Urinary, sexual, and bowel dysfunction, which are side effects of prostate cancer treatment, can cause elevated emotional distress for at least two years post-treatment, a new study shows.
The study, titled “Worse urinary, sexual, and bowel function cause emotional distress and vice versa in men treated for prostate cancer,” was published in The Journal of Urology.
In the United States alone, more than 2.8 million prostate cancer survivors received definitive therapy, such as surgery or radiotherapy. Many of these men tend to experience some degree of urinary incontinence, and the majority experience erectile dysfunction. Furthermore, radiation and brachytherapy have been associated with bowel pain and urgency.
These side effects have been associated with a negative impact on patients’ quality of life. Researchers set out to determine whether urinary, bowel, and sexual dysfunction induced by prostate cancer therapy also caused emotional distress, and vice versa.
The study recruited 1,148 men diagnosed with localized prostate cancer who received either surgery or radiotherapy. Participants’ urinary, sexual, and bowel function were determined using the Expanded Prostate Cancer Index Composite (EPIC). Then, emotional distress was determined using the Distress Thermometer.
The assessments were conducted pre-treatment, at six weeks, and then at six, 12, 18, and 24 months post-treatment.
Results showed that men with worse urinary, bowel, and sexual functioning tended to report more emotional distress than patients with better functioning at all time points after treatment.
Researchers also investigated whether the emotional distress, in turn, contributes to worsened functioning. They found that patients with high emotional distress also tended to have worse urinary, bowel, and sexual functioning at the subsequent periods of study.
To “improve wellbeing in prostate cancer survivorship, clinicians, supported by practice and payer policies, should screen for, and facilitate treatment of side-effects and heightened emotional distress,” the researchers wrote.
However, they added that it is not adequate to simply monitor patients for distress and physical quality of life problems, doctors also need to incorporate accessible psycho-social care into their practice.
Because emotional distress negatively impacts function, which can lead to further clinical issues, the team argues that treatments for psychological distress can potentially be cost-effective in the long-term.