Psychological Aspects of Prostate Cancer

A Clinical Review

A De Sousa; S Sonavane; J Mehta

Disclosures

Prostate Cancer Prostatic Dis. 2012;15(2):120-127. 

In This Article

Abstract and Introduction

Abstract

Prostate cancer is the most common non-skin cancer in men. It is fraught with both physical and psychological symptomatology. Depression, anxiety, stress, fatigue, pain and psychosocial factors all affect the patient with prostate cancer. Impotence, erectile dysfunction, sexual issues and incontinence in these patients complicate matters further. Anxiety may exist both before testing and while awaiting test results. Confusion over choosing from various interventions often adds to anxiety and depression in these patients. Various demographic factors and the developmental stage of the couple affect these psychological symptoms. The caregiver may undergo significant psychological turmoil while caring for a patient diagnosed with prostate cancer, which is addressed. The role of nurses in the management of prostate cancer is discussed. The present review looks at psychological issues in patients with prostate cancer from a clinical perspective, with the aim of highlighting these issues for the clinical urologist dealing with these patients. It also explores the consultation–liaison relationship between psychiatrists, psychologists and urologists as a team for the multimodal management of prostate cancer.

Introduction

The last few years have seen a rise in the incidence and prevalence of prostate cancer worldwide, making it the most common non-skin cancer in men today.[1] Better treatment procedures and diagnostic aids have prolonged the lifespan of patients with prostate cancer. Along with this, there has also been an increase in the number of patients with prostate cancer who face psychological distress in addition to their physical problems.[2] Depression, anxiety, posttraumatic stress symptoms, pain, sexual problems and difficulty in urinating, along with other symptoms, can potentially develop during both the initial and later stages of the disease. The management of these symptoms from a psychological point of view is essential when considering treatment alternatives for prostate cancer.[3] However, this aspect had often been neglected in the management of prostate cancer. The present article reviews the various psychological problems seen in patients with prostate cancer, highlighting these for the busy clinical urologist and/or oncologist dealing with these patients on a routine basis. This paper also reviews the consultation–liaison relationship between mental health professionals and urologists in a prostate cancer unit and the multidisciplinary and multimodal management of this problem.

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