Assessing anxiety in men with prostate cancer: Further data on the reliability and validity of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC)

Identifying which men with prostate cancer might benefit from mental health treatment has proven to be a challenging task. The authors developed the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) in order to facilitate the identification of prostate cancer-related anxiety. A revised version of this scale was tested in a more clinically varied population. Ambulatory men with prostate cancer (N = 367) completed a baseline assessment packet that included the MAXPC and other psychosocial questionnaires. The MAX-PC showed high internal consistency and concurrent and discriminant validity. Factor analysis identified three distinct factors for the MAX-PC that corresponded to the intended subscales (General Prostate Cancer Anxiety, PSA (prostate-specific antigen) Anxiety, and Fear of Recurrence). PSA levels were not correlated with anxiety overall; however, anxiety was significantly higher among patients whose PSA levels were changing (i.e., rising, falling, and unstable), versus those with stable PSA levels. Also, in a multivariate analysis, the change in PSA levels was a significant predictor of MAX-PC scores, but not Hospital Anxiety and Depression Scale (HADS) scores. These results indicate that the MAX-PC is a valid and reliable measure of anxiety that assesses aspects of anxiety unique to men with prostate cancer and it may provide a more sensitive measure of anxiety than the HADS for this population.