General Psychological Issues in Prostate Cancer
Psychological and social issues arise in 30–50% of prostate cancer patients irrespective of the stage and progression of cancer or the type of treatment they receive. With effective assessment and intervention, clinicians can help to recognize troublesome and disturbing problems, reduce their negative impact and enhance the QOL for patients and those close to them. Some of the psychological issues that are commonly seen in prostate cancer are anxiety related to the cancer and its cure, depression and depressive symptoms, guilt and remorse after a diagnosis, fear with regard to PSA assessment, fear with regard to recurrence of the cancer after treatment, an impending fear and recognition of death, fatigue and pain, which may be aggravated by social and psychological factors and the ensuing sexual problems during and after treatment. However, making a psychiatric diagnosis in a prostate cancer patient can be complicated by overlapping symptomatology seen in psychological disorder and cancer that includes fatigue, weight loss, sleep disturbance, loss of appetite and anxiety. One needs to assess the more subtle psychological or cognitive symptoms, such as feeling a lack of pleasure, depressed mood, hopelessness and helplessness along with anxiousness to help establish a diagnosis.