Dr. Laura Dunn, Professor of Psychiatry and Behavioral Sciences at Stanford and Prostate 8 Collaborating Scientist (and former Professor of Psychiatry at UCSF), is an expert in the field of psycho-oncology and routinely evaluates and treats cancer patients for a wide range of symptoms. We sat with Laura to learn more about her research.
Q: Is it common to feel anxious, depressed, or distressed after being diagnosed with prostate cancer?
A: After being diagnosed with cancer, it is common to feel a number of intense emotions. Many people experience some level of depression, anxiety, or distress when faced with the diagnosis of cancer. In a recent study, 14–20% of men with prostate cancer reported elevated levels of distress. These rates were higher than those seen in similarly aged men without a diagnosis of prostate cancer. While these emotions may feel overwhelming, it is important to know that men can learn ways to cope better with these feelings. Seeking help from a counselor experienced in working with cancer patients is often very helpful for patients and their families.
Q: Is there any difference in anxiety, depression, or distress between men treated with active surveillance and those treated with radical prostatectomy?
A: From what we know so far, patients with prostate cancer managed with active surveillance and those treated with radical prostatectomy appear to experience similar rates of depression, anxiety, and distress.
Q: Do anxiety, depression and distress affect sex life and urinary function in men treated for prostate cancer?
A: Studies have reported that higher levels of depression, anxiety, and distress are associated with worse sexual function, sexual bother, and urinary problems. While these complications are certainly due to the disease and its treatment, the emotional symptoms are also important to address. Support and guidance from a counselor may help you cope with these troublesome side effects and return to your normal function sooner.
Q: In the New York Times article, “Anxiety Lingers Long After Cancer,” you comment on how a prostate cancer diagnosis can sometimes lead to worse anxiety in a spouse or significant other than in the patient himself. Can you explain this?
A: Studies show that men do not want to worry their spouse or family members, so they often avoid mentioning the aches and pains that they experience. However, lack of communication can lead to MORE worry about the spouse/family members because they do not understand what their loved one is going through or feeling. These data underline the importance of communication during cancer. Talking honestly and truthfully can lessen uncertainty, stress, and anxiety — and, importantly, help both partners not feel so alone in the experience.
Q: Do you have any guidance for men who are coping with anxiety, depression and distress after prostate cancer?
A: Cancer is not easy and it can be very stressful. It is perfectly normal to feel depressed, anxious, and distressed after a cancer diagnosis; however, it is also important to acknowledge those feelings and seek help if the symptoms are interfering with one’s day-to-day functioning. If you are suffering from anxiety, depression, or distress, talk to your doctor. He or she can refer you to a counselor with expertise in evaluating and helping you manage the psychological aspects of cancer. It is also important to be open with your spouse or a close family member, and possibly include him or her in some of your counseling sessions, so that you are all on the same page and can support one another during difficult times.
Q: Finally, what are some tools to help men with prostate cancer deal with depression, anxiety, or distress?
A: There are many tools that can be used to help cope with depression, anxiety, and distress. Most importantly, do not be afraid to seek help. Consider joining a support group or seeking out counseling. It is also important to stay physically active. Exercise improves mood levels and helps maintain physical function. Take time to enjoy spending time with friends and family, and try to continue to participate in hobbies or activities that you enjoy (e.g., watching sports, going to the park, trying out a new hike, reading books, watching movies). Everyone has their own ways of coping; if your coping strategies that have helped you in the past don’t seem to be working, that is another indication that it might be a good idea to seek additional support.
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