Researchers at the Roswell Park Cancer Institute and the University at Buffalo recently found that the beliefs and personality traits in patients with a recent diagnosis of prostate cancer are associated with higher levels of distress. These results highlight the fact that such patients could benefit from informational and emotional support, along with early counselling for those more distressed.
The study titled “Factors Associated with Emotional Distress in Newly Diagnosed Prostate Cancer Patients” and published in the journal Psycho-Oncology, reveals that in this patient population, factors related with higher levels of distress are related to fear of cancer progression, lack of confidence in cancer treatment decisions, a feeling that one’s masculinity is under threat and tendencies to be less optimistic and resilient.
This study is part of a longitudinal trial called “Live Well Live Long!”, which involved 1,425 men with a recent diagnosis of prostate cancer assessed across five different centers. “There are several studies that have examined distress in prostate cancer patients after treatment, but few that assessed distress in men early in diagnosis, before receiving treatment,” said in a recent news release Heather Orom, PhD, study’s author and an assistant professor of community health and health behavior in UB’s School of Public Health and Health Professions. “Our study provides a stronger empirical basis for designing or selecting interventions for these men. To provide the correct support, we need a better understanding of what causes distress in these types of patients,” added Dr. Orom.
“As urologists, we have to find better ways to assist men and their families after a prostate cancer diagnosis, which can be a difficult time for many. This study brings us one step closer to doing so,” said author Willie Underwood III, MD, MPH, an associate professor in the Department of Urology at Roswell Park Cancer Institute Underwood,
Results from a second study titled “Emotional Distress Predicts Choosing Surgery over Active Surveillance in Clinically Localized Prostate Cancer Patients,” showed that emotional distress could encourage men to choose surgery. These results were presented at the American Urological Association Annual Meeting and involved 1,050 men with a diagnosis of localized prostate cancer.
“Importantly, greater distress was associated with choosing more aggressive treatment in men with lower-risk disease among those with potentially low-risk cancer,” said Dr. Orom. “These are men for whom active surveillance may be a viable option. Ideally, prostate cancer patients’ treatment decisions will reflect an accurate understanding of treatment options, assess treatment outcomes and chances of recovery, and also include personal preferences. Results of this study strongly support managing emotional distress in all prostate cancer patients.”
According to Orom other investigations revealed that levels of anxiety, depression and emotional distress in men with a diagnosis of prostate cancer are more elevated upon diagnosis and decline afterwards. However, only a quarter to a third of these men experience emotional distress early while some still have suffer from some type of emotional distress many years after treatment.
“Our findings suggest that providing early support when patients are deciding what treatment to pursue may help head off long-term distress,” Dr. Orom said, “and may also support men who are making a difficult decision between multiple treatment options with the potential for serious side effects. Understanding the factors associated with distress allows us to think in nuanced ways about the kinds of support needed by prostate cancer patients and when such support should be offered — particularly when men are first diagnosed.”
According to the researcher, some of these patients can benefit from explanations on the prognosis of their prostate cancer, while others may benefit from decision-making support. “Furthermore, developing interventions for men who are distressed at diagnosis could also improve clinical practice for all prostate cancer patients if it encourages more informative and supportive communication between providers and patients in general.”
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