Poster Presentation COSA-IPOS Joint Scientific Meeting 2012

Thinking about one’s own death when diagnosed with prostate cancer. (#507)

Thordis Thorsteinsdottir 1 , Heiddis Valdimarsdottir 2 3 , Johan Stranne 4 , Ulrica Wilderang 1 , Eva Haglind 5 , Gunnar Steineck 1 6
  1. Sahlgrenska Academy of the University of Gothenburg, Gothenburg, SWE, Sweden
  2. Department of Oncological Sciences, Mount Sinai School of Medicine, New York, USA
  3. Department of Psychology, Reykjavik University, Reykjavik, Iceland
  4. Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
  5. Sahlgrenska Academy of the University of Gothenburg, Gothenburg, SWE, Sweden
  6. Division of Clinical Cancer Epidemiology, Department of Oncology–Pathology, Karolinska Insitutet, Stockholm, Sweden

Objective: Being diagnosed with prostate cancer increases the risk of suicide. Among men with a diagnosis of clinically localized prostate cancer there could be an unmet need for psychiatric care signed by thoughts about one’s own death. Such thoughts constitute an indicator for depressive disorder but we do not know if they appear commonly among men who are diagnosed with prostate cancer or if these thoughts could be critical for some individuals.

Participants and Methods: In the prospective LAPPRO-trial 833 of the 971 (86%) men with localized prostate cancer undergoing radical prostatectomy during the first study-year answered two study-specific questionnaires, before and three months after radical prostatectomy. Multivariable prognostic models explaining thoughts about one’s own death were built with the help of stepwise regression and Bayesian Model Averaging.

Results: Three months after surgery 18 percent of the men had thoughts about their own death at least once a week. Urban living [Adjusted Relative Risk (RR) 2.39, 95% Confidence Interval (CI) 1.23 to 4.64], low control [RR 2.19, CI 1.35 to 3.57], uncertainty about the future [RR 3.37, CI 2.16 to 5.24] and crying [RR 1.95, CI 1.28 to 2.96] before surgery predicted thoughts about one’s own death after surgery.

Discussion: Men undergoing surgery for prostate cancer have thoughts about one’s own death simultaneously as symptoms of psychological distress. When aiming at improving the situation for men diagnosed with prostate cancer it could be advantageous to screen for thoughts about their own death and, when apparent, consider psychological interventions.