Supportive Care in Cancer

, Volume 26, Issue 5, pp 1665–1673 | Cite as

Thinking about one’s own death after prostate-cancer diagnosis

  • Thordis K. ThorsteinsdottirEmail author
  • Heiddis Valdimarsdottir
  • Johan Stranne
  • Ulrica Wilderäng
  • Eva Haglind
  • Gunnar Steineck
Original Article



Prostate-cancer diagnosis increases the risk for psychiatric morbidity and suicide. Thoughts about one’s own death could indicate need for psychiatric care among men with localized prostate cancer. We studied the prevalence and predictors of thoughts about own death among men with prostate cancer.


Of the 3930 men in the prospective, multi-centre LAPPRO-trial, having radical prostatectomy, 3154 (80%) answered two study-specific questionnaires, before and three months after surgery. Multivariable prognostic models were built with stepwise regression and Bayesian Model Averaging.


After surgery 46% had thoughts about their own death. Extra-prostatic tumor-growth [Adjusted Odds-Ratio 2.06, 95% Confidence Interval 1.66–2.56], university education [OR 1.66, CI 1.35–2.05], uncertainty [OR 2.20, CI 1.73–2.82], low control [OR 2.21, CI 1.68–2.91], loneliness [OR 1.75, CI 1.30–2.35], being a burden [OR 1.59, CI 1.23–2.07], and crying [OR 1.55, CI 1.23–1.96] before surgery predicted thoughts about one’s own death after surgery.


We identified predictors for thoughts about one’s own death after prostate cancer diagnosis and surgery. These factors may facilitate the identification of psychiatric morbidity and those who might benefit from psychosocial support already during primary treatment.


Prostate cancer Psychological adaptation Clinical trial Thoughts about death 



The authors gratefully acknowledge the participants in the LAPPRO trial, the members of the steering committee, the investigators at the participating hospitals, and the personnel at the trial secretariat for their provision of study material and administrative support.

Compliance with ethical standards


No conflicts of interest declared. The authors alone are responsible for the content and writing of the manuscript.

Supplementary material

520_2017_3986_MOESM1_ESM.docx (21 kb)
ESM 1 (DOCX 20 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Research Institute in Emergency CareLandspitali National University Hospital of IcelandReykjavikIceland
  2. 2.Faculty of NursingUniversity of IcelandReykjavikIceland
  3. 3.Department of Oncological SciencesMount Sinai School of MedicineNew YorkUSA
  4. 4.School of BusinessReykjavik UniversityReykjavikIceland
  5. 5.Department of UrologySahlgrenska University HospitalGothenburgSweden
  6. 6.Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical SciencesSahlgrenska Academy at University of GothenburgGothenburgSweden
  7. 7.Scandinavian Surgical Outcomes Research Group (SSORG/Göteborg), Department of Surgery, Institute of Clinical SciencesSahlgrenska Academy at University of GothenburgGothenburgSweden
  8. 8.Division of Clinical Cancer Epidemiology, Department of Oncology–PathologyKarolinska InstitutetStockholmSweden

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