Men who receive androgen deprivation therapy (ADT) following radical prostatectomy for prostate cancer (PCa) are at higher risk for depression, according to investigators.

Using data from the Danish Prostate Cancer Registry, Anne Sofie Friberg, MD, from the University Hospital of Copenhagen Rigshospitalet, Denmark, and colleagues conducted a retrospective review of 5570 men treated for PCa from 1998 to 2011. The team examined the effect of subsequent treatment with ADT or salvage radiation or both on the risk of depression after radical prostatectomy (RP). During 40,681 person-years of follow-up, 773 first events of depression occurred.

Men treated with ADT after surgery had a significant 1.8-fold increased risk of depression compared with those who received no subsequent treatment, after adjusting for age group at the time of surgery, year of surgery, income quintile, and cohabitation status, the investigators reported at the 34th Annual European Association of Urology Congress in Barcelona, Spain. Depression risk was increased 2.2-fold among men who received salvage radiation in addition to ADT. Salvage radiation without ADT did not significantly increase the risk of depression.

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“Clinicians should thus be aware of depressive symptoms in patients with postsurgical relapse and subsequent treatment with ADT,” the authors concluded in a poster presentation.

The study also found that low income, comorbidities, living alone at PCa diagnosis, and earlier period of surgery were associated with an increased risk of depression.

Dr Friberg’s team noted that lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are associated with an increased risk of depressive symptoms,

Following RP, 25% to 50% of men experience erectile dysfunction (ED) and up to 80% report urinary incontinence, Dr Friberg’s team noted. ED and lower urinary tract symptoms are associated with the prevalence of depressive symptoms.

“Subsequent treatments may introduce further problems with urinary continence, bowel and sexual function on top of the psychological effect of experiencing failure upon surgery with curative intent,” the investigators concluded.

“Increased risk of depression among patients treated with ADT is an important issue,” said Grace Lu-Yao, PhD, MPH, associate director of population science at the Sidney Kimmel Cancer Center–Jefferson Health and vice-chair of population science in the Department of Medical Oncology at Thomas Jefferson University in Philadelphia. “ADT is widely used for the management of prostate cancer and is associated with many side effects such as hot flashes, fatigue, fractures, weight gain, and increased risk of cardiac adverse events.”

This article originally appeared on Renal and Urology News