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Patient Anxiety Linked to Timing of Prostate Treatment

Higher anxiety in older men related to decision when to begin androgen deprivation therapy

THURSDAY, Mar. 5 (HealthDay News) -- Anxiety over the disease is a major predictor in older men's decision to begin androgen deprivation therapy early after biochemical recurrence of prostate cancer, according to research published online Mar. 2 in the Journal of Clinical Oncology.

William Dale, M.D., Ph.D., of the University of Chicago, and colleagues analyzed data from 67 patients (average age 68) with biochemical recurrence of prostate cancer. Patients reported on their anxiety at presentation and at follow-up visits until they began androgen deprivation therapy (ADT).

In multivariate analysis, elevated anxiety over the prostate cancer -- as measured with the Memorial Anxiety Scale for Prostate Cancer -- was the strongest predictor of early initiation of ADT, the researchers report. In addition, those with elevated scores started ADT an average of 11 months after presentation, compared with 24.9 months for those with lower anxiety, the report indicates.

"If it is true that anxious patients who experience biochemical recurrence are starting on ADT nearly 14 months earlier, for reasons unrelated to clinical factors, would this be important for their care?" the authors write. "ADT has known toxicities, many of which are especially concerning for older men, who are vulnerable to osteoporosis, fatigue, muscle loss and falls. The impact of ADT may be quite long lived, and an additional year on ADT for asymptomatic individuals is of concern, especially because anxiety could be a modifiable intervention target."

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