|
 Many men with early-stage prostate cancer may not need treatment
right away, or ever, because these tumors often don't grow fast
enough to cause symptoms or prove fatal. In the absence of symptoms
or tests that suggest tumors are growing quickly, doctors may advise
men to put off immediate treatments like surgery or radiation and
instead get regular screenings to reassess whether the cancer is
dangerous enough to warrant intervention.
For the current study, researchers examined data on men with
early-stage prostate cancer, including 4,952 people who had surgery,
4,994 who got radiation and 2,136 who opted instead for
surveillance, or "watchful waiting." In the year before their cancer
diagnosis, 7.7 percent of the men were prescribed antidepressants,
and this climbed to 10.5 percent in the first year after diagnosis.
Compared to a control group of men in the general population without
a prostate cancer diagnosis, men with prostate cancer were 49
percent more likely to be taking antidepressants five years after
surgery and 33 percent more likely to take antidepressants five
years after radiation treatment, the study found.
But watchful waiting wasn't linked to any increase in the odds of
men taking antidepressants.
"Prostate cancer patients often fit the demographic profile (white,
older age, and male) of someone at risk for depression," said senior
study author Dr. Robert Nam of Sunnybrook Health Sciences Centre in
Toronto.
"Once they receive treatment for prostate cancer, whether that is
surgery or radiation, they may experience treatment-related side
effects, such as erectile dysfunction, incontinence, and bowel
dysfunction, which can significantly worsen quality of life," Nam
said by email.
Roughly half of men diagnosed with prostate cancer receive treatment
known as androgen deprivation therapy, which suppresses production
of the male sex hormone testosterone and contributes to mood
disorders, Nam added.
Men in the study who received surveillance tended to be older and
were more likely to have multiple chronic health problems than the
patients who got surgery or radiation.
[to top of second column] |
The study wasn't a controlled experiment designed to prove whether
or how different approaches to prostate cancer treatment might
directly impact mental health. Another limitation is the potential
for factors not measured in the study to have influenced both the
treatment decisions men made and their mental health, researchers
note in European Urology.
A separate study in the same journal, however, looked at trends in
management of erectile function after prostate cancer surgery and
offered fresh evidence that many men may be missing out on
interventions that could improve their sexual health and quality of
life.
The study examined data on 2,364 patients who had prostate cancer
surgery at one U.S. academic medical center between 2008 and 2015.
Researchers didn't find any meaningful changes in the proportion of
men who had erectile dysfunction up to two years after surgery,
despite advances in surgical care and postoperative penile
rehabilitation during the study period.
This study also wasn't a controlled experiment, and it's possible
that results from a single medical center might not reflect outcomes
for men who got prostate cancer treatment elsewhere.
The study also didn't examine how any use of antidepressants might
have played a role in men's sexual health after prostate cancer
surgery.
"Sexual dysfunction is a common adverse effect of antidepressants,"
Nam said.
"Identifying the cause of the sexual dysfunction can be complicated
as these symptoms are also associated with depression and can be
improved once the patient's depression is treated," Nam added. "A
healthy lifestyle, consisting of a well-balanced diet and exercise,
is an important way to promote good sexual function, regardless of
underlying medical conditions."
SOURCE: https://bit.ly/2Jw28vO and https://bit.ly/2JvtphP European
Urology, online September 18 and 17, 2018.
[© 2018 Thomson Reuters. All rights
reserved.] Copyright 2018 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
