Stay Up
to Date
Stay Up
to Date
Breaking News,
Updates, & More
Breaking News,
Updates, & More
Click Here to
Subscribe
Click Here to
Subscribe

Hormonal Therapy Associated with Anxiety in Men with Localized Prostate Cancer

TON - May 2017, Vol 10, No 3 - Genitourinary Cancers
Phoebe Starr

Orlando, FL—Androgen deprivation therapy (ADT) for the treatment of prostate cancer has adverse effects that may be difficult for men to tolerate. Well-documented adverse events include weight gain, fatigue, cardiovascular effects, hot flashes, and cognitive effects. According to results of a new study presented at the 2017 Genitourinary Cancers Symposium, anxiety should be added to the list of side effects related to ADT.

In a large study of >78,000 patients with localized prostate cancer, the cumulative incidence of anxiety at 3 years was significantly higher among men treated with ADT versus those who did not receive ADT (4.1% vs 3.5%, respectively [P <.001]). Whereas the absolute difference is .6%, numerically this translates to 3198 men with anxiety related to ADT and 2730 with anxiety unrelated to ADT.

Using propensity score matching, any ADT use was associated with a 17% increased risk of an anxiety diagnosis (P <.001).

“These results suggest that anxiety should be considered among the possible psychiatric effects of ADT
and discussed prior to initiating ADT, particularly if a long course of treatment is anticipated,” the investigators reported.

The study was designed to assess whether ADT and longer treatment with ADT were associated with anxiety. The study cohort included 78,552 men aged ≥66 years with stage I to III prostate cancer included in the SEER- Medicare Linked Database from 1992 to 2006. Patients were excluded from the study if they died within 6 months of diagnosis, had orchiectomy, had stage IV or unknown stage of disease, or had received psychiatric treatment in the 12 months before and 6 months after prostate cancer diagnosis.

Comorbidity status was calculated using the Charlson Comorbidity Index. Patients could have received radiation, surgery, or no local therapy, with or without ADT, within 6 months of prostate cancer diagnosis.

An International Classification of Diseases, Ninth Edition diagnosis of anxiety was the primary end point. Baseline factors significantly associated with receipt of ADT included older age, intermediate risk (stage I-II and Gleason score 7-10, poorly differentiated), higher Charlson Comorbidity Index, and 1 to 6 months of ADT (all factors, P <.001).

In a multivariate analysis adjusted for demographic, clinical, and treatment factors, the following were significant factors associated with anxiety: ≥12 months of ADT (P = .010), unmarried status (P <.001), and higher Charlson Comorbidity Index ≥2 (P <.001).

These results may represent the tip of the iceberg, because patients were required to have an International Classification of Diseases, Ninth Edition, diagnosis of anxiety, and many patients may be anxious but not fulfill diagnostic criteria.

The take-home message is that clinicians who see patients with prostate cancer treated with ADT should be aware that their patients may be anxious, and they should ask them about it.

Related Items
Sitravatinib, Novel TKI, plus Nivolumab Elicits Good Responses in Renal-Cell Carcinoma
Phoebe Starr
TOP - May 2020, Vol 13, No 3 published on May 21, 2020 in Emerging Therapies
First-in-Class Oral MK-6482 Shows Exciting Results in Clear-Cell Renal-Cell Carcinoma
Phoebe Starr
TOP - May 2020, Vol 13, No 3 published on May 21, 2020 in Emerging Therapies
PSMA-PET Scanning Is Wave of the Future in Prostate Cancer
Phoebe Starr
TON - April 2020, Vol 13, No 2 published on April 16, 2020 in Prostate Cancer
SBRT plus Immunotherapy in Metastatic Renal-Cell Carcinoma Warrants Further Study
Phoebe Starr
TON - April 2020, Vol 13, No 2 published on April 16, 2020 in Renal-Cell Carcinoma
Targeted Therapy with Olaparib Beneficial in Metastatic Prostate Cancer with Gene Mutations
Phoebe Starr
Web Exclusives published on February 24, 2020 in ESMO
Postsurgery Observation Better Than Radiotherapy in Men with Prostate Cancer
Phoebe Starr
TON - February 2020, Vol 13, No 1 published on February 5, 2020 in ESMO
Real-World Healthcare Utilization and Costs Support Broader Use of CAR T-Cell Therapy
Phoebe Starr
TON - February 2020, Vol 13, No 1 published on February 5, 2020 in Value-Based Care
Long-Term Data Confirm Survival Benefit for Pembrolizumab in Advanced NSCLC
Phoebe Starr
Web Exclusives published on November 25, 2019 in Lung Cancer
Adding CDK4/6 Inhibitor to Endocrine Therapy Improves Survival in Advanced Breast Cancer: New Standard of Care
Phoebe Starr
Web Exclusives published on October 28, 2019 in ESMO, Breast Cancer
Reduced-Intensity Chemotherapy for Frail Elderly Patients with Advanced Gastroesophageal Cancer
Phoebe Starr
TON - October 2019, Vol 12, No 5 published on October 7, 2019 in Geriatric Cancer
Last modified: April 27, 2020