Anxiety may prompt prostate cancer patients to opt for potentially unnecessary treatments, a new study suggests.
The research included more than 1,500 men newly diagnosed with localised 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, New York.
"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 cancer 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 behaviour 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.
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.
Study co-author Dr Willie Underwood III is an associate professor in Roswell Park's department of urology. "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," he said.
"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," Underwood added.
The findings were published in the Journal of Urology.