Mental health status associated with higher mortality rates for prostate and urologic cancers

Patients with cancer of the prostate, bladder or kidney are more likely to die if they have received psychiatric care before cancer treatment. In addition, patients with these cancers have a higher risk of suicide than the general population, even after the data have been corrected for previous psychiatric care. These are the main conclusions of a new study presented at the congress of the European Association of Urology in Barcelona. They emphasize the need to integrate psychiatric care into cancer treatment.

It is increasingly apparent that the cancer survival rate is influenced by the patient's mental health status. This work is the first that badociates survival of urologic cancer with prior use (within five years) of psychiatric services, giving scientists an indication of the patient's mental health status before the cancer diagnosis. This is part of a larger study examining the effects of mental health on cancer survival.

An American and Canadian team led by Assistant Professor Zachary Klabaden (Georgia Cancer Center, Augusta, Georgia) examined the mental health records of 191,068 urological cancer patients from Ontario to Canada (where Professor Klabaden was on temporary badignment). These patients had suffered from cancer of the prostate, bladder or kidney. They then badigned each patient a score based on whether or not they had used psychiatric services in the previous 5 years. 57.1% had not used these services, while the remaining patients had benefited from an outpatient treatment (41.6%), an emergency treatment (0, 84%) or hospitalization (0.40%). Patients were matched to 528,387 control patients, that is, patients who had no cancer. Full figures are available in the attached summary.

The researchers found that patients previously treated for mental health issues were more likely to die of their cancer than those who had not been treated, with the risk of mortality increasing with the intensity of previous treatment for mental health. For example, the probabilities of cancer mortality were 1.78 times higher in patients hospitalized for mental health problems than in controls (Hazard Ratio, 1.78).

Zachary Klabaden said
"This is the first large population-level study showing that patients with previous mental health problems have a higher risk of cancer death than patients without a history of cancer. mental health.We believe that there will be several factors to us we need more studies to understand the causes. "

A second badysis looked at suicide rates after diagnosis and treatment of prostate, bladder or kidney cancer. As with other findings, the researchers found that suicide rates increased after cancer diagnosis. Professor Klabaden commented:

"This was the first population-level suicide study for which we were able to adjust the psychiatric history.We found that the overall risk of suicide increased by about 16% (HR = 1, 16) in patients diagnosed with this cancer, it increased by approximately 39% (HR = 1.39) in patients who had no history of mental health treatment, which shows the impact cancer diagnosis on the mental health of patients.

In general, it can be said that patients with genitourinary cancers who have used psychiatric services in the five years prior to their cancer diagnosis are at an increased risk of dying of their cancer compared to patients of the same type. who did not seek psychiatric help. In addition, these patients are at greater risk of suicide. The exact reason for this relationship is unknown, but it highlights the importance of identifying patients at risk and adopting a multidisciplinary approach (including psycho-oncology) to manage these patients. "

"There are more than 20 population-level studies suggesting that cancer patients have an increased risk of suicide compared to the general population.This is the first study to consider previous psychiatric status. at diagnosis, and it confirms that a cancer diagnosis per se is Considering that several studies suggest that bladder cancer patients are among the most at-risk patients, the Georgia Cancer Center strives to Include previous psychiatric data on these patients to help us understand whether early psychiatric badistance may be thought to be generally considered for these patients.

Commenting, Professor Francesco Montorsi (Milan), Deputy Secretary General for Science of the European Association of Urology, said:

"This large study shows that pre-existing mental status can have a significant influence on cancer outcomes, and it also shows that a simple diagnosis of cancer can affect whether or not the patient is trying to commit suicide. Clinic has the duty to treat the patient as a whole, not just cancer, so we need to take note of these findings and, if possible, include appropriate precautions to take into account the patient's mental health history. "

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This is an independent comment; Professor Montorsi did not participate in this research.

News Releases Facts: No Peer Observation / Observational Study / People

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

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