Thinking about one's own death after prostate-cancer diagnosis

Prostate-cancer diagnosis increases the risk for psychiatric morbidity and suicide. Thoughts about one's own death could indicate need for psychiatric care among men with localized prostate cancer. We studied the prevalence and predictors of thoughts about own death among men with prostate cancer.

Of the 3930 men in the prospective, multi-centre LAPPRO-trial, having radical prostatectomy, 3154 (80%) answered two study-specific questionnaires, before and three months after surgery. Multivariable prognostic models were built with stepwise regression and Bayesian Model Averaging.

After surgery 46% had thoughts about their own death. Extra-prostatic tumor-growth [Adjusted Odds-Ratio 2.06, 95% Confidence Interval 1.66-2.56], university education [OR 1.66, CI 1.35-2.05], uncertainty [OR 2.20, CI 1.73-2.82], low control [OR 2.21, CI 1.68-2.91], loneliness [OR 1.75, CI 1.30-2.35], being a burden [OR 1.59, CI 1.23-2.07], and crying [OR 1.55, CI 1.23-1.96] before surgery predicted thoughts about one's own death after surgery.

We identified predictors for thoughts about one's own death after prostate cancer diagnosis and surgery. These factors may facilitate the identification of psychiatric morbidity and those who might benefit from psychosocial support already during primary treatment.

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2017 Dec 09 [Epub ahead of print]

Thordis K Thorsteinsdottir, Heiddis Valdimarsdottir, Johan Stranne, Ulrica Wilderäng, Eva Haglind, Gunnar Steineck

Research Institute in Emergency Care, Landspitali National University Hospital of Iceland, Reykjavik, Iceland. ., Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY, USA., Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden., Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden., Scandinavian Surgical Outcomes Research Group (SSORG/Göteborg), Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.