High levels of anxiety and distress spare men with early stages of prostate cancer who delay radical treatment, and favor an approach of "expectant management".
This is the conclusion of a new study published in the September 1, 2009 issue of Cancer, a peer-reviewed journal of the American Cancer Society. The study's results suggest that living with untreated cancer is not upsetting for many patients with early prostate cancer.
The rapid increase in the use of screening using prostate specific antigen (PSA) testing has led to a large number of men diagnosed with prostate cancer, many of who do not require treatment. In these cases, close clinical monitoring—or active surveillance—is often recommended. If progression of the cancer occurs during active surveillance, patients may undergo radical therapy. While active surveillance may delay or even avoid the possible adverse side effects of radical treatment, it could also cause psychological harm in patients because they must live with untreated cancer. Data on the levels of such potentially negative emotions among men on active surveillance are lacking, however.
Certain men in the study—such as men with neurotic personalities and those who were in poor physical health—exhibited more anxiety and distress than others. These findings indicate that besides cancer-specific factors, mental and physical patient-specific factors are important aspects to take into account when selecting men for active surveillance. The results also suggest that psychological support may be indicated in certain patients undergoing active surveillance.
While this study's findings are useful, Dr. van den Bergh noted that longer-term analyses are needed on the psychological effects of active surveillance in men with early prostate cancer. His research team is currently conducting such a study.