Presentation Authors: Gagan Fervaha*, Jason Izard, Dean Tripp, Kingston, Canada, Selina Rajan, Sarah Karampatos, Bobby Shayegan, Hamilton, Canada, Edward Matsumoto, Hamiilton, Canada, Tamim Niazi, Annabel Chen-Tournoux, Montreal, Canada, Vincent Fradet, Yves Fradet, Quebec City, Canada, Emmanuelle Duceppe, Montreal, Canada, Luke Lavallee, Christopher Johnson, Ottawa, Canada, Joseph Chin, London, Canada, Darin Gopaul, Kitchener, Canada, Margot Davis, Vancouver, Canada, Jehnonathan Pinthus, Darryl Leong, Hamilton, Canada, Robert Siemens, Kingston, Canada
Introduction: Androgen deprivation therapy (ADT) for the treatment of prostate cancer has been shown, albeit not consistently, to be related to specific consequences such as incident depression. The presence of depressive symptoms in patients with advanced disease eligible for ADT is less well understood. The current study was undertaken to estimate the prevalence and predictors of depression in a contemporary sample of patients beginning ADT.
Methods: Data from the current study were drawn from the RADICAL PC study, a parent prospective cohort study conducted across 13 sites in Canada. Men with prostate cancer initiating ADT for the first time were recruited. Depressive symptoms were evaluated using the 9 item version of the Patient Health Questionnaire (PHQ-9). A score of 8 or higher on this scale represents clinically relevant depressive symptoms. To evaluate predictors of depressive symptoms, a logistic regression model was constructed including biological, psychological, and social predictor variables.
Results: Data from 407 patients were available at the time of this analysis. Of these, 43 (10.6%) endorsed clinically significant burden of depressive symptoms. Two variables were identified as independent predictors of depression - poor functional status (OR=5.18, p < 0.001) increased depression risk, whereas being retired was found to be protective (OR=0.37, p=0.03). Indicators of advanced disease (e.g. presence of metastatic disease) were not associated with depression in either univariate or multivariate models.
Conclusions: Our multi-centre study of depressive symptoms among prostate cancer patients starting ADT shows that these symptoms are already present in a sizeable sample of men. These do not seem to be affected by disease-related indicators, but rather are better predicted by psychosocial variables. Clinicians should be suspicious of poor psychological functioning especially among those prostate cancer patients with poorer functional status. Moving forward, it will be important to document the incidence and change in depressive symptoms as these patients begin ADT and are followed prospectively.
Source of Funding: Prostate Cancer Canada