Professor Prokar Dasgupta has written that surgeons ignore the mind at their peril. After many years of treating prostate cancer, he has come to believe that focusing only on removing the cancer is not enough. The effect of the disease on a man's mental health must not be underestimated. This article explains why mental health and prostate cancer are so closely linked, and what support can help.
Lessons from the pandemic
The COVID-19 pandemic brought mental health into sharp focus. Alongside the many people infected, one of the most striking effects of lockdown was the impact on wellbeing. For people already facing a serious illness such as cancer, isolation and uncertainty added to an already difficult time.
How common the problem is
In research presented at an international meeting, Professor Dasgupta's group showed that more than 17% of men with prostate cancer have depression, and nearly 10% have had suicidal thoughts. These figures underline why emotional wellbeing must be part of cancer care, not an afterthought.
A later systematic review also found that worry about the cancer returning, and anxiety around PSA tests, affect a significant proportion of men. Our article on PSA anxiety and fear of recurrence summarises that research.
How the mind shapes treatment choices
For localised prostate cancer, surgery and radiotherapy are equally effective at treating the disease. In practice, younger, fitter men often choose robotic radical prostatectomy, while older men more often choose radiotherapy. Our overview of prostate cancer describes these and other options, including active surveillance.
Professor Dasgupta also asks his patients whether they can live with the cancer inside them, in their minds. Men who feel they cannot tend to choose surgery over other treatments. Recognising this helps patients reach a decision that suits them emotionally as well as clinically. There is no wrong answer to this question, and it is worth discussing openly with your specialist and your family. Our article on whether robotic surgery is right for you explores the decision in more detail.
Signs that you may need support
It is normal to feel shocked, worried or low after a diagnosis or during treatment. It is worth seeking help if you notice:
- low mood that lasts for more than a couple of weeks
- loss of interest in things you usually enjoy
- difficulty sleeping, or sleeping far more than usual
- constant worry about the cancer or test results
- withdrawing from family and friends
If you ever have thoughts of harming yourself, seek help urgently. Samaritans can be contacted at any time on 116 123.
Support as part of care
Professor Dasgupta's team has invested in survivorship and mind and body programmes. Patients have access to counselling and holistic therapies as part of their care, both during treatment and while recovering from its after-effects. Many patients and their partners find this team-based approach helpful, and it is available at every stage, from diagnosis to life after treatment.
Other sources of support include specialist cancer nurses, GPs and charities. Prostate Cancer UK offers a specialist nurse helpline and support groups for men and their families.
Partners and families
A diagnosis affects partners and families too. Changes to continence, sexual function and daily life can place strain on relationships. Talking openly, attending appointments together and seeking support as a couple can all help. Our guide to recovery after prostate cancer surgery covers the emotional side of recovery.
Winning minds as well as battles
In Professor Dasgupta's words, to win the battle against prostate cancer, we must win the minds of our patients. Good care treats the whole person, not just the disease.
If you would like to discuss your diagnosis, treatment or support, please contact the clinic to arrange a consultation.