Prostate cancer survivors often experience physical symptoms from various treatments, such as urinary incontinence, urgency, diarrhea, and erectile dysfunction. These symptoms can reduce cancer-related self-efficacy and heighten fear of cancer recurrence. Given the interplay between physical symptoms, self-efficacy, and fear of recurrence, this study aims to (1) examine the relationships among disease characteristics, symptoms, self-efficacy, and fear of recurrence in prostate cancer survivors and (2) assess the predictive role of symptoms and self-efficacy in fear of recurrence. Understanding these associations may help develop targeted interventions to improve psychological well-being in this population.

This cross-sectional study recruited prostate cancer survivors and collected data using structured questionnaires, including the Fear of Recurrence Subscale in the Taiwanese version of the Memorial Anxiety Scale for Prostate Cancer, the Expanded Prostate Cancer Index Composite, and the Cancer Survivors’ Self-Efficacy Scale, along with demographic and clinical characteristics. Descriptive statistics, independent samples t-tests, one-way ANOVA, Pearson correlation, and multiple regression analyses were conducted to identify factors associated with fear of cancer recurrence.

Pearson correlation analysis indicated that prostate cancer survivors who experienced fewer physical symptoms, along with higher cancer-related self-efficacy, tended to have a lower fear of cancer recurrence. Multiple regression analysis further demonstrated that sexual symptoms, (β = -.24, p = .009), hormonal symptoms, (β = -.26, p = .005), and cancer-related self-efficacy (β = -.24, p = .005) were all significantly negatively associated with fear of cancer recurrence after adjusting for demographic and clinical characteristics. These factors collectively accounted for 31.6% of the variance in fear of cancer recurrence (R² = 0.316). The findings suggest that prostate cancer survivors with fewer physical symptoms related to sexual and hormonal domains, as well as greater cancer-related self-efficacy, are likely to experience lower levels of fear of cancer recurrence.

The findings of this study indicate that prostate cancer survivors with fewer physical symptoms, as well as higher cancer-related self-efficacy, tend to experience a lower fear of cancer recurrence. It is recommended that early interventions be implemented for survivors with elevated fear of cancer recurrence, focusing on providing knowledge and self-management skills to address cancer-related health concerns. Such interventions may help mitigate and prevent fear of cancer recurrence, ultimately improving the psychological well-being of prostate cancer survivors.