(This just in: New randomized study finds advantage to transperineal in preventing infections and sepsis. I’ll have a follow-up commentary.)
By Howard Wolinsky
A large, new Australian study demonstrates once again the risks of emotional distress (anxiety, stress, depression) in patients with prostate cancer.
Emotional distress covers the full-spectrum of prostate cancer, from very low-risk to very high-risk. It can include suicide. This finding is universal though rates may vary.
It covers the map in international studies and those focusing on Europe, France, North America, and now Australia.
Fans for the Cure support tonight—join me
Breaking. Join me at 7 p.m. EST Thursday, September 19. 2024 for the Fans for the Cure prostate cancer support group. Attendance is limited to 30 participants.
On the day of the meeting, those who have successfully registered for the online support group meeting will be sent the Zoom call link and password via email, at the email address used to register to attend. SAFETY NOTE: Please do not share the Zoom link with anyone, and do not post the link on social media site.
If you need help getting onto the Zoom call on the day of the Online Men’s Support Group’s meetings, you can email support@fansforthecure.org or call 484-321-3148 for help. (Please note that this phone number is monitored only in the hour before and during the Men’s Support Group meetings.)
Unlike other leading groups in the field, such as the National Comprehensive Cancer Network, the American Society of Clinical Oncology, American Cancer Society, and American College of Surgeons, the American Urological Association and the American Society of Radiation Oncology don’t support routine mental health screening of newly diagnosed prostate cancer patients. Read all about it: https://www.webmd.com/prostate-cancer/news/20221102/mental-distress-prostate-cancer-elephant-room
“Deep Prostate” explains why AUA doesn’t support guidelines for screening:
TheActiveSurveillor.com has been beating the drums for years about how a diagnosis of even low-risk prostate cancer can cause emotional distress.
The survey of more than 460 patients by this newsletter and leading support groups in the United States and Canada showed that more than 55% of men diagnosed with low-risk prostate cancer experience distress, such as anxiety, depression, and stress. 10% have severe emotional distress, sometimes so severe that men opt for aggressive treatment even though their Grade Group scores are low.
The new Australian study of nearly 14,000 patients with all grades of prostate cancer suggests that early intervention can help patients better manage their emotional issues,
Lead researcher Tenaw Tiruye, PhD, of the University of South Australia, noted, “Prostate cancer can take a serious toll on the mental health of men throughout all stages of the illness – including diagnosis, surveillance, treatment, and follow‐up – with an estimated one in six people experiencing clinical depression.
“In fact, the rates of depression and anxiety among prostate cancer patients are significantly higher than those in the general population, as is the risk of suicide.”
Tenaw Tiruye, PhD
The study showed that 15% of individuals with prostate cancer started anti-anxiety and antidepression medication for the first time upon diagnosis. Six percent initiated mental health services, such as seeing a mental health practitioner, after diagnosis. The percentage of men prescribed medications for mental health issues increased from 34.5% before diagnosis to 40.3% after diagnosis.
European researchers also found high anxiety levels in prostate cancer patients, especially those on Active Surveillance. “Active surveillance seems to be associated with higher levels of depression or anxiety than treatments such as radical prostatectomy and radiotherapy. This may be related to the long-term worry that can be brought by regular testing, and the fact that treatment decisions may still have to be made,” according to EUOPROMS 2, a survey of more than 5,5000 patients from 32 countries, including the U.S. and Canada.
University of Southern Australia epidemiologist Kerri Beckmann, PhD, said: “So, rather than waiting for men to proactively seek out mental health supports once they’ve been diagnosed with prostate cancer, we should be offering supports at the time of diagnosis and throughout treatment. That way it can be seen as a normal and required part of treatment.”
Kerri Beckman, PhD
“Whether it’s the stigma surrounding mental health, or a fear about being seen as weak, statistics shows that many men struggle to seek help for mental health concerns,” Beckmann said. “Only by normalizing mental health discussions, can we improve access to wellbeing tools and services, to ensure that men with prostate cancer have every opportunity to voice their struggles and receive the support they need.”
What do you think? Do you have emotional distress (anxiety, depression, stress) over the whole prostate cancer process, especially low-risk prostate cancer? Please answer this confidential survey: https://forms.gle/sgo5ir5haER73tiW6
Testimonial from Laurence Klotz, MD, Active Surveillance Pioneer
Irecently moderated a Q&A session with Dr. Klotz at the Prostate Cancer Research Institute in Los Angeles. I introduced him as “the man who needs no introduction.”
Then, to my surprise, he responded: “I'll just say it's a real pleasure to be introduced by Howard who I've known for some years. And Howard is a force of nature in the sense that is his passion and persistence for this topic of active surveillance of asking tough and challenging questions, of really pushing people to beyond -- maybe beyond their comfort zone.
(Dr. Laurence Klotz at podium at Prostate Cancer Research Insititute meeting in Los Angeles.)
“And I think for the active surveillance community, Howard's persistence and dogged enthusiasm has really been hugely important in, I think, raising the profile, and in also in getting me and my colleagues who don't necessarily value speaking to patient groups as much as we should. We're much more focused on interacting with our colleagues, but Howard has really brought the importance of this home I think to many of us including certainly me. And so he deserves a great deal of credit for that.”
Thanks, Dr. Klotz.
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Thanks, Jeff. Shucks.
I agree with Dr. Klotz Howard....you are a force of nature! Thanks again for all you have done for all AS patients and for me personally.
Jeff,
Thanks to you--and Dr. Klotz,
All I can add is shucks.
Howard