Post-surgery anxiety and depression in prostate cancer patients: prevalence, longitudinal progression, and their correlations with survival profiles during a 3-year follow-up

Abstract

Background Anxiety and depression are more frequent in cancer patients than general population and may be correlated with cancer prognosis; however, their value in prostate cancer patients is largely unknown. We aimed to evaluate prevalence of anxiety and depression in prostate cancer survivors post the surgeries, and their correlations with patients’ disease-free survival (DFS) and overall survival (OS). Methods A hundred and ninety-four patients with prostate cancer who underwent radical prostatectomy were enrolled. After discharged from hospital, patients were assessed for post-surgery anxiety and depression every 3 months using Zung Self-rating Anxiety/Depression Scale (SAS/SDS) for a total of 36 months. In addition, disease conditions, DFS, and OS were also documented. Results SAS score (P < 0.001), anxiety rate (P = 0.004), SDS score (P < 0.001), and depression rate (P < 0.001) gradually elevated from baseline to month 36 in prostate cancer patients. Anxiety at baseline (P = 0.009) and anxiety at 3 years (P = 0.017) were correlated with worse DFS, and anxiety at baseline (P = 0.009) was also correlated with shorter OS in prostate cancer patients. Furthermore, depression at baseline (P = 0.005) and depression at 2 years (P = 0.008) were associated with unfavorable DFS, and depression at baseline (P = 0.001), 1 year (P = 0.025), and 2 years (P = 0.008) were associated with worse OS in prostate cancer patients. Moreover, multivariate Cox’s proportional hazards regression analysis elucidated that depression at baseline (P = 0.027) was an independent predictive factor for shorter DFS in prostate cancer patients. Conclusion Anxiety and depression both gradually deteriorate, and they correlate with unfavorable survival profile in prostate cancer patients after radical prostatectomy.

Longitudinal Association of Universal Screening and Treatment for Major Depressive Disorder with Survival in Cancer Patients

“…The only previous paper reporting survival outcomes from RCTs of interventions for comorbid MDD in cancer patients found no significant evidence confirming that it improved survival [ 24 ]. When it comes to observational studies, our finding that depression was associated with worse survival prognosis is consistent with several studies of patients with prostate cancer [ 7 ], colorectal cancer [ 9 , 11 ], and several common cancers [ 16 ]. However, our finding that screening and treatment for MDD was correlated to favorable survival prognosis of cancer has never been found before in any observational study.…”

“…The four most common cancers are colorectal, lung, breast, and liver cancers; the top four leading causes of cancer death are lung, liver, colorectal, and breast cancers. While combatting cancers, new interventions in surgery, radiotherapy, chemotherapy, and target therapy as well as advanced prognostic factors such as biomarkers, nutrition state [ 4 ], and depression [ 5 , 6 , 7 , 8 , 9 ] all play critical roles. Compared to the focus on treatments for cancer itself, less focus has been provided to interventions for managing modifiable prognostic factors.…”

“…Furthermore, a recent meta-analysis revealed that depression is significantly associated with higher breast cancer recurrence, all-cause mortality, and cancer-specific mortality [ 6 ]. In a 3-year follow-up study of patients with prostate cancer undergoing radical prostatectomy, depression was correlated with an unfavorable survival profile [ 7 ]. Similarly, in two other follow-up studies, depression was correlated with the worse survival prognosis of colorectal cancer [ 9 , 11 ].…”

Atrazine Inhalation Worsen Pulmonary Fibrosis Regulating the Nuclear Factor-Erythroid 2-Related Factor (Nrf2) Pathways Inducing Brain Comorbidities

“…This is likely attributable to 1) decreased treatment compliance in depressed patients; 2) a worsened sense of dyspnea in depressed and anxious patients, which may result in greater hospital admissions; and 3) a sad and/or anxious patient's ability to cope with a chronic disease. On the other hand, cognitive problems are associated with worsening of the disease progression, which leads to an infinity loop until death [139][140][141][142][143][144][145][146][147][148][149]. Considering the severity of the worsened symptoms, the treatment for such brain comorbidities requires further investigations [150].…”

Reminiscence therapy-based care program serves as an optional nursing modality in alleviating anxiety and depression, improving quality of life in surgical prostate cancer patients

“…Even though the survival of prostate cancer patients is satisfactory with 5-year survival ranging from 42.0% to nearly 100% after surgical resection [ 4 – 6 ], the mental burden of surgical prostate cancer patients is still huge, which manifests as a frequent occurrence of phycological disorders (including anxiety and depression) and decreased life quality resulted from the disease itself or the treatment modalities, such as orchiectomy and androgen deprivation (ADT) [ 7 , 8 ]. Meanwhile, the emergence of anxiety and depression might further cause a decrement of the survival of surgical prostate cancer patients [ 9 ]. Despite great efforts that have been made to relieve anxiety and depression, improve the quality of life, and further prolong the survival of surgical prostate cancer patients, how to figure out these problems in a preferable manner still challenges modern health care providers.…”