Is stress killing men with localized prostate cancer (at least in Sweden)?


An article just published on line in the Scandinavian Journal of Urology is entitled, “The roles of stress and social support in prostate cancer mortality.”

This new paper by Jan et al. suggests that there is an association between perceived levels of stress, access to and availability of  social support systems, disease progression, and mortality among a nationwide cohort of men diagnosed with and treated for clinically localized prostate cancer in Sweden.

The paper is based on the results of a survey of just over 4,100 Swedish men — with specific emphasis on things like their stress levels, grief, sleep habits, and social support.

The authors report that

  • Men with the highest levels of perceived stress were significantly more likely to die of prostate cancer than men with low stress levels (hazard ratio [HR] = 1.66).
  • Men with high stress levels also had
    • A high frequency of grieving and sleep loss
    • Fewer people with whom to share their emotional problems
    • A self-perceived inability to share most of their problems with partners, friends, and family

Over the years there have been numerous suggestions that certain categories of men with prostate cancer, including those who are unmarried, those living alone, and those who are less socially integrated in other ways, do a good deal less well over time than their better socially integrated peers. It is unlikely that this finding is specific to prostate cancer. One might reasonably expect this to be true for male patients (and female patients too) with all sorts of serious disorders.

When humans are sick, they benefit significantly from the care, attention, and love of others. Such care and attention help us to “deal better” with the bad days and they help us to recognize that we can get past the immediate “downsides” of any specific disorder to see a future worth working toward. In the absence of such care and attention — when relative isolation becomes the norm — it is a great deal more likely that any patient with a chronic disorder will succumb to a degree of depression and stress … together with a lower standard of care as a consequence.

The “New” Prostate Cancer InfoLink is doubtful that having prostate cancer is really any more likely than other chronic disorders to lead to patients’ deaths as a consequence of stress, grief, sleep habits, social support, etc.  The problem of isolation and the lack of a viable social support network can be a critical factor in “coping” with any chronic disease. A key factor, from a social perspective, is the willingness of a nation’s healthcare system to ensure that it can offer additional help to those who are socially isolated and stressed in such a manner. If these types of consequence are evident in the highly sophisticated Swedish health care system, we are of the opinion that the situation is only likely to be worse in a nation like the USA, where there is little obligation on the healthcare systems to even identify people who are at such risks, let alone help them by providing a responsive set of social supports.

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