CUA 2017: Incidence and Predictors of Clinical Depression in Men with Prostate Cancer

Toronto, Ontario ( Dr. Robert Siemens and colleagues presented their results of incidence and predictors of clinical depression in men with prostate cancer at the prostate cancer poster session at the CUA 2017 annual meeting. Although depression in prostate cancer was previously linked only to men receiving androgen deprivation therapy (ADT), previous studies have demonstrated that up to 20% of men with prostate cancer report clinical depressive symptoms.1

The objective of this study was to investigate the incidence of clinical depression at baseline and evaluating biopsychosocial factors predictive of clinical depression in men with prostate cancer.

This study was a cross-sectional analysis of a prospective cohort of men with prostate cancer (n=65). Patients were enrolled regardless of local or advanced disease who were either on watchful waiting or ADT treatment protocols. Patients were assessed every three months from baseline with questionnaires (standardized Center for Epidemiologic Studies‒Depression Scale (CESD) measure) to assess depression, anxiety, social factors, catastrophizing, and sexual function for a two-year period. Among these 65 patients, 26% of men were classified as clinically depressed. Using logistic depression to assess for predictors of clinical depression, testosterone level (OR 1.41, p=0.02), pain (OR 1.20, p=0.02), and anxiety (OR 1.18, p=0.008). However, time from diagnosis, social support, and sexual function were not significant predictors of clinical depression. A potential limitation of this study is the relatively small sample size and thus event rate (clinical depression).

The authors concluded that the incidence of clinical depression in men with prostate cancer is likely higher than the elderly general population. Interestingly, sexual function was not a predictor of clinical depression. This study highlights the clinical significance of depression in this patient population, as well as potentially modifiable risk factors (testosterone and pain level, anxiety) that can be addressed as part of a comprehensive treatment plan.

Presented By: Robert D. Siemens, Queens University, Kingston, ON, Canada

Co-Authors: Steven Tong1, Jason P. Izard1, Angela Black1, Dean Tripp1, Phylicia Verreault

Written By: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre  Twitter: @zklaassen_md at the  72nd Canadian Urological Association Annual Meeting - June 24 - 27, 2017 - Toronto, Ontario, Canada

1. Ravi P, Karakiewicz PI, Roghmann F, et al. Mental health outcomes in elderly men with prostate cancer. Urol Oncol 2014;32(8):1333-1340.