Patients with prostate cancer (PCa) who express regret from surgery experience depression-associated disruptions to the circadian rhythm (DCR), a study published in Supportive Care in Cancer has shown.

Surgery is a common treatment for patients with PCa but it is not without adverse events: evidence suggests that patients who undergo radical prostatectomies may experience regret and melancholic depression, a form of major depressive disorder (MDD). A common symptom of melancholic depression evaluated in this study was disruption to the circadian rhythm.

For this study, 40 patients with PCa who underwent surgery completed a survey by mail, providing background data on age, time since diagnosis and treatment, disease status, and marital status.

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The Decisional Regrets Scale (DRS) was used to measure patient regret due to harm from surgery, the Zung Self-Rating Depression Scale (SDS), which measures various items in depression, was used to measure depressed mood, DCR, and anhedonia.

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Results demonstrated that the background data was not significantly associated with any of the DRS or SDS measures.

Regret was significantly correlated with DCR, but was not correlated with depressed mood or anhedonia.

Depressed mood, DCR, and anhedonia were all significantly correlated, suggesting that they were all measures of a particular type of MDD.

The authors concluded that “clinicians need to be aware of the possible presence of DCR in these men and take steps to assess it and include it in overall treatment models.”


1. Christie J, Sharpley CF, Bitsika V, Christie D. Evidence of depression-associated circadian rhythm disruption and regret in prostate cancer patients after surgery [published online October 4, 2017]. Support Care Cancer. doi: 10.1007/s00520-017-3913-3