Younger age and higher Gleason scores are among the factors underlying distress in newly diagnosed prostate cancer (PCa) patients, according to a new study.

Other factors include low confidence in decision-making, a concern that PCa is uncontrollable, low optimism, low resilience, and feeling less manly. What drives distress in individual patients varies.

For the study, published online in Psycho-Oncology, investigators led by Heather Orom, PhD, assistant professor at the University of Buffalo in New York, examined 4 classes of factors that could influence patient distress, including prognosis, individual beliefs, personality resources and demographics. The researchers employed various questionnaires and scales, such as the Life Orientation Test and Distress Thermometer, and then reviewed the self-reported responses from 1,425 men newly diagnosed with localized PCa.

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The American Cancer Society and other organizations recommend screening for emotional distress in PCa patients, the investigators noted. By understanding the clinical, demographic, and psychographic factors, the researchers hope to develop a framework for identifying and designing appropriate interventions to help recently diagnosed patients during the critical window before PCa treatment, when they may more motivated to participate.

Interventions might target improving provider communication about prognosis and providing decision-making support to reduce patient’s feelings of treatment regret, the researchers suggested. They also recommended referrals for brief cognitive behavioral interventions to help patients reframe threats to masculine identity, optimism, or resilience (such as fear of treatment adverse effects or recurrence).

Almost all patients had health insurance. Although the researchers found only a modest association between very low household income and distress, they urged further research on this issue. Low income patients may benefit the most from material support, such as subsidies or transportation.    


  1. Orom, H, et al. Psycho-Oncology, 2015; doi: 10.1002/pon.3751.