“Cardiovascular disease and suicide can be viewed as a manifestation of exceptional psychological stress,” says Katja Fall, one of the researchers behind the study. “The study results offer some indication of the mental suffering in this group of patients, particularly around the time of diagnosis.”
The study is based on register information on almost 170,000 Swedish men who were diagnosed with prostate cancer between 1961 and 2004, of whom a very small proportion committed suicide in connection with their diagnosis. However, compared to men without prostate cancer, the risk of committing suicide was increased eightfold during the first week after diagnosis, and almost threefold during the first year.
Men who were diagnosed with prostate cancer before 1987 were 11 times more likely to die of cardiovascular disease during the first week after diagnosis, while the risk was twice as high during the first year as for men without prostate cancer.
After 1987 the combined risk of hospitalisation or death as a result of cardiovascular disease was increased threefold during the first week after diagnosis, and was slightly higher during the first year. Although it is not known why the risk was greater before 1987, the researchers believe that it may be due to less developed cardiovascular care combined with the fact that more men were diagnosed with more advanced prostate cancer and had a more negative attitude to the diagnosis.
The risk of both dying from cardiovascular disease and committing suicide was higher among young men than older men, which may be because young men have a greater sense of potential loss of different aspects of their lives.
“Our hypothesis is that the emotional stress that goes with a prostate cancer diagnosis can itself have a negative impact on patients’ health,” says Fall. “This should be noted by staff who deal with the increasing number of men who are diagnosed with prostate cancer each year.”
Immediate Risk for Cardiovascular Events and Suicide Following a Prostate Cancer Diagnosis: Prospective Cohort Study
PLoS Medicine, online 14 December 2009