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



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.

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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.

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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).

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  • Prostate cancer
  • Psychological adaptation
  • Clinical trial
  • Thoughts about death