Cancer is a major health issue, and over 24,000 Australian men are diagnosed with prostate cancer each year, making it the most common cancer diagnosis among men in Australia. While the survival rate is high – with about 96% of men surviving at least five years post-diagnosis – prostate cancer can deeply impact men’s mental health. This can occur at any stage of the illness, including the initial diagnosis, treatment, and follow-up care. Men with prostate cancer experience higher rates of anxiety, depression, and suicide compared to the general population.
In a recent study, we aimed to grasp the extent and timing of mental health problems faced by men with prostate cancer. Our results indicate that these men require more substantial support earlier on. We examined the cases of 13,693 men in South Australia diagnosed with prostate cancer between 2012 and 2020. We analyzed data from a prostate cancer registry along with information from the Pharmaceutical Benefits Scheme and the Medicare Benefits Schedule. By doing so, we tracked prescription medication usage, such as for antidepressants and anti-anxiety drugs, and mental health service utilization, including general practitioner (GP) mental health visits and psychiatrist consultations, five years before and after the cancer diagnosis. We observed that the percentage of men taking antidepressants or anti-anxiety medication increased from 34.5% five years before their diagnosis to 40.3% five years after. Furthermore, 10.2% of men used mental health services five years before being diagnosed, compared to 12.1% five years after. GP mental health visits showed the most notable increase, rising from 7.8% to 10.6%.
The largest rise in the usage of medication and mental health services for mental illness happened near the time of prostate cancer diagnosis. Around 15% of men started on antidepressants or anti-anxiety medications upon diagnosis, and 6.4% sought help from mental health services for the first time. It’s important to note that our study likely underestimates the true impact of a prostate cancer diagnosis on men’s mental health, as we only considered mental health services subsidized by Medicare. It is possible that some men seek mental health support privately or through community services, or do not seek help at all. Our research indicates that men are more inclined to use medication than engage with mental health services. This could be due to a preference for medication, limited availability of mental health services, or the stigma associated with seeking help. Research suggests many cancer patients hesitate to get help for mental health issues, and in general, men may be less likely to do so than women.
Concerns about stigma or appearing weak may contribute to only one-quarter of men saying they would approach a mental health professional for personal or emotional problems. Based on our study’s findings regarding medication and mental health service usage, men seem particularly susceptible to psychological issues at the time of a prostate cancer diagnosis. This vulnerability may arise from the stress of the diagnosis, decisions about treatment, and worries about the future. Therefore, incorporating mental health screening into regular prostate cancer diagnostic processes could be beneficial. Early detection of mental health issues is crucial for timely interventions and support, which can greatly improve mental wellbeing.
Instead of waiting for men to independently seek mental health support after being diagnosed with prostate cancer, we should offer support identified through screening at diagnosis and throughout treatment. Addressing psychological issues is one of the most commonly unmet needs among men with prostate cancer. Enhancing access to mental health care might involve increasing the number of Medicare-subsidized mental health service sessions available annually and providing more GP mental health plans for men with prostate cancer.
Expansion of counseling services by organizations such as the Prostate Cancer Foundation of Australia and the Cancer Council, alongside the hiring of more prostate cancer nurses, is also recommended. Additionally, it would be advantageous to expand telehealth services, offering a vital option when cost or distance pose barriers to mental health service access for some prostate cancer patients. Finally, fostering open discussions about mental health is crucial to give men with prostate cancer a chance to express their struggles and receive the necessary support.