Impact of psychiatric illness on decreased survival in elderly patients with bladder cancer in the United States

Abstract

One-half of patients with muscle-invasive bladder cancer who underwent treatment were diagnosed with a psychiatric disorder, which resulted in worse survival outcomes compared with patients who did not have a posttreatment psychiatric diagnosis. This information can be used to inform interventions to educate patients with muscle-invasive bladder cancer regarding the impact of different treatments on mental health. Cancer 2018. © 2018 American Cancer Society.

Melancholia and cancer: The bladder cancer narrative

“…The most interesting finding by Jazzar and colleagues is the distribution of psychiatric diagnoses in their cohort. Before reading the article, it would seem reasonable to assume that the most common psychiatric diagnoses affecting a cancer population would be anxiety and depression; yet substance abuse was the most common psychiatric illness noted, affecting almost one‐third (32.5%) of the cohort.…”

“…17 Early involvement of palliative care services in the care of patients with cancer (even those with localized disease) has produced improvements in the domains of pain and symptom control, reductions in associated depression and anxiety, and reductions in repeat hospital admissions. 18 The most interesting finding by Jazzar and colleagues 6 is the distribution of psychiatric diagnoses in their cohort. Before reading the article, it would seem reasonable to assume that the most common psychiatric diagnoses affecting a cancer population would be anxiety and depression; yet substance abuse was the most common psychiatric illness noted, affecting almost one-third (32.5%) of the cohort.…”

“…After 100 years of forced divergence by advances in cancer biology and the biochemical understanding of mental illness, observational studies have brought a renaissance to the interplay between cancer outcomes and mental illness. The above findings by Jazzar and colleagues add bladder cancer to the growing number of malignancies that are directly affected by psychiatric illness. Moreover, the report sheds light on the alarming rates of posttreatment psychiatric diagnoses observed in patients with muscle‐invasive bladder cancer, which, unlike prostate or breast cancer, has a restricted treatment armamentarium that limits the options available for those at risk for emotional stress during pretreatment screening.…”

Chronic Unpredictable Mild Stress Accelerates the Growth of Bladder Cancer in a Xenograft Mouse Model

“…4 Additionally, substantial evidence demonstrated that the diagnosis of posttreatment psychiatric disorder resulted in significantly worse overall survival and cancer-specific survival in bladder cancer. 5 Chronic psychological stress has been shown to intervene in immune function and play a role in the tumor growth and progression in diverse carcinomas. [6][7][8] However, the effects of chronic psychological stress on the biological behaviors of bladder cancer and possible underlying mechanisms are unknown.…”

Addressing Mental Health in Urology Patients: The Time is Now

“…Among men with prostate cancer in Ontario, Canada, those treated with radical prostatectomy had a 49% greater likelihood of receiving antidepressant therapy in the 5 yr following treatment (odds ratio [OR] 1.49, 95% confidence interval [CI] 1.35–1.64), whereas those receiving radiotherapy had a 33% increase in odds (OR 1.33, 95% CI 1.21–1.47), and those treated with active surveillance had a 15% increase in likelihood (OR 1.15, 95% CI 0.94–1.41) [4] . Specific to bladder cancer and the highly comorbid patient population afflicted by this disease, Jazzar et al [5] found that 50.4% of bladder cancer patients in the SEER-Medicare database were diagnosed with a post-treatment psychiatric disorder. In addition, those undergoing radical cystectomy were 19% more likely to be diagnosed with a psychiatric disorder compared to those undergoing chemoradiation.…”