Mental Well-Being in Patients With Prostate Cancer

Prostate cancer is the second most common cancer in men worldwide, affecting nearly 1.4 million individuals each year. As survival rates improve, increasing attention is being paid to the psychological burden of the disease. Approximately 17% of patients experience depression or anxiety, while up to 45% report significant emotional distress during the first year after diagnosis when broader concerns such as fear of recurrence, body image, and masculinity are considered. Suicide risk is also elevated, particularly within 18 months of diagnosis and among men with metastatic disease.

Psychological distress can begin immediately after diagnosis, with many patients experiencing shock, anxiety, and uncertainty. Men undergoing active surveillance often report recurring anxiety surrounding prostate-specific antigen (PSA) monitoring. Treatment type also influences mental well-being. Androgen deprivation therapy (ADT) is associated with an increased risk of depression and anxiety, typically emerging around nine months after treatment begins, while radical prostatectomy may negatively affect body image and masculine identity. Radiotherapy has also been linked to higher rates of depression.

Several factors increase vulnerability, including younger age, previous psychiatric illness, social isolation, poor baseline mental health, and impaired urinary or sexual function. Depression may also worsen treatment outcomes, including urinary incontinence.

Routine psychological screening using validated tools such as PHQ-9, GAD-7, FCR7, BIS, and MAX-PC is recommended. Management includes cognitive behavioral therapy, psychotherapy, peer support, patient education, and appropriate pharmacologic treatment, with selective serotonin reuptake inhibitors commonly used when medication is needed. Strong social support and shared decision-making can improve coping and quality of life. Early recognition and integrated psychological care are essential to optimize both mental health and overall outcomes for men living with prostate cancer.

Stieg, R. (2026, July 29). Hope and healing: Managing mental health after prostate cancer. Medscape. https://www.medscape.com/viewarticle/hope-and-healing-managing-mental-health-after-prostate-2026a1000g33