Self-efficacy high among survivors of prostate cancer

Long-term prostate cancer survivors report high levels of self-efficacy, but the contrary is true for subgroups who are facing some challenges, a study presented at EAU 2025 has found.

“Particularly for older survivors or those with lower educational level, interventions enhancing self-efficacy, as part of follow-up care, could improve quality of life (QoL) and well-being,” said lead author Dr Lilly J Schmalbrock from the Department of Urology, Technical University of Munich (TUM), School of Medicine and Health, and TUM University of Hospital, Munich, Germany.

Self-efficacy refers to the “belief in one’s ability to manage challenges,” according to the researchers, noting that “cancer-related distress can extend long after diagnosis and initial treatment,” affecting the survivor’s QoL.

In this study, Schmalbrock and her team examined self-efficacy among long-term prostate cancer survivors following radical prostatectomy (RP) and identified related factors.

Eligible participants completed a follow-up survey as part of the national “Familial Prostate Cancer” project, which included the validated General Self-Efficacy Short Scale (ASKU). The ASKU consists of three items, each rated on a scale of 1–5. Higher scores indicated greater self-efficacy.

Schmalbrock and colleagues then collected sociodemographic, clinical, and psychosocial data, covering health-related QoL (HRQoL), depression and anxiety screenings, benefit finding, happiness, and perceived disease severity. Participants were included in the final analysis if they had RP as their primary treatment and if they had complete responses to all three ASKU items.

A total of 2,534 prostate cancer survivors (mean age 79.9 years, mean follow-up 18.3 years post-RP) were included in the analysis. [EAU 2025, abstract P110]

The mean self-efficacy score of survivors was 4.0, which was considered high. Of the participants, only 11.1 percent were undergoing therapy at the time of the survey, while 38.1 percent had a current of past biochemical recurrence, and 13.1 percent had another malignancy during their lifetime.

Prostate cancer survivors had a mean HRQoL score of 68.2. Some of them had positive screening for anxiety (11.0 percent) and depression (13.8 percent). Most of these men (97.0 percent) were still undergoing regular follow-up.

Predictors

In univariable analysis, men who were older, had lower educational level, had poorer economic status, had another malignancy during their lifetime, and were under treatment reported lower self-efficacy (p<0.05 for all).

Additionally, lower self-efficacy was found to be significantly associated with the following factors: poorer HRQoL, reduced benefit finding, lower happiness, positive screenings for anxiety and depression, and higher perceived disease severity (p<0.01 for all).

In multivariable analysis, lower self-efficacy significantly correlated with higher age, lower educational level, lower QoL, lower well-being, and symptoms of anxiety.

“Interventions aimed at enhancing self-efficacy could be particularly beneficial for older survivors, those with lower income and educational level, those with another malignancy during lifetime, high perceived disease severity, or positive depression and anxiety screenings,” Schmalbrock said. 

“Such interventions, implemented in outpatient settings as part of follow-up care, could potentially improve well-being, as most prostate cancer survivors reported receiving regular follow-up care, even many years [after] initial treatment,” she added.

Prostate cancer is the most common malignancy among men in Europe. Depending on disease stage, its 5- and 10-year survival rates were 91 percent and 89 percent, respectively, according to the researchers.