Physical and Psychological Distress Following Prostate Cancer Diagnosis

This study explored the differences in physical and psychological symptoms experienced by men treated with radical prostatectomy versus watchful waiting, over the course of 8 years. While each treatment option leads to negative symptoms, the level of discomfort and anxiety men felt at diagnosis was suggestive of how they would feel over the eight years studied.

While many men newly diagnosed with low-risk prostate cancer are treated surgically, it has not been shown that this treatment has a significant benefit over watchful waiting.  Patients who choose watchful waiting (WW) may however experience more anxiety than those who are treated with radical prostatectomy (RP). The previous Scandinavian Prostate Cancer Group-4 (SPCG-4) study showed that men who receive RP show more physical symptoms over time, but both groups report lower quality of life and higher anxiety compared to men without prostate cancer.  However, this study did not take into account the symptoms men experienced at their initial diagnosis.

The present study included 272 men diagnosed with low-risk prostate cancer (confined to the prostate). 136 men received RP and 136 chose WW. Patients completed Quality of Life assessment questionnaires over 8 years, specifying the degree of any psychological and physical symptoms.  Some symptoms, such as health-related distress, sleeping problems, and anxiety were reported by 30-40% of both treatment groups, while symptoms such as urinary leakage and erectile dysfunction were reported more often by the RP group. Importantly, this study took into account symptoms reported by patients at diagnosis, and it was found that men who initially reported higher anxiety maintained this high level of anxiety. Those that did not feel anxious at diagnosis remained less anxious throughout the 8 years of the study.

In summary, while both groups reported prostate cancer having a negative influence on their lives, the presence of physical and psychological symptoms at diagnosis was more indicative of symptoms after eight years.

The analysis was based on subjective questionnaires, which are not always the most reliable research tools.

If newly-diagnosed men are experiencing a high level of anxiety, they should thoroughly discuss treatment options with their doctor.