Psychological aspects of Prostate Cancer

General psychological problems in prostate cancer

Emotional and social problems arise in 30--50 % of prostate cancer patients irrespective of the stage and development of cancer or the sort of treatment they get. 4 With powerful assessment and intervention, clinicians can help to recognize troublesome and disturbing issues, reduce their negative impact and improve the QOL for patients and people near them. A number of the psychological issues that are commonly seen in prostate cancer are anxiety related to cancer and its cure, depression and depressive symptoms, guilt and guilt after a diagnosis, anxiety concerning PSA assessment, fears about a recurrence of their cancer after treatment, an impending fear and recognition of death, pain and fatigue, which may be aggravated by social and psychological factors and the resultant sexual issues during and following treatment. 5 But, making a psychiatric diagnosis in a prostate cancer patient can be complicated by overlapping symptomatology seen in emotional illness and cancer which includes fatigue, weight loss, sleep disturbance, loss of desire, and stress. One wants to assess the subtle cognitive or psychological symptoms, such as sense a lack of enjoyment, depressed mood, hopelessness, and helplessness along with anxiousness to help establish a diagnosis. 

Stress and prostate cancer

Stress is an affective state that may frequently occur without an identifiable triggering stimulation. As such, it has to be distinguished from panic, which is an emotional response to a perceived threat. Additionally, anxiety is also related to specific behaviors of escape and avoidance, whereas anxiety is related to situations perceived as uncontrollable or inevitable. Another sort of stress is anticipatory anxiety, which can be a future-oriented mood state where one is anxiously expecting a future upcoming negative event. 7 Stress is seen in a variety of kinds in patients with prostate cancer. Anxiety might be viewed while studying for prostate cancer (PSA testing), diagnosis, through therapy, while handling the social stigma, could be associated with sexual functioning, and anxiety with a fear linked to recurrence of cancer after treatment. 8 Studies have demonstrated that at any given time 20--60% of patients with prostate cancer may suffer from nervousness in general. 9

PSA testing is associated with a significant amount of stress in prostate cancer sufferers. A study on stress in prostate carcinoma indicates that while screening for prostate carcinoma, anxiety levels change plausibly over the clinical timeline in reaction to stress and uncertainty both before testing and while awaiting the reports. Baseline levels of stress related to screening are considerably lower for elderly men than younger guys with the illness. Reducing anxiety by itself is a possible motivation for screening, because folks may expect reassurance from a standard test result. Urologists are well conscious of the anxiety, physical and psychological distress undergone by men who are getting their PSA tested and those who have raised PSA levels, a state called PSAdynia.

Depression in prostate cancer

It's likewise essential that one distinguishes between anxiety attributes, which may be present as a backdrop characteristic of their individual's character, and nervousness condition, which is a situational reaction to a stressor. Anxiety trait when current indicates that the individual is anxious by nature and shall carry the stress with him throughout the clinical process and treatment. Stress state in turn indicates a transient response of anxiety concerning evaluation results if awful, prognosis, and certain treatment results. The memorial anxiety scale for prostate cancer is a proper tool that can be used for screening anxiety in patients with prostate cancer.

Having a family member with prostate cancer raised stress about having prostate cancer. In the majority of the studies, 30--40 % of patients complained the stress affected their day-to-day functioning. Anxiety levels were highest in a group awaiting biopsy results and have been associated with the evaluation report rather than doubts regarding the biopsy procedure. A diagnosis of prostate cancer when demonstrated did reduce stress as the doubt reduced, but this anxiety reduction was not as much as obtaining a negative outcome. Most studies on stress in prostate cancer were modest in proportion, and several were potential in design. In areas where anxiety was analyzed most closely, particularly in the domain of chasing screening, stress effects were consistent with the hypothesis that stressed men were more likely to pursue screening, particularly younger men and people who had relatives with a history of prostate carcinoma. This may help determine the choice of remedies for localized disease, as more worried guys may undergo surgery to prevent worry about cancer spread. One neglected area of our current understanding for your HRQOL and decision making in prostate carcinoma is the role of patient anxiety and our existing knowledge does stay fragmentary in a sense. Future research needs to estimate the role that patient anxiety would have in prostate cancer screening, treatment decisions, and recovery.

When and if a patient is diagnosed with prostate cancer via biopsy or after the discovery of elevated levels of PSA, the urologist must send the individual for a psychological evaluation to help the individual manage the news and also prepare him to handle the treatment processes that may follow. In addition to this, it is also essential to involve the principal caregivers to comprehend the treatment procedure and mental distress of the patient together with an allaying of the own anxieties. In our clinical experience, we have noted that awareness about the disease makes patients more comfortable, thereby making them feel in charge of their bodies and this could help them become more receptive to treatment options. Counselling helps patients understand their limits, how to deal with the pain, depression, and anxiety that follow. Counsellors help to restrain the psychological issues faced and may bridge the gap between physicians and patients.

Anxiety as an effect

Anxiety about cancer as a diagnosis, lack of consciousness, medical complications that ensue, the fear of death, and fiscal burdens are some of the factors that result in depression among prostate cancer patients. There is often a delay in diagnosis of depression, which reduces the chances of long-term cancer survival by 10--20%. Effective psychotherapeutic treatment for depression, together with antidepressant treatment, has been found to impact the course of prostate cancer. Psychotherapy benefits in decreased depression and anxiety, and frequent pain reduction. Psychotherapy also contributes to a longer survival time for the patients. The physiological or neurobiological mechanism for these findings hasn't yet been ascertained, but the chances for psychotherapeutic effects on physical effect include health maintenance behavior, health-care usage, hormonal and endocrine changes, and positive changes in immune function. Therefore, effective treatment of depression results in greater patient modification, reduced symptoms, low cost of maintenance, and might influence disease course. A joint evaluation and therapy approach in which the urologist and psychotherapist or psychiatrist work out an effective treatment plan considering psychological and urological viewpoints on the etiology of depression is best for the individual.