(HealthDay News) — Depressed men with a diagnosis of intermediate- or high-risk prostate cancer have worse overall outcomes, according to a study published online July 7 in the Journal of Clinical Oncology.
Sandip M. Prasad, M.D., from the Medical University of South Carolina in Charleston, and colleagues reviewed Surveillance, Epidemiology, and End Results-Medicare linked data. Of the 41,275 men diagnosed with clinically localized prostate cancer from 2004 to 2007, 1,894 men were identified with a depressive disorder in the two years before the prostate cancer diagnosis. The effect of this diagnosis on treatment and survival was evaluated.
The researchers found that men with depressive disorder were older, white or Hispanic, unmarried, resided in nonmetropolitan areas and areas of lower median income, and had more comorbidities (P < 0.05 for all). Men with depressive disorder were more likely to undergo expectant management for low-, intermediate-, and high-risk disease (P ≤ 0.05, respectively), in adjusted analysis. Depressed men were less likely to undergo definitive therapy (surgery or radiation) across all risk strata (P < 0.01, respectively). There was worse overall mortality seen in depressed men across risk strata (low: relative risk [RR], 1.86 [P = 0.001]; intermediate: RR, 1.25 [P = 0.01]; high: RR, 1.16 [P = 0.02]).
“In summary, these results point toward a newly identified disparity in the management of men with incident prostate cancer,” the authors write. “Men diagnosed with depression and intermediate- or high-risk prostate cancer are less likely to undergo definitive therapy.”