The psychological impact of prostate cancer after treatment: a critical review of the literature

Introduction: It is well documented that an increasing number of men are now living with and beyond prostate cancer and its treatment. The physical effects of the disease and its treatment are well documented, but less so, the psychological impact of these. Depression and anxiety have been reported in prostate cancer patients1 and men experience unmet needs regarding their psychological wellbeing2. To better understand the needs of men and enable improvements in the care provided, this critical review sought to understand the psychological impact that treatment may have on prostate cancer survivors. Method and Materials: A literature search, for peer-reviewed literature in the last 10 years, was conducted using three reputable databases. PRISMA guidance was used to report the study selection process. Critical appraisal tools were used to appraise each individual study. The data extracted was subject to thematic analysis and narrative synthesis. Results: Analysis revealed three major themes that were used to describe the psychological impact of prostate cancer treatment. 1.) Impact on masculinity 2.) Impact on depression and anxiety and 3.) Psychological impact of sexual dysfunction. All themes could be interlinked and were related to the physical effects of treatment. Analysis also revealed possible influential factors. These being age, marital status and treatment intervention, as well as the presence of specific treatment side effects such as erectile dysfunction, urinary incontinence and bowel incontinence. Conclusion and Discussion: Evidence demonstrates how the physical effects of prostate cancer treatment can impact on psychological wellbeing. Prostate cancer patients should be fully informed of the potential risks to their psychological wellbeing. When assessing the physical effects, practitioners should also explore the psychological impact of these. Advanced communication skills e.g. use of open questioning, are important in establishing specific concerns/needs, and ensuring the support provided is tailored to the individual. Practitioners should also be aware of factors that could increase the risk of psychological impact. Assessment aids that incorporate these, could be useful in recognising at risk individuals.