There have been a number of articles that claim that older cancer patients report less distress than younger cancer patients report. However, this research has generally not sorted the differences among general distress, anxiety, and depression in older vs. younger survivors.
Elson CJ, Weinberger MI, Balk E, Holland J, Breitbart W, Roth AJ. From the Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York did a secondary analysis of merged data sets using cross-sectional data on 716 men with prostate cancer (mean age, 68 +/- 10 years; range, 50-93 years).
They recruited about half the study participants from doctor’s offices throughout the U.S. and the other half came from Memorial Sloan-Kettering Cancer Center (New York). The subjects completed the Distress Thermometer, the Hospital Anxiety and Depression Scale, the Functional Assessment of Cancer Therapy-Prostate Quality of Life questionnaire and a demographic questionnaire.
They found that as a man aged he experienced less distress (r = -0.14), less anxiety (r = -0.22), and a better emotional quality of life (r = 0.16). However, in contrast, aging was associated with greater depressive symptoms in these prostate cancer patients (r = 0.18). The significant association between age and depression remained after controlling for stage of disease, hormone therapy use, time since diagnosis, and social, physical, and functional well-being.
The study tells us that older cancer survivors may cope more effectively than younger cancer patients, nonetheless, depressive symptoms need to remain an important concern for older prostate cancer survivors. We currently fail miserably in providing even basic psychological services to men with prostate cancer. We need to spend greater attention to the psychological needs of both younger and older prostate cancer survivors.
What I find even more significant is that the increase in depression seen in older cancer survivors runs contrary to some findings in the general aging literature, raising the possibility that this trend is unique to older cancer patients.
Oncologist. 2009 Sep;14(9):891-9.
Joel T Nowak MA, MSW