Anxiety may prompt prostate cancer patients to
opt for potentially unnecessary treatments, a new study suggests.
The research included more than 1,500 men
newly diagnosed with localized prostate cancer. They were more likely to choose
surgery and radiation therapy than active surveillance. Active surveillance --
also known as "watchful waiting" -- is when the patient is monitored
closely, but not treated.
"Men's level of emotional distress
shortly after diagnosis predicted greater likelihood of choosing surgery over
active surveillance," said the researchers from the University at Buffalo
and Roswell
Park Cancer Institute in
Buffalo, N.Y.
"Importantly, this was true among men
with low-risk disease, for whom active surveillance may be a clinically viable
option and side effects of surgery might be avoided," they noted.
Though the study found an association between
anxiety and more aggressive treatment, it didn't prove cause and effect.
"Emotional distress may motivate men with
low-risk prostate cancer to choose more aggressive treatment," said study
author Heather Orom, an associate professor of community health and health
behavior at the University at Buffalo.
"If distress early on is influencing
treatment choice, then maybe we help men by providing clearer information about
prognosis and strategies for dealing with anxiety. We hope this will help
improve the treatment decision-making process and ultimately, the patient's
quality of life," Orom said in a university news release.
Overtreatment is a concern because surgery and
radiation therapy can cause side effects such as erectile dysfunction and
incontinence. These problems can be avoided in men with low-risk prostate
cancer by choosing active surveillance, the researchers said.
Study co-author Dr. Willie Underwood III is an
associate professor in Roswell Park's department of urology. "The goal of
most physicians treating men with prostate cancer is to help their patients and
family members through a difficult process and help their patients receive
appropriate treatment," he said.
"To do so, it is helpful for physicians
to better understand what is motivating men's decisions and to address negative
motivators such as emotional distress to prevent men from receiving a treatment
that they don't need or will later regret," Underwood added.
The findings were published in the February
issue of the Journal of Urology.
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