Studies have shown that PTSD is one of the most common mental health diagnoses among men with prostate cancer. Yet, research on the link between PTSD and prostate cancer, particularly on how PTSD may influence suicide risk in this population, has been limited.
Now, a VA-funded study led by Dr. Maya Aboumrad of the White River Junction VA Medical Center in Vermont sheds light on these questions. The study found that patients with prostate cancer and PTSD experienced greater suicide risk than men with prostate cancer and no PTSD, even after adjusting for factors such as depression, substance use disorder, and prostate cancer treatment.
Conversely, the researchers concluded that men with prostate cancer and PTSD may have been at lower risk of death from non-suicidal causes due to favorable physical health resulting from greater health care use and early diagnosis of localized – or low-risk – cancer.
`Improved non-suicide survival’
The results appeared online in the journal Psychooncology in November 2020.
“We showed that men with preexisting PTSD and a new prostate cancer diagnosis experienced improved non‐suicide survival despite being at greater suicide risk,” the researchers write. “We encourage collaboration between oncology and psychiatry providers when treating patients with PTSD and newly diagnosed prostate cancer. We hope this may mitigate some of the increased suicide risk shown in the current study. Given the high prevalence of PTSD and prostate cancer among Veterans, understanding the interplay between the two diseases warrants further study.”
The primary goal of the study was to assess the impact of a PTSD diagnosis on suicide and non‐suicide death rates among Veterans with prostate cancer. “This population is of particular interest given its higher rates of prostate cancer, suicide, and PTSD, as well as poorer engagement in preventative care, such as screening for prostate cancer,” the research team writes. “Our secondary [goal] was to examine potential mediating factors for the [link] between PTSD and suicide, including depression, substance use disorder, and receipt of any definitive prostate cancer treatment.”
`Dive deeper into these findings’
Aboumrad and her colleagues decided to pursue the research after one of their prior studies showed that patients with prostate cancer and mental health conditions, including PTSD, had a higher suicide risk. “We wanted to dive deeper into these findings by learning more about the specific factors that contribute to or alleviate this risk for a vulnerable population, in this case those with mental health conditions,” she says. “In order to adequately examine suicide risk for patients with prostate cancer, we had to consider competing risk of death from other non-suicidal causes.”
She continued: “Patients with PTSD, with or without prostate cancer, may have an elevated risk of suicide compared to those without PTSD. It’s also true that patients with prostate cancer, with or without co-existing mental health conditions, may have an elevated risk of suicide compared to those without prostate cancer. Our study highlighted the apparent exacerbation of suicide risk for patients with prostate cancer and PTSD. In other words, the risk is compounded for patients that have both suicide risk factors.”
Prostate cancer commonly diagnosed among Veterans
In VA, prostate cancer is one of the most commonly diagnosed forms of cancer among Veterans, many of whom also have PTSD. The disease is most common in men ages 65 and older. Prostate cancer is usually found in its early stages and often grows slowly. Most men live with the cancer for decades without symptoms and die of other causes even without early surgery.
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