Depression in older patients with prostate cancer

There has been good evidence that older cancer patients report less “distress” than younger cancer patients. However, there has been very little research to date into the distinctions among general distress, anxiety, and depression in aging prostate cancer patients.

Nelson et al. report results of a careful analysis of data from 716 men with prostate cancer (mean age, 68 ±10 years; range, 50-93 years). About half the patients had been treated at Memorial Sloan-Kettering Cancer Center, and the other half were being treated in community practices for across America. All patients were asked to complete a series of validated questionnaires assessing their anxiety and distress related to their diagnosis with and treatment for prostate cancer.

Nelson and colleagues state the following results from their research:

  • Greater age was associated with less distress, less anxiety, and greater emotional quality of life.
  • Aging was also associated with greater depressive symptoms in these patients.
  • The mean depression scores of 5-year cohorts consistently trended upward.
  • The significant association between age and depression remained after controlling for stage of disease, hormone therapy use, time since diagnosis, and social, physical, and functional well-being.

The authors conclude that, “Despite theoretical and empirical evidence that older cancer patients may cope more effectively than younger cancer patients, depressive symptoms remain an important concern for aging cancer patients, …. The increase in depression is in contrast to some findings in the general aging literature, raising the possibility that this trend is unique to older cancer patients.”

The “New” Prostate Cancer InfoLink wonders whether this is, in fact, unique to cancer patients. The diagnosis of any serious disorder that might lead to one’s death in older people is liable to be a clear indicator and constrant reminder of the inevitability of mortality. However “cheerful” the normal disposition of an aging person, such a clear signal that “time is starting to run down” is likely to induce a degree of depression — especially when one sits down to answer questions about the topic! Maybe this has nothing to do with prostate cancer or cancer in general, and just has to do with being asked to think about the nearness of mortality.

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