Effect of depression on outcomes of prostate cancer

The authors assessed the effect of depression on men with newly diagnosed prostate cancer. 

Localized prostate cancer is confined within the prostate gland. Common treatments in prostate cancers include prostate surgery, hormone therapy and radiation therapy. Prostate surgery involves surgically removing the prostate gland. Hormone therapy targets the male sex hormones active in prostate cancer, such as testosterone. Radiation therapy directs a beam of radiation at the cancer site, with minimal damage to surrounding healthy cells. It has been suggested that mental health issues, such as depression, can negatively affect treatment and outcome in patients with prostate cancer.

Further studies are needed to evaluate the effect of depression on outcomes of prostate cancer. 

The aim of this study was to assess the effect of depression on men with localized prostate cancer.

41,275 patients with localized prostate cancer were analyzed in this study. 4.6% of patients were diagnosed with depression 2 years before the diagnosis.

Patients with depression had 23% higher chance of undergoing hormone therapy alone. They also had 29% higher chance of undergoing expectant management (EM). EM is the monitoring of prostate cancer for signs of progression without using active treatment. Patients with depression and low-risk (stage I/II) cancer had 24% reduced risk of undergoing radiation therapy. Patients with depression and high-risk (stage III/IV) cancer had 18% reduced risk of undergoing radiation therapy. Patients with depression and medium-risk (stage II/III) cancer had 28% reduced risk of undergoing prostate surgery.

Better overall survival was associated with younger age, presence of fewer additional diseases, being married and use of radiation therapy or prostate surgery. Overall survival is defined as patients who were still alive following treatment. Patients with depression had an increased risk of experiencing shorter overall survival.

The authors concluded that patients with intermediate or high-risk prostate cancer recently diagnosed with depression were less likely to undergo radiation therapy or surgery and experience a worse overall survival.