Emotional Distress from Prostate Cancer Treatment

If your anxiety is off the charts due to a prostate cancer diagnosis, get help for your distress before you make the wrong prostate cancer treatment decision. 

It’s normal for a man to feel anxious and worried when told he has prostate cancer. But not all cancers are deadly, especially those found at an early stage. What’s more, many small prostate malignancies are low-risk and may never grow or be life-threatening.

Treatments for prostate cancer, depending on the stage of the cancer and whether tests indicate the tumor is aggressive or not, can include chemotherapy, radiation, surgery, and hormone therapy.

But for the majority of men diagnosed with low-risk prostate cancer, there’s another option — watchful waiting, also called active surveillance.

By monitoring the cancer and symptoms to see if the disease progresses, most men with low-risk prostate malignancies can avoid aggressive prostate cancer treatments like surgery and radiation, which can cause incontinence and impotence.

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Some men are so anxious over having cancer, even if the odds are great they can safely forego treatment, they may push for — and end up receiving — treatments they didn’t need, with side effects that impact their quality of life, according to a research team from the University at Buffalo and Roswell Park Cancer Institute.

The researchers studied 1,531 men who were recently diagnosed with low-to-moderate risk prostate cancer that had not spread to other parts of their bodies. The research subjects were questioned about their emotional distress soon after being told they had prostate cancer and after they made their treatment decisions.

The results of the study found the men who felt the most emotional distress shortly after diagnosis were far more likely to choose surgery instead of active surveillance. This was true for patients with low-risk disease who were given the option of watchful waiting.

“Emotional distress may motivate men with low-risk prostate cancer to choose more aggressive treatment, such as choosing surgery over active surveillance,” said lead researcher Heather Orom, PhD, associate professor of community health and health behavior at the University at Buffalo.

“It underscores what we have been pushing a long time for, which is, ‘Let’s make this decision as informed and supported as possible,’” she added. “If distress early on is influencing treatment choice, then maybe we can 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.”

About 13 percent of men in the U.S. will be diagnosed with the disease during their lifetime. While it’s true in some cases the cancers metastasize and can be life-threatening, most men with prostate cancer don’t die from it, according to the American Cancer Society.

Understanding those facts about prostate cancer can help men cope with their diagnosis and avoid excessive emotional upset. Speaking openly with their physicians about prostate cancer treatment options — including watchful waiting, if appropriate for their case — can help lower feelings of anxiety and worry, too.

“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,” said urologist Willie Underwood III, MD, an associate professor at Roswell Park Cancer Institute who participated in the study. “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.”

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