Study suggests need for early mental health screening in men with prostate cancer

Data from a recent study show a marked increase in psychotropic medication use and mental health service use among men in the time immediately before and the first 2 years following a diagnosis of prostate cancer, suggesting a potential need for early intervention.¹

Data showed that 15% of men began using psychotropic medications and 6.4% of men sought out mental health services for the first time following their diagnosis.

The findings were recently published in Psychooncology.

“Prostate cancer is the most common cancer affecting Australian men. But despite high survival rates, psychological issues are one of the most frequently reported unmet needs among prostate cancer survivors,” explained lead author Tenaw Tiruye, PhD, BSc, in a news release on the study findings.² Tiruye is a research associate at the University of South Australia in Adelaide.

The study included all men diagnosed with prostate cancer in South Australia between July 2012 and December 2020, totaling 13,693 patients. Population-based registry data was linked to Pharmaceutical Benefits Scheme and Medicare Benefits Schedule data to assess the proportion and rates of psychotropic medication use and mental health service use in the 5 years before and after diagnosis. The mean age at diagnosis was 70.2 years.

Overall, the investigators observed a significant rise in psychotropic medication and mental health service use immediately prior to and in the first 2 years following a prostate cancer diagnosis, according to multivariable interrupted time series analysis. Data showed that 15% of men were prescribed medications for mental health issues and 6.4% of men sought out mental health services for the first time following their diagnosis.

The use of psychotropic medications increased from 34.5% in the 5 years prior to diagnosis to 40.3% in the 5 years following diagnosis. Specifically, the use of antidepressants rose from 20.7% in the 5 years prior to diagnosis to 26.0% in the 5 years after. Similarly, the use of anxiolytics rose from 11.3% to 12.8% in the same timeframe.

The use of mental health services also increased from 10.2% in the 5 years prior to diagnosis to 12.1% in the 5 years following diagnosis. The increase was driven by general practice mental health visits, which rose from 7.8% to 10.6%.

According to the authors, these findings indicate that mental health screening, particularly during the diagnostic process, may enable early intervention and improve mental health outcomes among men with prostate cancer.

“Whether it’s the stigma surrounding mental health or a fear about being seen as weak, statistics shows that many men struggle to seek help for mental health concerns,” said senior author Kerri Beckmann, PhD, a senior research fellow at the University of Australia, in the news release.² “So, rather than waiting for men to proactively seek out mental health supports once they’ve been diagnosed with prostate cancer, we should be offering supports at the time of diagnosis and throughout treatment. That way it can be seen as a normal and required part of treatment. Only by normalizing mental health discussions can we improve access to wellbeing tools and services, to ensure that men with prostate cancer have every opportunity to voice their struggles and receive the support they need.”

References

1. Tiruye T, Hiwase M, Charlick M, et al. Temporal trends in medication and service use patterns for mental health issues among men with prostate cancer. Psychooncology. 2024;33(7):e6369. doi:10.1002/pon.6369

2. Upfront mental health supports for men with prostate cancer. News release. University of South Australia. August 4, 2024. Accessed August 5, 2024. https://www.newswise.com/articles/upfront-mental-health-supports-for-men-with-prostate-cancer