Anxiety And Depression In Patients With Prostate Cancer And Other Urogenital Cancer: A Longitudinal Study

Main Category: Urology / Nephrology
Also Included In: Prostate / Prostate Cancer;  Cancer / Oncology;  Depression
Article Date: 27 Jun 2008 - 2:00 PDT

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UroToday.com - In the online version or Urologic Oncology, Dr. Andreas Hinz and associates from Germany report on a longitudinal study to assess psychological distress in cancer patients. They sought to investigate the impact of the cancer, side effects related to treatment of the cancer and patient anxiety regarding possible cancer recurrence.

Patients treated at their University Hospital between 2002 and 2004 for prostate or other urogenital cancers were included and compared to a control group from the general population and a cohort of cardiac patients. Patients were tested at 4 time points: (T1) at the beginning of the stay in the hospital, (T2) before discharge, (T3) 6 months after discharge, and (T4) 1 year after discharge. The Hospital Anxiety and Depression Scale (HADS) was completed and sum scores in the range from 0-8 are called no cases, 8-10 borderline cases, and above 11 definitive cases. The optimal cut-off for case definition was fixed at 15.

Sample size was not large enough for separate analyses for each cancer diagnosis. Values were highest at T1, with only minor changes between T2 and T4. Two significant results were identified; depression at T3 and depression at T4 with lower scores for prostate cancer patients. Anxiety at T1 was significantly higher than the mean value of the general population. Compared with cardiac patients, there were significantly higher values for cardiac patients at T2 to T4. Prostate cancer patients had significantly lower depression scores than the control groups for T2-T4. HADS scores >15 occurred in 28% of prostate cancer patients, 39% of other urogenital cancer patients, 24% of the general public and 35% of cardiac patients. Anxiety was more pronounced among young patients, and patients treated with radiotherapy or chemotherapy suffered from higher levels of depression at T1 compared to surgical patients.

The investigators conclude that the rate of psychological distress is not very high and only 18-28% of prostate cancer patients had HADS totals >15.

Hinz A, Krauss O, Stolzenburg JU, Schwalenberg T, Michalski D, Schwarz R.
Urol Oncol. 2008 Apr 25. (Epub ahead of print)
doi:10.1016/j.urolonc.2008.02.003

Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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