Mental Health Problems are Common in Bladder Cancer Patients - Expert Commentary

Bladder cancer takes an enormous physical, emotional and economic toll on patients. Psychological distress can be caused by the diagnosis, the associated high risk of recurrence, and the stress from major surgery and the possible loss of sexual and urinary function. In the literature, little attention is paid to the impact of both pre- and post- treatment mental health of bladder cancer on clinical outcomes.

A new review published by Pham et al. in Urologic Oncology summarized the relevant publications discussing the effect of the diagnosis and treatment on mental health and the impact of psychological distress on prognosis and the risk of suicide. The authors reviewed studies performed from 2000 to 2018 and listed in PubMed, Web of Science, EMBASE, SCOPUS, and OVID.

The authors found that depression and anxiety were frequently observed at the time of bladder cancer diagnosis. Several studies showed that a large proportion of patients undergoing radical cystectomy experienced psychological distress preoperatively. Several studies also showed that depressive symptoms or psychological distress were associated with worse clinical outcomes including higher mortality. The authors also reported that bladder cancer patients have a higher risk of suicide. The risk was higher in older, unmarried Caucasian male patients with more aggressive disease. 

This study sheds light on the need for more research efforts to define the prevalence of psychosocial problems associated with the diagnosis and treatment of bladder cancer. Developing tailored pharmacological and non-pharmacological therapeutic interventions for these patients is critical to improving clinical outcomes.

Written by: Bishoy M. Faltas, MD, Director of Bladder Cancer Research, Englander Institute for Precision Medicine, Weill Cornell Medicine

Pham H, Torres H, Sharma P. Mental health implications in bladder cancer patients: A review. Urol Oncol. 2019 Feb;37(2):97-107. doi: 10.1016/j.urolonc.2018.12.006. Epub 2018 Dec 21
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