Anxiety may lead to unnecessary aggressive treatments for prostate cancer

When men are diagnosed with prostate cancer, they may become overwhelmed with stress and anxiety. Recent research found that newly diagnosed men with localized prostate cancer found that this can lead to poor decision-making regarding treatment options.

It has been observed that most men who experience anxiety and distress are inclined towards opting for surgical and radiation therapies rather than active surveillance for their treatment. It’s true that many men may require more aggressive treatment as recommended by their physician. Yet, a less aggressive approach called active surveillance, is a useful treatment for men who’ve been determined to have a slow-growing, tumor that has not spread beyond the prostate gland. 

However, it should be noted that while there is a correlation between anxiety and aggressive treatment, there is no conclusive evidence to suggest a causal relationship.

What is active surveillance?

Active surveillance, also called “watchful waiting,” is a viable clinical option that does not come with any side effects associated with surgery or radiation. Previously, active surveillance was a method where a man diagnosed with localized prostate cancer, which had not spread and was considered slow-growing, would live his life until he developed symptoms, which would then be treated. In fact, a 2021 cohort study of over 20,000 men being treated at almost 350 urology practices across the United States, rates of active surveillance increased sharply from 26.5% in 2014 to 59.6% in 2021.

Today, active surveillance involves monitoring a man’s health closely through regular doctor visits, where prostate-specific antigen blood tests and digital rectal exams are conducted every six months. Additionally, prostate biopsies may be performed annually. The doctor will discuss alternative treatment options with the patient if any changes arise in the test results.

Study findings

According to this study, men who experience higher levels of emotional distress after being diagnosed with even low-risk prostate cancer are more likely to choose more aggressive treatments such as surgery or radiation. While active surveillance is an option for men with localized, low-risk prostate cancer and is considered a viable option that avoids the side effects of invasive treatments.

When deciding between surgery, radiation, or active surveillance for low-risk prostate cancer, one concern to consider is the potential for side effects such as erectile dysfunction and urinary incontinence. However, choosing active surveillance can help avoid these issues.

This study’s findings could aid doctors in identifying and assisting men struggling with significant levels of distress and anxiety related to their diagnosis. Suppose a man’s emotional state is affecting their treatment decisions. In that case, a doctor can intervene by offering precise and concise information about their prostate cancer, potentially reducing invasive treatments and unnecessary side effects.

The ultimate aim is to enhance the treatment decision-making process to improve men’s quality of life.

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncolo gy and prostate cancer 911. 

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