman in surgery photo by shutterstock.