Antidepressant medication use and prostate cancer recurrence in men with depressive disorders.

[podsart]

Antidepressant medication use and prostate cancer recurrence in men with depressive disorders.

September 14, 2022

Whether treating prostate cancer survivors with a depressive disorder with antidepressants can affect their cancer outcomes is unknown. We evaluated the association between antidepressant use and prostate cancer recurrence, in survivors with comorbid depressive disorders.

We conducted a longitudinal cohort study of 10,017 men with prostate cancer (stages I-II) diagnosed who also had a comorbid depressive disorder followed a maximum of 22 years, and examined rates of biochemical recurrence by antidepressant medication use. We conducted multivariable Cox models based on time-dependent antidepressant drug use status, and examined the risk of biochemical recurrence by cumulative duration of antidepressant use.

Of these 10,017 survivors, 1842 (18%) experienced biochemical recurrence over 69,500 person-years of follow-up. The prostate cancer biochemical recurrence rate was greater with antidepressant non-use (31.3/1000 person-years) compared to antidepressant use (23.5/1000 person-years). In Cox proportional hazards multivariable adjusted models, non-use of antidepressants was associated with a 34% increased risk of biochemical recurrence compared to antidepressant use (HR = 1.34, 95% CI: 1.24-1.44). Longer use of antidepressants was associated with a lower biochemical recurrence risk (P trend test < 0.001).

Untreated depressive disorders in prostate cancer patients may be associated with an increased risk of biochemical recurrence.

Cancer causes & control : CCC. 2022 Sep 09 [Epub ahead of print]

Reina Haque, Stephanie Reading, Michael R Irwin, Lie Hong Chen, Jeff Slezak

[MateoBeach]

Very interesting. Thanks. Hard to think what confounders might be present. Those being treated with anti-depressants possibly getting more attentive medical care in other respects? Untreated depression's effects on overall health and immunity increasing risk of BCR? Specific benefits of antidepressants on PC, and if so which ones?

[podsart in reply to MateoBeach]

just a guess: I think clinical depression lowers the immune system , accompanied many times with poor nutrition and loss of sleep, might increase internal inflammation, disinterest in social relationships and probably more …: the mind-body is said to be an integrated system

[Hidden in reply to MateoBeach]

I'll guess too. Anti-depressants cut down on obsessive and gloomy thoughts thus greatly reducing stress and improving sleep. Or is it some unknown but fortuitous biochemical property that inhibits cancer cell growth? Yes interesting.

[bluepacifica]

It's a good thing I was sitting down when I read this. My husband, Gleason 10, stage IV, was started on Lexapro in February 2005 after radical surgery in Dec. 2004. Because he was young they threw everything at him, but I wanted him on an antidepressant and his Radiation Oncologist agreed. He's in his 18th year and leading a normal life for a 73 year old. His doctor is thrilled every 6 months when he goes in to get his Lupron shot and has stated that he has no idea why Les has done this well. His prognosis was awful! Could it be the Lexapro that he's been on for so many years?? Nothing else makes sense. He is a picky eater and his diet is crappy. He still smokes but not a heavy smoker at all. So, it's not like he's been worried about his life style. Instead, he gardens and enjoys a ride on his Harley almost every day. Living on Kauai certainly hasn't been detrimental to his health! Wow!

[podsart in reply to bluepacifica]

glad he’s doing well; good luck!

[MateoBeach in reply to bluepacifica]

well that is an amazing example. Does he surf or any other activity to get into the ocean? I live on the beach in Cabo half the year. And ride a big BMW. Daily swims when there and some surfing and kite-surfing when conditions are friendly. (Would not smoke though!) Happy story that he I’d doing so well. Aloha

[bluepacifica in reply to MateoBeach]

No surfing for him. He's very lean, always has been, and sinks quickly in water so he's always avoided it. I also want to mention that when he went on Lupron, he had no side effects, still doesn't. No hot flashes, no nothing! No weight gain, he's around 120 pounds, and his doctor is fine with it.

[jimreilly]

Yes, as asked above, which depressants? was there any difference between one anti-depressant or another, or one class of drugs and another? between those people who felt that their anti-depressants worked well, and those who didn't? lots of things one would love to know!

[bluepacifica in reply to jimreilly]

Initially, our co-pay for Lexapro was $150 a month with our insurance. (that's another story) Lexapro had no generic in those days. Anyway, our family doctor told us a few years later that he could switch to Celexa which came in generic, much cheaper and was a "cousin" to Lexapro. After Les went on Celexa, he griped about it not working. Once Lexapro went generic, he went back on it. Then, in 2015 we had our dna tested. I uploaded our results to promethease and because they used to do a pharmacology report, Les's dna indicated that 4 antidepressants would not work on him, Paxil, Effexor, Celexa and another one I can't recall. The FDA has since stopped the pharmacology reports but it sure did expand our knowledge about a bunch of things! He's never had any luck with pain killers, ALL pain killers. Well, the pharmacology report cleared that up, too. This has been an amazing journey for both of us since that fateful day in 2004.

[podsart]

As there are a variety to chose from, l think a lot has to do with finding a good match between the med and how well the patient tolerates and feels on the med. also, some meds are used for certain symptom patterns

[podsart]

with Pca we face both an existential threat and dread of some frightening symptoms appearing or already existing

[maggiedrum]

I wonder if they separated out the treatment resistant depressed men from the treatment positive ones. I have been taking specific meds for my chronic depression for years and they definitely are minimally effective. I went through the different classes of anti-depressants so I never found any that worked.