Nav: Home

Mental health state associated with higher death rates for prostate and urological cancers

March 17, 2019

Patients with prostate, bladder or kidney cancers are at greater risk of dying if they have had psychiatric care prior to the cancer treatment. In addition, patients with these cancers show greater suicide risk than the general population, even once the data is corrected for previous psychiatric care. These are the main findings of a new study presented at the European Association of Urology congress in Barcelona. They highlight the need for psychiatric care to be integrated into cancer treatment.

There is emerging evidence that cancer survival rate is influenced by the mental health state of the patient. This work is the first which relates urological cancer survival to previous (within 5 years) use of psychiatric services, giving scientists an indication of the mental health state of patient before the cancer diagnosis. This is part of a larger study looking at the effect of mental health on cancer survival.

What did they do?

A US/Canadian team led by Assistant Professor Zachary Klaassen (Georgia Cancer Centre, Augusta, Georgia) looked at the mental health records of 191,068 urology cancer patients from Ontario in Canada (where Professor Klaassen was on temporary assignment). These patients had either suffered from prostate, bladder, or kidney cancer. They then assigned each patient a score based on whether they had used psychiatric services within the previous 5 years. 57.1% had not used these services whereas the remaining patients had received outpatient treatment (41.6%), emergency department treatment (0.84%) or hospital admission (0.40%). The patients were matched to 528,387 control patients, i.e. patients who had not suffered any cancers. Full figures are available in the attached abstract.

What did they find?

The researchers found that patients previously treated for mental health conditions had a greater risk of dying of their cancer than those who had not been treated, with the mortality risk increasing in line with the intensity of the prior mental health treatment. For example, the odds of cancer mortality were 1.78 times greater in patients who had been hospitalised for mental health problems, when compared with controls (Hazard Ratio, 1.78).

Zachary Klaassen said "This is the first large, population-level study to show that patients with previous mental health problems are at greater risk of dying of their cancer compared to patients with no mental health history. We believe that there will be several factors behind this, but we need more studies to understand the causes".

A second analysis looked at suicide rates following diagnosis and treatment with prostate, bladder, or kidney cancer. In common with other findings, the researchers found that suicide rates increased after cancer diagnosis. Professor Klaassen commented:

"This is the first population-level suicide study where we have been able to adjust for previous psychiatric history. We found that whereas the overall risk of suicide increased by around 16% (HR=1.16) for patients who had been diagnosed with these cancers, it went up by around 39% (HR=1.39) in patients who had no previous history of mental health treatment. This shows the significant toll that cancer diagnosis has on the mental health of patients.

In general, we can say that patients with genitourinary malignancies who have utilized psychiatric services in the five years leading up to their cancer diagnosis are at increased risk of dying of their cancer compared to patients with the same cancer who have not sought psychiatric help. Furthermore, these patients are at greater risk of suicide. The exact reason for this relationship is unknown, however it highlights the importance of identifying at-risk patients and having a multi-disciplinary approach (including psycho-oncology) to managing these patients".

"There are more than 20 population-level studies suggesting that cancer patients are at increased risk of suicide compared to the general population. This is the first study to account for pre-diagnosis psychiatric status, and it confirms that a cancer diagnosis in itself is a driving factor for suicidal risk. Considering that several studies have suggested that bladder cancer patients are amongst the highest-risk patients, at the Georgia Cancer Center we are working towards including prior psychiatric data on these patients to help us understand if early psychiatric assistance may help in the overall outcome. We think that this needs to be generally considered for these patients.

Commenting, Professor Francesco Montorsi (Milano), European Association of Urology's Adjunct Secretary General for Science said:

"This large study shows that pre-existing mental state can have a significant influence on cancer outcomes. In addition, it shows that just the diagnosis of cancer can have a bearing on whether or not the patient attempts suicide. The clinical community has a duty to treat the whole patient, not just the cancer, so we need to take note of these findings, and where possible to include appropriate precautions to take account of a patient's mental health history"
-end-
This is an independent comment; Professor Montorsi was not involved in this research.

Press release info: Not peer-reviewed/observational study/People

This work was part-funded by part by the University of Toronto, and by a grant from the Canadian Urological Association/Canadian Urologic Oncology Group/Astellas

European Association of Urology

Related Cancer Articles:

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.
Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.
Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.
Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.
More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.
New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.
American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.
Oncotarget: Cancer pioneer employs physics to approach cancer in last research article
In the cover article of Tuesday's issue of Oncotarget, James Frost, MD, PhD, Kenneth Pienta, MD, and the late Donald Coffey, Ph.D., use a theory of physical and biophysical symmetry to derive a new conceptualization of cancer.
Health indicators for newborns of breast cancer survivors may vary by cancer type
In a study published in the International Journal of Cancer, researchers from the UNC Lineberger Comprehensive Cancer Center analyzed health indicators for children born to young breast cancer survivors in North Carolina.
Few women with history of breast cancer and ovarian cancer take a recommended genetic test
More than 80 percent of women living with a history of breast or ovarian cancer at high-risk of having a gene mutation have never taken the test that can detect it.
More Cancer News and Cancer Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Processing The Pandemic
Between the pandemic and America's reckoning with racism and police brutality, many of us are anxious, angry, and depressed. This hour, TED Fellow and writer Laurel Braitman helps us process it all.
Now Playing: Science for the People

#568 Poker Face Psychology
Anyone who's seen pop culture depictions of poker might think statistics and math is the only way to get ahead. But no, there's psychology too. Author Maria Konnikova took her Ph.D. in psychology to the poker table, and turned out to be good. So good, she went pro in poker, and learned all about her own biases on the way. We're talking about her new book "The Biggest Bluff: How I Learned to Pay Attention, Master Myself, and Win".
Now Playing: Radiolab

Invisible Allies
As scientists have been scrambling to find new and better ways to treat covid-19, they've come across some unexpected allies. Invisible and primordial, these protectors have been with us all along. And they just might help us to better weather this viral storm. To kick things off, we travel through time from a homeless shelter to a military hospital, pondering the pandemic-fighting power of the sun. And then, we dive deep into the periodic table to look at how a simple element might actually be a microbe's biggest foe. This episode was reported by Simon Adler and Molly Webster, and produced by Annie McEwen and Pat Walters. Support Radiolab today at Radiolab.org/donate.