Clinicians May Want To Address Emotional Stress to Prevent Overtreatment of Localized Prostate Cancer

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Emotional distress may motivate men with low-risk prostate cancers to select certain treatment options.
Emotional distress may motivate men with low-risk prostate cancers to select certain treatment options.

Emotional distress may motivate men with low-risk prostate cancer to choose more aggressive treatment, according to a study published in the Journal of Urology.

Researchers at the University at Buffalo and Roswell Park Cancer Institute report that addressing emotional distress before and during treatment decision-making may help lead to more appropriate choices when deciding between active surveillance, surgery, and radiation.1

The researchers conducted a study that included 1531 patients with newly diagnosed, clinically localized prostate cancer (83% white, 11% black, and 6% Hispanic).  The men had low-risk (36%), intermediate-risk (49%), or high-risk (15%) disease.  The researchers measured emotional distress with the Distress Thermometer, an 11-point scale ranging from 0 (no distress) to 10 (extreme distress). The men were assessed after diagnosis and again as soon as they had made their treatment decision.

The researchers found that among all the men, those who were more emotionally distressed at the time of diagnosis were more likely to opt for surgery over active surveillance (relative risk ratio [RRR] 1.07). They also found that those men who were more distressed close to the time they made their treatment decision were more likely to pick surgery over active surveillance (RRR 1.16) or surgery over radiation (RRR 1.12). The investigators report that this pattern was also found when just looking at the men with low-risk disease.

Reference

1. Orom H, Underwood W, Biddle C. Emotional distress increases the likelihood of undergoing surgery among men with localized prostate cancer. J Urol. 2017 Feb;197(2):350-355. doi: 10.1016/j.juro.2016.08.007

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