Depression Negatively Impacts Survival of Patients with Metastatic Prostate Cancer - Beyond the Abstract

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Prostate cancer is the most common male urologic malignancy around the world. In Taiwan, it was also growing the number of patients with prostate cancer in recent years. Androgen deprivation therapy (ADT) has been a mainstay treatment for advanced prostate cancer for decades. However, ADT has several adverse effects such as metabolic, bone, cardiovascular and erectile function. ADT is also associated with negative mood status or depression.

In this retrospective study of 1101 newly diagnosed cases with prostate cancer utilizing the Taiwan National Health Insurance Research Database. 267 /1101 (24.3%) developed depression with mean follow-up period was 8.30±3.12 years. Patients with depression were associated with an increased risk of mortality (aHR: 1.37; 95% CI: 1.04–1.80). Furthermore, patients in the metastatic prostate cancer group with depression had a significantly higher mortality risk compared to the non-depression group (aHR: 1.49; 95% CI: 1.05–2.11).

This result demonstrated that metastatic prostate cancer patients with depression may have a 49% higher risk of mortality compared to patients in the same disease stage without depression. Physicians should pay attention to the mood and psychiatric illness adverse effect in patients with metastatic prostate cancer. We suggested that treating psychiatric disorder and cancer are both important in patients with prostate cancer.

Written By: Jui-Ming Liu MD1,2,3, Po-Hung Lin MD 4,5, Shun-Ku Lin MD6,7, Ren-Jun Hsu PhD3
1. Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
2. Department of Medicine, National Yang-Ming University, Taipei, Taiwan
3. Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
4. Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
5. Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
6. Department of Chinese medicine, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
7. Institute of Public Health, National Yang-Ming University

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