A new study published in the Journal of Urology suggests that anxiety may prompt prostate cancer patients to opt for potentially unnecessary treatments.
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.
Study co-author Dr. Willie Underwood III, an associate professor in Roswell Park’s department of urology, said that to help men and families through this difficult process, “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.” 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.