Facing a prostate cancer diagnosis can come with complex feelings of uncertainty and fear for what lies ahead. Some of the symptoms and treatment options for prostate cancer can result in difficult or embarrassing lifestyle changes. Whether or not they had successful treatment, these lifestyle changes combined with tremendous emotional stress can lead men to develop depression and anxiety. It’s normal to have these thoughts and feelings; what’s important is to be able to recognize the signs and seek support if you start experiencing any changes.
There are different treatment options to take into consideration when deciding how to manage your prostate cancer. New research is finding that some treatment options, specifically hormone therapy (ADT), are causing more men to report experiencing depression as a side effect.
Many of these side effects might negatively impact your quality of life, which can add to a sense of depression or social isolation. It can feel overwhelming to go out in public if you are experiencing incontinence or a leaky bowel. Or you might not seek intimacy if you are having erectile dysfunction. All of this can compound the feelings of depression, loneliness, and worry that men living with prostate cancer sometimes carry.
Hormone therapy basics
One of the treatment strategies for prostate cancer is hormone therapy, or androgen deprivation therapy (ADT). There are many different approaches to hormone therapy, but they are all designed to reduce the amount of male hormones, called androgens, in the body. These hormones stimulate the growth of prostate cancers, so limiting them can limit cancer growth.3
If it’s not possible to undergo surgery or radiation therapy for other reasons;
If you are at a higher risk of having the cancer recur, for example if you have a high PSA or Gleason score or if the cancer has grown outside the prostate;
Before radiation, to shrink the tumor to make treatment more effective.
There is still a lot of ongoing research around hormone therapy to understand when to start and stop it, how to combine it with other treatments, and how to administer it. Some doctors even use it in early-stage cancers, rather than watchful waiting or active surveillance, for men who do not want surgery or radiation therapy.
Hormone therapy and depression
Recent research suggests that hormone therapy might be linked with some increase in depression among men living with prostate cancer.4
Men who took longer courses of the medication also report higher levels of depression and a greater need for psychiatric treatment. This increase was not found in all men who needed longer hormone therapy courses, but it’s a factor to be aware of when choosing between treatment options.
Studies found the survival rate for those newly diagnosed with high-risk or locally advanced prostate cancer increased following ADT.4 This high survival rate lead to an increased use of ADT to treat prostate cancer. Unfortunately, this heavier reliance on hormone therapy coincided with more men reporting negative side effects following treatment. These include symptoms relating to digestion, the heart and circulatory system, bone health, and mental and mood issues.
Treatment options and managing your emotional health
Regardless of the treatment method you and your doctor choose to manage your prostate cancer, it’s important to discuss possible side-effects of all the options. Then once you are undergoing treatment, and when you are living with prostate cancer, be sure to mention any feelings of loneliness, depression, hopelessness, or worry you may have. Talking to people, including friends, support groups, and professionals is one of the best ways to begin coping with these negative thoughts and feelings.
Radiation Therapy for Prostate Cancer. American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/treating/radiation-therapy.html. Published March 11, 2016. Accessed February 2, 2018.
Surgery for Prostate Cancer. American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/treating/surgery.html. Published November 20, 2017. Accessed February 2, 2018.
Hormone Therapy for Prostate Cancer. American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/treating/hormone-therapy.html. Published March 11, 2016. Accessed February 2, 2018.
Kathryn T. Dinh, Gally Reznor, Vinayak Muralidhar, et. al., Association of Androgen Deprivation Therapy With Depression in Localized Prostate Cancer. Journal of Clinical Oncology June 2016; 34(16), 1905-1912. Available from http://ascopubs.org/doi/full/10.1200/JCO.2015.64.1969. Accessed February 2, 2018.