Depression and prostate cancer: A focused review for the clinician

Gagan Fervaha; Jason P Izard; Dean A Tripp; Selina Rajan; Darryl P Leong; D Robert Siemens

doi:10.1016/j.urolonc.2018.12.020

Depression and prostate cancer: A focused review for the clinician

Urol Oncol. 2019 Apr;37(4):282-288. doi: 10.1016/j.urolonc.2018.12.020. Epub 2019 Jan 7.

Authors

Gagan Fervaha¹, Jason P Izard², Dean A Tripp³, Selina Rajan⁴, Darryl P Leong⁵, D Robert Siemens²

Affiliations

¹ School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada; Department of Urology, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada. Electronic address: gfervaha@qmed.ca.
² Department of Urology, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada; Department of Oncology, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
³ Department of Urology, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada; Department of Psychology, Faculty of Arts and Sciences, Queen's University, Kingston, ON, Canada.
⁴ The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
⁵ The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.

PMID: 30630735
DOI: 10.1016/j.urolonc.2018.12.020

Abstract

Prostate cancer is the most common malignancy among men. Given its prevalence and relatively low mortality rates, several biopsychosocial survivorship issues have garnered recent attention. This article reviews the literature on the association between depression and prostate cancer, emphasizing key practice points relevant for clinicians. Depression is prevalent among men with prostate cancer, with approximately 1 in 6 patients experiencing clinical depression. Suicidal ideation is also not uncommon in this population and does not always present in those with other depressive symptoms. While choice of definitive cancer treatment (radiation or surgery) does not seem to affect depressive symptoms, receipt of androgen deprivation therapy appears to have a negative effect. Not only are patients at increased risk for depression following a prostate cancer diagnosis, but depression itself seems to adversely affect oncologic outcomes. We were not able to identify any clinical trials examining the efficacy of antidepressant medications for depressive symptoms in these patients, however population-based studies suggest antidepressant prescriptions are commonly utilized. Taken together, the literature on the intersection between urologic oncology and psychology/psychiatry affirms the importance of depression among men with prostate cancer. Clinicians should consider assessment of this symptom domain and treat or refer judiciously. Clinical trials represent a priority for future research.

Keywords: Androgen deprivation therapy; Major depressive disorder; Patient-reported outcomes; Prostate carcinoma; Quality of life; Suicide.

Publication types

Review

MeSH terms

Depression / etiology*
Humans
Male
Prostatic Neoplasms / psychology*
Quality of Life / psychology*