***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The objective was to explore the psychosocial adaptation of female partners living with men with a diagnosis of either localized or metastatic prostate cancer .  Semi-structured qualitative interviews were conducted with 50 women at two time points ( baseline and 6 months later ) . The interviews examined emotions , experiences , attitudes to sexual and continence issues and treatment decision making . As part of a larger prospect i ve observational study , demographic data and scores for depression and anxiety were collected . Initial analysis demonstrated that the group of 11 women assessed as distressed on the anxiety and depression measures described reduced coping skills and poorer adaptation after 6 months . In contrast , the 39 women in the non-distressed group reported emotional adaptation that fitted the Lazarus and Folkman pattern of coping through appraisal of the impact of the diagnosis on their partner and themselves , appraisal of coping strategies and re appraisal of the situation . A surprise finding was the high level of resilience displayed by majority of these women . Results suggest that a psychosocial intervention could strengthen healthy adaptation and provide better coping skills for distressed couples Prostatic carcinoma and its treatment have been associated with adverse effects on health-related quality of life ( HRQoL ) . Individual differences in appraisal and coping have been suggested to mediate these HRQoL outcomes . A r and omized trial of 65 men with non-localized prostate cancer compared several treatments and tested associations between appraisal , coping , and HRQoL. These patients , and 16 community volunteers matched for age and general health , undertook psychosocial assessment s before treatment and after 6 months of treatment . Compared with baseline assessment s , men on hormonal treatments reported impaired sexual function . Groups did not differ on emotional distress , existential satisfaction , subjective cognitive function , physical symptoms , or social and role functioning . For individuals , hormonal treatments were more frequently associated with decreased sexual , social and role functioning , but were also associated with improved physical symptoms . In hierarchical regression analysis , HRQoL was lower for men who had more comorbid illnesses , a history of neurological dysfunction , higher threat appraisal s , or higher use of coping strategies at baseline . These results showed that pharmacological hormonal ablation for prostate cancer can improve or decrease HRQoL in different domains . HRQoL  in men with prostate cancer was associated more strongly with appraisal and coping than with medical variables PURPOSE We prospect ively examined the development of depressive symptoms and fatigue among men with locally advanced prostate cancer receiving hormone therapy .  METHODS Fifty-two men with advanced or recurrent prostate cancer were r and omly assigned to receive either parenteral leuprolide or oral bicalutamide . Patients completed the Beck Depression Inventory ( BDI ) and Fatigue Severity Scale ( FSS ) at pretreatment baseline , 6 months , and 12 months . RESULTS Rates of at least mild depression ranged from 10.4 to 16.3 % over the 12 months and were not significantly different at each time point . Mean change in BDI scores from baseline to 6 months for the entire sample was 0.91 ( SE = 0.73 ) , and from baseline to 12 months was 0.35 ( SE = 0.67 ) . Mean FSS scores increased significantly from baseline ( M = 24.43 , SD = 11.75 ) to 6 months ( M = 27.93 , SD = 13.52 ) and remained steady at 12 months ( M = 27.80 , SD = 14.44 ) . There were no significant differences in depression between the two types of hormone therapy . CONCLUSION Hormone therapy does not appear to cause clinical ly significant changes in depression among men with locally advanced prostate cancer . However , fatigue increased significantly over the study period This study was undertaken to evaluate the quality of life ( QoL ) of previously untreated patients with M1 prostate cancer before and during and rogen-suppressive treatment . Assessment of QoL was included as an optimal component of EORTC protocol 30853 , a phase III trial comparing LH-RH ( luteinising hormone-releasing hormone ) analogue combined with a non-steroidal anti- and rogen versus orchiectomy in patients with M1 prostate cancer . At pretreatment and during the follow-up period , patients were asked to complete a question naire assessing their physical and psychosocial functioning , and their symptom levels . Physicians rated the patients ' performance status , pain , urological symptoms and erectile function . Due to its optional nature , only a minority of the patients in the trial were recruited for the QoL investigation . 63 patients completed a pretreatment question  naire , of whom 49 completed a second question naire at least once during the initial 15 month follow-up period . While statistically significant correlations were observed between patients ' and physicians ' ratings of physical functioning and pain , these were of only a moderate magnitude ( r = 0.43 and 0.30 , respectively ) . No significant association was observed between physicians ' and patients ' ratings of micturation problems or of erectile function . Before treatment , fatigue , pain and decreased social role and sexual functioning were the problems most frequently reported by patients . With an average of approximately 1 year follow-up , statistically significant improvements were observed in patients ' self-reported urological symptoms and metastatic pain . No significant changes were noted for the other QoL domains assessed . The results of this study confirm earlier findings that physicians ' ratings may not reflect accurately the functional health and symptom experience of their patients . Patient-based QoL question naires offer the most direct means of evaluating the subjective morbidity associated with prostate cancer and its treatment . To increase participation and compliance rates in future studies , it is recommended that QoL assessment be made m and atory in those clinical trials in which QoL is considered to be an important study endpoint OBJECTIVES The quality of life ( QoL ) of 44 men with HRPC and 37 partners ( primary caregivers , most residing with the patient ) was assessed in a multicenter Phase II trial of docetaxel , estramustine and low dose hydrocortisone ( CALGB 9780 ) . A secondary objective was to test the feasibility of assessing partners ' QoL in a cooperative group setting . PATIENTS AND METHODS Patients and partners were separately interviewed by telephone at baseline , two , four and six months by a single trained research interviewer . Patients ' QoL was measured by the FACT-P , Mental Health Inventory-17 ( MHI-17 ) , Brief Pain Inventory ( BPI ) , a two-day log of pain medications , and the OARS for co-morbid conditions . Partners ' QoL was measured by the MHI-17 ,  Caregiver Burden Interview  , and co-morbid conditions . RESULTS The QoL study refusal rates were low for patients ( 4 % ) and partners ( 3 % ) . Although patients tended to experience greater treatment side effects in the first two months ( FACT Physical Well-Being item , P = 0.057 ) , their cancer-specific emotions ( e.g. , worrying about worsening health ) significantly improved at two and four months ( FACT-Emotional Well-Being , P = 0.003 , P = 0.03 , respectively ) , as did their prostate cancer-specific physical problems ( e.g. , urination , pain ) , at two and four months ( FACT-P , P = 0.001 , P = 0.005 , respectively ) . Partners ' anxiety significantly decreased over time ( MHI , P < 0.05 ) . Patients ' quality of life at two months was significantly related to their clinical response ( FACT-P total and prostate cancer-specific problems , P < 0.05 ) , and their clinical response was significantly related to a decrease in their partners ' anxiety at two months ( MHI , P < 0.05 ) . CONCLUSIONS Despite feeling worse from side effects , patients ' prostate cancer-specific problems and emotional state significantly improved in the first four months of treatment . With treatment significantly affecting both patients ' and partners ' lives . and the successful assessment of partners ' QoL , QoL of both patients and partners could be used as important endpoints in selected clinical trials OBJECTIVE To assess psychosocial distress in patients with early ( localised ) and advanced ( metastatic ) prostate cancer ( PCA ) at diagnosis ( Time 1 ) and 12 months later ( Time 2 ) , and identify psychosocial factors predictive of later distress . DESIGN , PARTICIPANTS AND SETTING Observational , prospect i ve study of 367 men with early ( 211 ) or advanced ( 156 ) PCA recruited as consecutive attendees at clinics at seven public hospitals and practice s in metropolitan Melbourne between 1 April 2001 and 30 December 2005 . Both groups completed question naires at Time 1 and Time 2 . MAIN OUTCOME MEASURES Health-related quality of life as assessed by the  Short Form 36-item Health Survey ; psychological distress , including depression and anxiety as assessed by the Brief Symptom Inventory ; and coping patterns as assessed by the  Mini-Mental Adjustment to Cancer scale .  RESULTS Over the 12 months , both the early and advanced PCA group showed reduced vitality and increased depression and anxiety ; this effect was greater in the advanced PCA group . Mental health , social functioning and role-emotional functioning also deteriorated in the advanced group . Predictors of depression at Time 2 for the early PCA group were depression , vitality and a fatalistic coping pattern at Time 1 ; anxiety at Time 2 was predicted by anxiety and vitality at Time 1 . In the advanced PCA group , depression at Time 2 was predicted by depression and mental health at Time 1 ; anxiety at Time 2 was predicted by anxiety , mental health , cognitive avoidance and lower anxious preoccupation at Time 1 . CONCLUSIONS Men with early PCA experience decreasing vitality and increasing psychological distress over the 12 months following diagnosis ; this trend is accelerated after diagnosis with advanced PCA . A fatalistic coping pattern at diagnosis of early PCA predicts later depression while cognitive avoidance and lower anxious preoccupation at diagnosis of advanced PCA predict later anxiety AIMS The prevalence of anxiety and depression  in patients with advanced cancer has been reported to be on average 25 % and to significantly affect patients ' quality of life . Despite high prevalence rates , these disorders remain underdiagnosed and undertreated . The purpose of our study was to examine the self-report rates of anxiety and depression with the Edmonton Symptom Assessment System ( ESAS ) and to assess the predictive factors for these reports in cancer patients with metastatic disease . MATERIAL S AND METHODS Consecutive patients who attended the Rapid Response Radiotherapy Program ( RRRP ) completed the ESAS as well as baseline demographic information . Ordinal logistic regression analysis was used to determine factors that significantly predicted anxiety and /or depression . Pearson χ(2 ) was used to test goodness-of-fit for categorical variables and established whether or not an observed frequency distribution differed from a predicted frequency distribution . A univariate analysis was conducted first and those variables with a P value<0.100 were included in a multivariate analysis . A score test was used to test the proportional odds assumption . RESULTS In total , 1439 patients seen in the RRRP between January 1999 and October 2009 completed ESAS question naires . Fifty-five per cent of patients reported at least mild symptoms of depression and 65 % reported at least mild anxiety . In the univariate analysis , patients who were female , who had a lower performance status score , or primary lung cancer were more likely to report depressed and anxious feelings . Primary prostate cancer patients were significantly less likely to report depression and anxiety . Patients referred for spinal cord compression were significantly less depressed . The multivariate models showed that younger patients were significantly more anxious than older patients and females reported more anxiety than males . Patients who reported higher feelings of nausea , tiredness , drowsiness , dyspnoea , and worse appetite and overall well-being on the ESAS tool were more likely to report feelings of depression . Patients who reported higher nausea , drowsiness , dyspnoea and worse overall well-being more often reported higher feelings of anxiety . CONCLUSION The self-report rates of anxiety and depression were consistent with published prevalence rates . However , the explained variance based on factors included in the model remains low . Additional predictive factors should be examined in future studies in this population . The ESAS tool seems to be an efficient screening tool for anxiety and depression ; however , future studies should examine its correlative properties with other known screening tools in the advanced cancer population . A prospect i ve study should be conducted to assess the severity cut-off point in which the ESAS scores most frequently lead to a further diagnosis of an anxiety or depressive disorder in the advance cancer population PURPOSE To examine prospect ively the influence of social networks on health-related quality of life ( HRQoL ) among breast cancer survivors . METHODS  Social networks  and  HRQoL  were assessed among women free of breast cancer in the Nurses ' Health Study ( NHS ) . Women who developed breast cancer over a 4-year follow-up ( n=708 ) completed detailed questions related to treatment together with an assessment of general and cancer-specific HRQoL. RESULTS On average , socially isolated women were more adversely affected by breast cancer -- their role function was lower by 14 points , vitality lower by 7 points , and physical function lower by 6 points compared to the most socially integrated women . CONCLUSION Prediagnosis level of social integration is an important factor in future HRQoL among breast cancer survivors , and appears to explain more of the variance in HRQoL than treatment or tumor characteristics . Rehabilitation programs should incorporate interventions that address the availability of adequate social support among breast cancer survivors 
    Output:
    
Depression and fatigue are highly prevalent , and the dyads , patient and partner , are at higher risk for distress symptoms .
The efforts of individuals to cope with metastatic PC appear influenced by adaptative skills and specific types of family support .
In metastatic PC patients , needs change during the course of the disease .
Social support plays a major role in maintaining or disrupting QoL and in the efficacy of psychosocial treatments .