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PATIENT PERSPECTIVES No Laughing Matter: Mental Health Support for Prostate Cancer Patients

By: Pat Kresnak, BSc, Occupational Health Director | Posted on: 19 Apr 2024

Living with prostate cancer or other male illness is physically demanding and, in some patients, psychologically challenging. While many men are aware of the benefits of physical activity and develop self-directed plans to maintain or improve their physical condition during treatment, many do not have resources available to help manage their emotional well-being. Many prostate cancer patients experience severe levels of fear and anxiety driven by the lack of knowledge, uncertain prognosis, and feelings that they have lost control of their lives.

In some cases, the patient’s emotional state could negatively impact the desired outcome and management of the disease. Psychological screening and referrals for at-risk or vulnerable patients by qualified mental health professionals are as important to a patient’s health as having a highly skilled team of doctors, specialists, and clinicians to treat the physical effects of his illness.

If you engage a man in a conversation about baseball, you might get a long, impassioned reply full of hopes and dreams, and fantastical stories of glory, doubt, and humility. Ask a man about his job, and you will get more of the same. If you get a guy talking about his family, he might go on and on and on about his perfect love and his perfect kids, and all the passion, glory, doubt, and humility a heart can take. But ask a man about his health, chances are you will get a short answer like, “I’m fine,” or “I have a little problem, but it’ll go away.”

If you finally get a man to talk openly about the wide range of issues that are unique to men’s health, including their emotional well-being, his response is likely to be given from a second- or third-person perspective. They might talk about “him” or “them,” or “my friend,” or “this guy I know.” A lot of men will not talk about their health problems.

Others do talk about their health by taking a less serious approach to their problem. This guy I know frequently speaks about what his illness means to his family and friends, the financial burden of treatment, his regrets, his depression, fatigue, anxiety, and whether he will survive. He’ll smile and say, “Sadly, most of those discussions occur inside my head.”

To cope with the variety of emotions triggered by his prostate cancer diagnosis, he tells jokes. If you need a good laugh, he has a funny story about digital rectal examinations, supply chain issues, and a shortage of examination gloves.

While my friend is quick with a joke, serious health problems are no laughing matter.

Men with chronic or life-threatening conditions often have feelings of anxiety and depression. These emotions may be new to some men, or for others, it may be more of the same. In either case, high levels of distress and anxiety in men with newly diagnosed conditions are common.

A September 2023 report published in European Urology regarding the long-term risks for persons diagnosed with prostate cancer indicates that high-risk patients are shown to have relatively higher rates of major depression and suicide.1 While most men diagnosed with prostate cancer do not commit suicide or have suicidal thoughts, other studies have found that these same risk factors impact the mental health of patients, which can hurt treatment outcomes. In the report published in European Urology, researchers also found that prostate cancer patients with low- to intermediate-risk disease had moderately higher rates of psychological distress within the first year of diagnosis.

In my work as a patient advocate, I have seen this high level of anxiety at the onset of diagnosis. Driven by a lack of information, many patients experience sadness and confusion, unsure of how to proceed or whom to trust. Even the most loquacious men can become tongue tied and quiet when discussing their condition. Patients I have spoken to have said that they are uncomfortable engaging in meaningful discourse with their medical team about treatment decisions because they struggle to understand the information presented to them.

Innovative technologies that apply multimodal artificial intelligence, such as the ArteraAI Prostate Test, which has recently been added to the newly released National Comprehensive Cancer Network guidelines for prostate cancer, can help address the knowledge gap by providing not only prognostic, but also predictive information for clinicians and patients to develop personalized treatment plans based on more informed decisions.2 This type of knowledge, combined with mental health interventions, can promote treatment for reluctant patients by lowering their fear and anxiety levels.

Predictive medicine and treatment options are having a positive impact on the success factors used to measure men’s health outcomes. Nurturing the ingenuity and creativity that drive this progression should be applied to advancing techniques for psychiatric care as well.

There are barriers to including mental health practitioners in plans to treat men’s illnesses, such as prioritizing treatment of the physical effects of the illness and the lack of qualified mental health practitioners. Economic factors such as reimbursement and exclusion from medical case management plans are others. To remove these barriers, medical services, insurance providers, higher education, patient advocates, and other concerned stakeholders must work together to establish a road map that considers the psychological impacts of treatment and the economics of holistic care, and to certify mental health resources so that every patient has access to qualified professionals who specialize in men’s psychological well-being.

Laughter is good medicine, but it only serves to mask the symptoms. It is not a cure.

  1. Crump C, Stattin P, Brooks JD, et al. Long-term risks of depression and suicide among men with prostate cancer: a national cohort study. Eur Urol. 2023;84(3):263-272.
  2. ArteraAI announced as the first-and-only predictive test for therapy personalization in the 2024 NCCN guidelines for prostate cancer. BusinessWire. 2024. https://www.businesswire.com/news/home/20240304893588/en/ArteraAI-Announced-as-the-First-and-Only-Predictive-Test-for-Therapy-Personalization-in-the-2024-NCCN-Guidelines%C2%AE-for-Prostate-Cancer

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