Prostate Cancer Surgery Tied to Antidepressant Use

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Men with prostate cancer who get surgery or radiation are also more likely start taking antidepressants than their counterparts who don't get aggressive treatment, a recent study suggests.

Many men with early-stage prostate cancer may not need treatment right away, or ever, because these tumors often don't grow fast enough to cause symptoms or prove fatal. In the absence of symptoms or tests that suggest tumors are growing quickly, doctors may advise men to put off immediate treatments like surgery or radiation and instead get regular screenings to reassess whether the cancer is dangerous enough to warrant
intervention.

For the current study, researchers examined data on men with early-stage prostate cancer, including 4,952 people who had surgery, 4,994 who got radiation and 2,136 who opted instead for surveillance, or "watchful waiting." In the year before their cancer diagnosis, 7.7 percent of the men were prescribed antidepressants, and this climbed to 10.5 percent in the first
year after diagnosis.

Compared to a control group of men in the general population without a prostate cancer diagnosis, men with prostate cancer were 49 percent more likely to be taking antidepressants five years after surgery and 33 percent more likely to take antidepressants five years after radiation treatment, the study found.

But watchful waiting wasn't linked to any increase in the odds of men taking antidepressants.

"Prostate cancer patients often fit the demographic profile (white, older age, and male) of someone at risk for depression," said senior study author Dr. Robert Nam of Sunnybrook Health Sciences Centre in Toronto.

"Once they receive treatment for prostate cancer, whether that is surgery or radiation, they may experience treatment-related side effects, such as erectile dysfunction, incontinence, and bowel dysfunction, which can significantly
worsen quality of life," Nam said by email.

Roughly half of men diagnosed with prostate cancer receive treatment known as androgen deprivation therapy, which suppresses production of the male sex hormone testosterone and contributes to mood disorders, Nam added.

Men in the study who received surveillance tended to be older and were more likely to have multiple chronic health problems than the patients who got surgery or radiation.