Prostate Cancer and Depression: There is Hope

Richard Beven-Thomas Urologists at USMDPCC
By: Dr. Richard Bevan-Thomas

By: Dr. Rich Bevan-Thomas, M.D.
Medical Director of USMD Prostate Cancer Center

You have had your prostate biopsy and are awaiting the results. In the intervening time you have realized that your anxiety has risen dramatically. The day to receive your results arrives and you hear the words you did not want to hear, “You have prostate cancer.” “What if’s “flood your mind and it is difficult to listen to the further information the doctor is sharing with you. You are not alone in your experience.

Many men receiving a prostate cancer diagnosis experience sadness, anger, bitterness, and fear. With a strong support system of family, faith, or friends, patients often adapt to the initial emotional difficulties they felt. However, if you continue to experience anxiety, grief, anger or fear for weeks or months, this could indicate clinical depression.

Symptoms of clinical depression include:

  • difficulty concentrating, remembering details, and making decisions
  • fatigue and decreased energy • feelings of guilt, worthlessness, and/or helplessness
  • feelings of hopelessness and/or pessimism • insomnia, early-morning wakefulness, or excessive sleeping
  • irritability, restlessness
  • loss of interest in activities or hobbies once pleasurable, including sex
  • overeating or appetite loss • persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment • persistent sad, anxious, or "empty" feelings
  • thoughts of suicide, suicide attempts

While some of these symptoms might be a result of your treatment, it is important to tell your USMD PCC physician that you are experiencing them. Joanna L. Fine, M.A., M.D., and clinical instructor in the Department of Psychiatry at New York University Medical School states:

Clinical depression is not a normal consequence of cancer and should be vigorously treated, in much the same ways as the cancer itself is treated. It is important to remember that depression is very different from sadness. Depression is a syndrome that represents an array of symptoms. (John Hopkins Prostate Library, Advanced Prostate Cancer Treatments: Know Your Options When Your Cancer Comes Back)

While the exact cause of depression is not fully known, there appears to be a tie to an imbalance of serotonin, dopamine, and norepinephrine, chemicals needed by the brain to process. Many men fail to understand the biochemical nature of clinical depression and attempt to willpower, or white knuckle, their way through it. While we can shape the thoughts of our mind, it is also important to realize our brain is an organ that often needs to be medically treated when in a state of depression. Clinical depression responds well to a combination of antidepressant medication and non-drug therapies. Freeing yourself from depression allows you to focus on your cancer treatments and quality of life.

If you feel you might be suffering from depression, do not feel like you are unique or possess a character flaw. About 28% of all cancer patients experience a degree of clinical depression. It is important to notify your USMD PCC physician immediately if you have symptoms of depression, as the longer you put off treatment, the more debilitating the depression may become. If you and your physician conclude that some clinical depression is present, know that help is available.

With proper treatment, 80% of clinically depressed patients see dramatic improvements. Your USMD PCC physician will also ensure that your depression treatment and cancer treatment do not counteract one another. Cancer is not a hopeless diagnosis, and despite the obvious anxiety and sadness, you do not have to suffer with clinical depression as you battle prostate cancer. Help is available.

If you have cancer or you’re undergoing cancer treatment, there are places in your community that will provide help. To find a prostate cancer support group in your area, contact the American Cancer Society (www.cancer.org) at 1-800-ACS-2345; the National Cancer Institute (www.cancer.gov) at 1-800-4-CANCER; and The Cancer Care Counseling Line (www.cancercare.org) at 1-800-813-HOPE.

(Additional sources, Depression in Cancer Patients, THE LANCET Oncology Vol 2 August 2001 Harvey Max Chochinov, MD, PhD, FRCPC; Treating Prostate Cancer and Depression, THE JOHNS HOPKINS PROSTATE LIBRARY, Joanna L. Fine, M.A., M.D.,)

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