We aim to compare patient-reported mental health outcomes for men undergoing treatment for localized prostate cancer, longitudinally over 5 years.
We conducted a prospective population-based analysis using the Comparative Effectiveness Analysis of Surgery and Radiation study (CEASAR) study. Patient-reported depressive symptoms (Centers for Epidemiologic Studies Depression, CES-D) and domains of the Medical Outcomes Study 36-item short form survey evaluating emotional well-being and energy/fatigue, were assessed through 5 years after treatment with surgery, radiotherapy (with or without androgen deprivation therapy) and active surveillance. Regression models were adjusted for outcome-specific baseline function, demographic and clinicopathologic characteristics, and treatment approach.
2742 men (median [quartiles] age 64 [59-70]) met inclusion criteria. Baseline depressive symptoms, as measured by the CES-D, were low (median 4, quartiles 1-8) without differences between groups. We found no effect of treatment modality on depressive symptoms (p=0.78), though older age, poorer health, being unmarried, and baseline CES-D score were associated with declines in mental health. There was no clinically meaningful association between treatment modality and scores for either emotional well-being (p=0.81) or energy/fatigue (p=0.054).
This prospective, population-based cohort study of men with localized prostate cancer showed no clinically important differences in mental health outcomes including depressive symptoms, emotional well-being, and energy/fatigue according to the treatment received (surgery, radiotherapy, or surveillance). However, we identified a number of characteristics associated with worse mental health outcomes including: older age, poorer health, being unmarried, and baseline CES-D score which may allow for early identification of patients most at risk of these outcomes following treatment.
The Journal of urology. 2022 Jan 03 [Epub ahead of print]
Amy N Luckenbaugh, Christopher J D Wallis, Li-Ching Huang, Daniela Wittmann, Zachary Klaassen, Zighuo Zhao, Tatsuki Koyama, Aaron A Laviana, Ralph Conwill, Michael Goodman, Ann S Hamilton, Xiao-Cheng Wu, Lisa E Paddock, Antoinette Stroup, Matthew R Cooperberg, Mia Hashibe, Brock B O'Neil, Sherrie H Kaplan, Sheldon Greenfield, Karen E Hoffman, David F Penson, Daniel A Barocas
Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee., Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee., Department of Urology, University of Michigan Medical Center, Ann Arbor, Michigan., Division of Urology, Medical College of Georgia at Augusta University, Augusta, Georgia., Department of Surgery and Perioperative Care, Dell Medical School, Austin, Texas., Office of Patient and Community Education, Patient Advocacy Program, Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center., Department of Epidemiology, Emory University Rollins School of Public Health., Department of Preventive Medicine, Keck School of Medicine at the University of Southern California., Department of Epidemiology, Louisiana State University Health Sciences Center New Orleans School of Public Health., Department of Epidemiology, Cancer Institute of New Jersey, Rutgers Health., Department of Urology, University of California, San Francisco., Department of Family and Preventative Medicine, University of Utah School of Medicine., Department of Urology, University of Utah Health., Department of Medicine, University of California Irvine., Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.