Men diagnosed with prostate cancer are often told it is best to wait and see how it develops – and new findings suggest that most patients happily live with this.
Only the most neurotic males start to panic when they are told it is best not to treat the cancer.
Both surgery and radiotherapy treatment for prostate cancer have unpleasant side-effects and are not always necessary if the tumour is slow-growing, so a wait-and-see approach is chosen in many cases.
In fact, autopsies show that about 60 per cent of men have cancer cells in their prostate when they die, although most of their deaths are due to another cause.
Dr Roderick van den Bergh of Erasmus University Medical Centre, Rotterdam, the Netherlands, looked at the effects of the wait-and-see approach with regular check-ups.
They gave 129 men on active surveillance questionnaires in the first few months after being diagnosed. Levels of decisional conflict, depression, general anxiety, and prostate cancer specific anxiety were compared with expected values from the general population.
For each psychological aspect, the vast majority of the men scored more favourably than expected.
"Scores were comparable to or more favourable than those of men (reported in literature) who underwent other treatments for localised prostate cancer," the team reports in the journal Cancer.
Further analysis showed that "a perceived important role of the physician in shared decision-making" was linked to higher decisional conflict.
Better physical health was associated with lower depression, and having a neurotic personality was associated with higher depression and with generic and prostate cancer-specific anxiety.
As expected, men with higher prostate-specific antigen levels tended to have higher prostate cancer -specific anxiety.
The authors write: "These findings may help to optimise patient selection for active surveillance or to select men for supportive measures."
van den Bergh, R. C. N. et al. Anxiety and distress during active surveillance for early prostate cancer. Cancer, published online July 27, 2009.
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