Pretreatment depressive symptoms and treatment modality predict post-treatment disease-specific quality of life among patients with localized prostate cancer

• Published in: Urologic oncology Vol. 30; no. 6; pp. 804 - 812
• Main Authors: Mohamed, Nihal E., Ph.D, Bovbjerg, Dana H., Ph.D, Montgomery, Guy H., Ph.D, Hall, Simon J., M.D, Diefenbach, Michael A., Ph.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2012; Elsevier
• Subjects: Aged; Biological and medical sciences; Depression - epidemiology; Depression - psychology; Depressive symptoms; Humans; Male; Medical sciences; Middle Aged; Neoplasm Grading; Nephrology. Urinary tract diseases; Prevalence; Prostate cancer; Prostate-Specific Antigen - blood; Prostatic Neoplasms - pathology; Prostatic Neoplasms - psychology; Prostatic Neoplasms - therapy; Quality of life; Quality of Life - psychology; Surveys and Questionnaires; Treatment modality; Tumors; Tumors of the urinary system; Urinary tract. Prostate gland; Urology; Depressive symptoms; Prostate cancer; Treatment modality; Quality of life; Mood disorder; Human; Nephrology; Urinary system disease; Prostate disease; Disease; Depression; Early stage; Malignant tumor; Urology; Cancerology; Treatment; Pretreatment; Predictive factor; Male genital diseases; Localized; Cancer
• ISSN: 1078-1439; 1873-2496
• DOI: 10.1016/j.urolonc.2011.02.002

Abstract Purpose This study examines the prevalence of depressive symptoms before prostate cancer treatment and explores associations among pre-treatment depressive symptoms and post-treatment disease-specific QOL, controlling for treatment modality, and demographic and clinical covariates. Materials and methods A case series of patients diagnosed with localized prostate cancer (T1-2N0M0) at a comprehensive cancer center was assessed. Of the 1,370 eligible patients, 869 (63.34%) completed questionnaires at diagnosis (baseline) and 6 months following treatment. Patients were treated with surgery (16.8%), brachytherapy (27.6%), or external beam radiation (EBRT; 55.6%). Depressive symptoms and disease-specific QOL were assessed with established measures (i.e., Center for Epidemiologic Studies Depression Scale (CES-D); sexual adjustment questionnaire (SAQ); and the American Urological Association symptom index). Results A fifth of the sample (19.7%) reported clinically elevated levels of depressive symptoms at baseline. The proportion of clinically elevated levels of baseline depressive symptoms was higher among surgery patients compared with patients treated with brachytherapy or external beam radiation. Depressive symptoms at baseline and treatment modality significantly predicted sexual and urinary dysfunction, related bother, activity limitation due to urinary dysfunction at 6 months, controlling for, age, PSA level, Gleason score, relevant baseline indicators of sexual and urinary dysfunction, related bother, and activity limitation ( P < 0.05). Conclusions Pretreatment depressive symptoms and treatment modality predict QOL after PrCa treatment. Health care providers should be sensitive to the display of depressive symptoms before PrCa treatment and consider preventative interventions, including preparing patients for the changes in disease-specific QOL and related bother following prostate cancer treatment.