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

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgements

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.

Author information

Authors and Affiliations

  1. Research Institute in Emergency Care, Landspitali National University Hospital of Iceland, Reykjavik, Iceland

    Thordis K. Thorsteinsdottir

  2. Faculty of Nursing, University of Iceland, Reykjavik, Iceland

    Thordis K. Thorsteinsdottir

  3. Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY, USA

    Heiddis Valdimarsdottir

  4. School of Business, Reykjavik University, Reykjavik, Iceland

    Heiddis Valdimarsdottir

  5. Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden

    Johan Stranne

  6. Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

    Ulrica Wilderäng & Gunnar Steineck

  7. Scandinavian Surgical Outcomes Research Group (SSORG/Göteborg), Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

    Eva Haglind

  8. Division of Clinical Cancer Epidemiology, Department of Oncology–Pathology, Karolinska Institutet, Stockholm, Sweden

    Gunnar Steineck

Authors
  1. Thordis K. Thorsteinsdottir
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  2. Heiddis Valdimarsdottir
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  3. Johan Stranne
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  4. Ulrica Wilderäng
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  6. Gunnar Steineck
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Corresponding author

Correspondence to Thordis K. Thorsteinsdottir.

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

Additional information

Eva Haglind Principal investigator of the LAPPRO trial; Gunnar Steineck Deputy principal investigator

This work was supported by: The LAPPRO trial was supported by the Swedish Cancer Society (CAN2008/922, CAN2009/1099, CAN2010/593), Västra Götaland Region (ALFGBG-11573) and the Sahlgrenska University Hospital (HTAVGR-6011).

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Thorsteinsdottir, T.K., Valdimarsdottir, H., Stranne, J. et al. Thinking about one’s own death after prostate-cancer diagnosis. Support Care Cancer 26, 1665–1673 (2018). https://doi.org/10.1007/s00520-017-3986-z

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  • DOI: https://doi.org/10.1007/s00520-017-3986-z

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