Prostate Cancer, Depression, and Risk of Suicide: Should We Pay More Attention?
2009; Elsevier BV; Volume: 57; Issue: 3 Linguagem: Inglês
10.1016/j.eururo.2009.11.039
ISSN1873-7560
Autores Tópico(s)Optimism, Hope, and Well-being
ResumoA very good friend of mine, aged 54 yr, has recently lived through the unpleasant experience of an elevated prostatespecific antigen (PSA), a prostate biopsy, and, ultimately, the diagnosis of a Gleason 7 bilateral prostate cancer. He decided to have radical prostatectomy, and after 4 mo, he is doing fine but has weak erections. When talking about his disease and the bad times he had, he repeatedly insisted that what he lacked the most from his surgeon was ‘‘compassion.’’ He was well informed about all of the strategies, drugs, and techniques, but he said that he never had the opportunity to talk about how he was really feeling and how dreadful the disease was. Having gone through a painful divorce and a recent depression, he confessed that one night, alone, he had the strong desire to anticipate death, just as an escape from his fear of the disease. It is fortunate that it was no more than a bad night. Beyond this banal discussion lies this important question: Does the diagnosis of prostate cancer cause so much stress that itmay lead to severe psychological disorders and, eventually, to suicide? If yes, what can we do about it? Anxiety, worry, and fear are certainly common emotional responses to the threat of a disease and particularly to the threat of metastases and death associated with the diagnosis of cancer. Several reports have indicated that screenings, investigations, announcements, and treatment of prostate cancer may induce or precipitate a series of psychological disorders including transient anxiety at one extreme and elevated rate of depression and suicide at the other [1,2]. In a study reported by Korfage et al using the
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