guess what: men with prostate cancer... - Advanced Prostate...

Advanced Prostate Cancer

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guess what: men with prostate cancer have depression!

dadzone43 profile image
dadzone43

Fervaha et al. Urol Onc: Seminars and Original Investigations 37(2019) 282-288 report that 1 in 6 men with CaP have depression. Some have suicidal ideations. They note "receipt of androgen deprivation therapy appears to have a negative effect (on mood)." They note and lament the lack of any clinical trials on antidepressant medications in men with CaP. They note that depression has a negative effect on oncologic outcomes. They suggest that urologic oncologists "consider assessment of this symptom domain..." Have any of your doctors assessed your depression symptoms at office visits? Mine have ignored them.

36 Replies

My Doctors seem to like to reinforce the "be a good little soldier" mantra that I remember from my youth....in other words. "Shut up and be a man". I find I'm not able to complain about any symptoms. I do not have much of anything I would call actual "depression" ...but, the Lupron/Xtandi combo I am on...does give me days when it's like I have a heavy lead blanket over me...and I have to fight to keep my head up (and be happy)...But fight I do.

Depression with this disease and during these treatments for people who have ever had any depression before has to be life threatening. Doctors should discuss it more and offer help. And, I was shocked that there were no close local support groups for the "Castrato" choir that we are all mostly a part of. That alone, without cancer, is enough to bring down all but the "best little soldiers"...LOL(but not really)

John

dadzone43 profile image
dadzone43 in reply to greatjohn

Hope all our little soldiers stand up one day.

greatjohn profile image
greatjohn in reply to dadzone43

ha ha ha...that's a whole different little soldier...but I think he's retired with honors.

J.

Thanks for your post. Sometime I think I am alone. Two days after I was injected with Elegard I wanted to be dead and that was early May '19 and even though RP was Oct. 15 I still struggle with depression and all the emotional chasm which seems endless after your body is altered or in my shoes "desecrated". I still struggle every day with being positive. I used to be a joyous person but thanks to this desease he seems to be gone forever. Thanks for your post it helps me realize that I am not alone. Arlis

you are soooo NOT alone.

all the best,

John

I’m on vacation from the Chicago area and I still have my ups and downs. Today I Visited the beach by the ocean by Charleston SC and remarked to my wife that I feel like my life is becoming a series of lasts. I felt like this may be my last time to be by the ocean and I became very sad. By the way I am receiving treatment so I can’t imagine where I would be without it.

Daddybearblue profile image
Daddybearblue in reply to Hex40

Thanks Hex, nine months after your post I too am experiencing a series of "lasts" and realizing that life is different in this new world beyond RP. Everything in my life reminds me of this change in my life then there is the emotional void that tells me go sit in the back of the room and shut up. I guess it's grieving for what has been taken away. Thanks for your post several months ago. It helped me today.

WOW. lots of last times. Sounds like depression to me... I try to think, I made it again after thinking I never would.

Great.. I was a complete invalid from Xtandi full dose. Couldn't shower myself, cut my food, feel my face, feet, hands or ass. Blessings every time I have a meal. Pick up a glass or wipe my rearend. Life can be good with Apc.

You made it! There is some hope. I'm still coming through the process of the depression after RP and severing the nerves. WOW, that really is deep emotionally. Some days I think it's time to go, permanently. But you say we can make it through. I have cried more the last foura months than in the 67 years before. I will be fine and suddenly here come tears running down my cheeks seemingly out of nowhere. But you talk about hope. Thanks. Arlis

Great post, DZ. This is exactly why I use this forum as my go-to. IMO, doctors are not healers, they are technicians and tacticians - particularly oncologists. My nurses and administrators keep me involved with treatment, not the technicians. I would not be surprised if one of my docs came in and laid the full Patton routine on me!

Yes, two years ago, shortly after losing my father to APCa, I was in a foul mood when I visited my urologist for my 3 mo office visit. He picked up on this and referred me to a specialist for depression. Good for him. I never followed up because shortly thereafter I resumed Eligard shots and was proscribed (at my request) venlafaxine to help reduce the sweats and hot flashes. A "side effect" is the reduction in depression!

Immelmann profile image
Immelmann in reply to tallguy2

I agree. The hot flashes had me at the end of my rope, but Venlafaxine made them tolerable. Might have made me easier to get along with too.

I am not sure if depression is an issue for me or not. Certainly after retirement I am not as active as I was, perhaps indicating some depression. Or is it just a sensible slowing down. However, more of an issue has been anxiety. I have been given Lorazepam to cope with that.

WSOPeddie profile image
WSOPeddie in reply to BrentW

You are lucky. I used lorazepam for years for occasional insomnia. When I tried to get a refill my doctor refused. 'Controlled substance' and all that DEA / FDA paperwork nonsense. Crack down on anything resembling an opioid.

My husband had to take a health assessment via computer or tablet every time before he saw the MO. It had your normal questions related to prostrate cancer.

Incontinence

Urinary issues

Erectile issues

Bloody urine etc

Then there was a total section on emotional well being. Which included questions about depression. They had tons of support for this issue if needed.

tallguy2 profile image
tallguy2 in reply to Godschild62

Yes thank you, I forgot about the screening that comes every time I visit my MO. Includes depression, religious beliefs, etc.

None of my doctors picked up on depression, but a social worker that seen me waiting for my next EBRT session interviewed me. She said just the look on my face was freighting. She told me to see my PCP and explain what she found in the interview. He put me on an antidepressant right away. I was on that for 1 year. That was 23 years ago. Now my MO thinks the PCa is morphing into neuroendocrine cancer and from what I have read I agree with him. I will not go to a nursing home and have my exit strategy planned. I will not leave my wife a pauper.

Mike P.

My oncologist gave me a script for Effexor to help with the. Depression and hot flashes. Does help but still get the blues every once in a while fighting the monster 🙏🙏🙏🙏

Shocking!

Your doctor isn’t going to know what is going on unless you tell him. I was having emotional swings and often lashed out ar my wife for no good reason. Finally we brought it up to my oncologist and he agreed I was probably depressed with all I had been going through (prostatectomy and radiation, etc.).

He suggested i consider and research several anti depressants and essentially let him know which, if any, I would like to try. I settled on Wellbutrin which has been a God-send. It has really helped me enjoy life again with out all the mood changes and best of all it has no sexual side effects in terms of climax. I have an implant and so I am good to go any time. I have been on others before PCa which effected interest, erections and ability to climax. Hope this is helpful.

dadzone43 profile image
dadzone43 in reply to Dbeckman

Certainly cannot disagree with this. But some doctors signal through body language and words the level of interest or disinterest in ones emotional state. It is good if your MO is open; many are not.

One of the odd things about depression is that depressed people generally see their situation more realistically than "normal" people. Beating depression does involve a certain amount of reality distortion in the form of being able to focus on the good (however small) and ignore the bad (however large).

With this in mind, it's probably a good thing that I had depression and anxiety and was on medication for years before developing cancer. This gave me a head start in that aspect of dealing with the disease. It's relatively easy for me right now. I'm responding well to treatment, and everybody loves a good "beating cancer" story. Even with that, I recently said something like "When I see the state of politics in this country, I'm glad I have cancer and won't be around too long". It seem I still have my dark thoughts and moments even when things are going well.

I really wish I had been more aware - what I thought was a slump turned into a complete and utterly destructive depression after my husband got a tough PSA result. We are just past it - by three days honestly - but it seems as if to get help in that arena you have to fight like hell to get people to recognize it when you are least capable of doing so. I did a pretty deep dive into PCA and depression and there is definitely a link - why the hell don't they tell us? Finding out the hard way almost cost him his life.

dadzone43 profile image
dadzone43 in reply to mintlatte

This is a sad story. Happens too often.

I believe we are left to figure things out ourselves, no wonder we get depressed! Bet it's more than 1 out of 6! way more!

Funny thing....Every time I visit my MO, he tells me he gets depressed.

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 04/12/2019 7:39 PM EDT

monte1111 profile image
monte1111 in reply to j-o-h-n

That was good. I am still laughing.

Is that a special gift you have, j-o-h-n?

j-o-h-n profile image
j-o-h-n in reply to dadzone43

I don't think it's a gift, i'm sure I inherited it....

Good Luck, Good Health and Good Humor.

J-o-h-n Sunday 04/14/2019 1:45 AM DST

I do pretty good with depression until I walk into the oncology waiting room and there is the funeral music playing again. They screwed my blood work up again and I had to go up there yesterday. It was lunch. Said "Well, I'm not listening to this music for a half hour." Got a good laugh. Wandered the hospital checking out all the people on crutches and in wheel chairs. I'm not going to say that cheered me up immensely because I don't want to hear the backlash. I'll just say it was better than the funeral music.

j-o-h-n profile image
j-o-h-n in reply to monte1111

Did you know that the funeral music is a slower version of the wedding march?

Now you made me tell this one Gosh by Golly.

Woman visiting her friend in the nursing home.

Friend in a wheel chair comes wheeling down the hall from her room to greet the woman when all of a sudden a male patient sticks his head out of his room and hands her a piece of paper.

Woman says to her friend what's that all about?

Friend says he thinks he's the floor traffic officer and he just gave me a speeding ticket.

Later on Friend has do go to her room to get a sweater and sure enough as she returns in her wheelchair to visit with the woman she's stopped by the man again and he hands her another piece of paper.

Woman says what did he ticket you for this time?

Friend says he gave me a ticket for an illegal u turn.

Sure enough the Friend has to return to her room for a moment and comes wheeling back to be with the Woman when the man pops out of the room with his willy exposed.

Woman say OMG what now?

Friend says Geez oh no the breathalyzer test.

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 04/13/2019 6:14 PM EDT

monte1111 profile image
monte1111 in reply to j-o-h-n

My granddaughter just asked me why I was laughing so hard. I could only shake my head. She asked me if I was possessed. I shook my head, still laughing, and she went back to her cell phone chat. She is coming this way. Have to go. POS.

Thanks j-o-h-n, love your humor hope my joyous nature comes back someday.

For sure, you actually have a joyous nature. Just forget Pca and all the crap that comes with it...Laugh at cancer... here's one:

Woman on a plane sneezes and they cries out like she's having an orgasm...

Man sitting next to her is concerned and asks "excuse me miss, but do you need medical attention?"

Woman replies "oh no sir, but i'm a bit embarrassed to tell you, that every time I sneeze I have an orgasm...

Man says "Oh wow, are you taking anything for it?"

Woman says "yes, black pepper"....

Keep Smiling - because most people look better smiling than grimacing....

Happy New Year....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 12/30/2019 5::40 PM EST

Thanks john, that is funny. I'm not to laughing at cancer yet, and yet is a big word sometimes. Arlis

I call it a deep funk.

Somedays it seems awfully dark around me.

My poor significant other has had to be super duper to keep from imploding

on occasion.

I want to yell God help me !

Add me to the stats .....

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