Kathryn T Dinh1, David D Yang2, Kevin T Nead3, Gally Reznor4, Quoc-Dien Trinh2,4,5, Paul L Nguyen2,6. 1. Department of Medicine, University of Washington, Seattle, Washington, USA. 2. Harvard Medical School, Boston, Massachusetts, USA. 3. Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA. 4. Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA. 5. Division of Urological Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA. 6. Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Abstract
OBJECTIVES: To examine whether any androgen deprivation therapy use or longer duration is associated with an increased risk of anxiety in patients with prostate cancer. METHODS: We identified 78 552 men aged ≥66 years with stage I-III prostate cancer using the Surveillance, Epidemiology, and End Results-Medicare linked database from 1992 to 2006, excluding patients with psychiatric diagnoses within the year prior or 6 months after prostate cancer diagnosis. Multivariable Cox regression was used to examine the association between pharmacological androgen deprivation therapy and diagnosis of anxiety. RESULTS: The 43.1% (33 882) of patients who received androgen deprivation therapy experienced a higher 3-year cumulative incidence of anxiety compared with men who did not (4.1% vs 3.5%, P < 0.001). Any androgen deprivation therapy use was associated with a nearly significant increased risk of anxiety (adjusted hazard ratio 1.08, 95% confidence interval 1.00-1.17, P = 0.054). There was a significant trend between a longer duration of therapy and increased risk of anxiety (P-trend = 0.012), with a 16% higher risk for ≥12 months (adjusted hazard ratio 1.16, 95% confidence interval 1.04-1.29, P = 0.010). CONCLUSIONS: Androgen deprivation therapy was associated with an elevated risk of anxiety in this cohort of elderly men with localized prostate cancer, with the risk higher with a longer duration of treatment. Anxiety should be considered among the possible psychiatric effects of androgen deprivation therapy and discussed before initiating treatment, particularly if a long course is anticipated.
OBJECTIVES: To examine whether any androgen deprivation therapy use or longer duration is associated with an increased risk of anxiety in patients with prostate cancer. METHODS: We identified 78 552 men aged ≥66 years with stage I-III prostate cancer using the Surveillance, Epidemiology, and End Results-Medicare linked database from 1992 to 2006, excluding patients with psychiatric diagnoses within the year prior or 6 months after prostate cancer diagnosis. Multivariable Cox regression was used to examine the association between pharmacological androgen deprivation therapy and diagnosis of anxiety. RESULTS: The 43.1% (33 882) of patients who received androgen deprivation therapy experienced a higher 3-year cumulative incidence of anxiety compared with men who did not (4.1% vs 3.5%, P < 0.001). Any androgen deprivation therapy use was associated with a nearly significant increased risk of anxiety (adjusted hazard ratio 1.08, 95% confidence interval 1.00-1.17, P = 0.054). There was a significant trend between a longer duration of therapy and increased risk of anxiety (P-trend = 0.012), with a 16% higher risk for ≥12 months (adjusted hazard ratio 1.16, 95% confidence interval 1.04-1.29, P = 0.010). CONCLUSIONS: Androgen deprivation therapy was associated with an elevated risk of anxiety in this cohort of elderly men with localized prostate cancer, with the risk higher with a longer duration of treatment. Anxiety should be considered among the possible psychiatric effects of androgen deprivation therapy and discussed before initiating treatment, particularly if a long course is anticipated.
Authors: Sarah Wilding; Amy Downing; Penny Wright; Peter Selby; Eila Watson; Richard Wagland; David W Donnelly; Luke Hounsome; Hugh Butcher; Malcolm Mason; Ann Henry; Anna Gavin; Adam W Glaser Journal: Qual Life Res Date: 2019-05-21 Impact factor: 4.147
Authors: Pedro Lopez; Dennis R Taaffe; Robert U Newton; Laurien M Buffart; Daniel A Galvão Journal: Prostate Cancer Prostatic Dis Date: 2020-11-20 Impact factor: 5.554