HealthDay News — Men with intermediate- or high-risk prostate cancer who were diagnosed with depression have worse overall outcomes, according researchers.
Sandip M. Prasad, MD, from the Medical University of South Carolina in Charleston, and colleagues reviewed Surveillance, Epidemiology, and End Results-Medicare linked data to examine the effect of depressive disorder on prostate cancer outcomes. The findings were published in the Journal of Clinical Oncology.
The study included 41,275 men diagnosed with clinically localized prostate cancer from 2004 to 2007, 1,894 of who were identified as having a depressive disorder in the two years before the prostate cancer diagnosis. The effect of this diagnosis on treatment and survival was evaluated.
Mortality was higher among men with depression across the prostate cancer spectrum, including those with low-risk disease (relative risk, 1.86; P=0.001), intermediate (RR, 1.25; P=0.01), and high (RR, 1.16; P=0.02).
Men with depressive disorder were more likely to undergo expectant management for low-, intermediate-, and high-risk disease (P≤0.05, respectively) in adjusted analysis, but were less likely to undergo definitive therapy (surgery or radiation) across all risk strata (P<0.01, respectively).
Overall, patients with depressive disorder were older, white or Hispanic, unmarried, resided in nonmetropolitan areas and areas of lower median income, and had more comorbidities (P< 0.05 for all).
“In summary, these results point toward a newly identified disparity in the management of men with incident prostate cancer,” the authors write. “Men diagnosed with depression and intermediate- or high-risk prostate cancer are less likely to undergo definitive therapy.”