Psychosocial issues during the treatment of non-muscle invasive bladder cancer

The psychosocial impact of intravesical therapy with Bacillus Calmette-Guerin (BCG) and Mitomycine (MMC) is an issue that urological oncology nurses are confronted with. It was unclear to us as to how many patients are confronted with psychosocial issues during treatment and we wanted to gain more understanding regarding the impact of intravesical therapy with BCG or MMC. We could find only a few studies regarding quality of life and psychosocial issues of patients undergoing intravesical therapy. The aim of this study was to assess which psychosocial issues, patients are confronted with during intravesical therapy with BCG or MMC, and the impact thereof on daily life, social, emotional and physical well-being. A quantitative study was conducted in a general hospital on 80 men and women undergoing intravesical therapy with BCG or MMC, aged between 40 and 94. Data were collected by using the EORTC BLS-24, the Psychosocial Distress screening tool and a questionnaire collecting demographic data. Results from this study showed that 32% of the participants indicated that intravesical therapy had an impact on emotional and physical well-being. Specific items were fatigue (55%), feeling out of shape/physical condition (39%), lack of sleep (34%) and muscle strength (23%). Emotional items were depression/gloom (28%), anxiety (28%), coping with emotions (28%) and self-confidence (20%). In our study we observed a statistically significant difference between patients undergoing intravesical therapy with BCG or MMC. BCG intravesical therapy had more of a psychosocial impact, a statistically significant difference (P<.001). We also observed an increase in psychosocial burden over a period of time in participants undergoing BCG maintenance therapy. Nurses need to be aware that intravesical therapy does have an impact on daily life, social, emotional and physical well-being, and that patients have psychosocial issues which need to be addressed.