NEW YORK (Reuters Health) – In older prostate cancer patients with a biochemical recurrence, cancer anxiety predicts earlier use of androgen deprivation therapy (ADT), new research shows.

This finding is important since early ADT may not improve survival but could impinge on quality of life, Dr. William Dale, from the University of Chicago, and colleagues point out.

As reported in the Journal of Clinical Oncology, the researchers used the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) to assess the emotional status of 67 older men (average age of 68 years) with a biochemical recurrence of prostate cancer.

Questionnaires were given to the subjects at presentation and at each follow-up visit prior to initiation of ADT. Treating oncologists were also surveyed to record their recommendations for ADT initiation.

A subject was considered to be an early ADT initiator if he decided to begin treatment at either the first or second clinic visit. On that basis, 33% of patients were early ADT initiators, the report shows. Increased prostate cancer-specific anxiety (a MAX-PC score >16) was the strongest predictor of early treatment, with an odds ratio of 9.19 (p = 0.01).

The prostate specific antigen level, which did not correlate with the MAX-PC score, was also an independent predictor of early ADT initiation (p = 0.01).

The findings “suggest that the nonclinical factor of patient anxiety about cancer may be both important and overlooked in choosing when to initiate ADT,” Dr. Dale and colleagues conclude.

“It is important for physicians to discuss with patients worries and anxieties of the patient about cancer,” they add. “Doing so may help prevent unnecessary early initiation of a therapy with significant toxicities and questionable impact on life expectancy in otherwise asymptomatic older men.”

Reference:
J Clin Oncol 2009;27.