Implications of Mental Health Illness on Outcomes of Prostate Cancer Patients in the Veterans Affairs Medical System
Abstract
To determine whether mental health illness (MHI) impacts risk of prostate cancer (PC) diagnosis and aggressiveness; to explore whether MHI prior to PC diagnosis (i) impacts treatment received, (ii) adherence to guideline-specific follow-up, (iii) PC-specific outcomes, and whether (iv) MHI specific therapy improves PC outcomes among those with MHI. Scope: PC is the most common malignancy diagnosed in the VA system, making up 29 percent of oncology diagnoses. Secondary to the proportion of older men and African Americans served, a disproportionate burden of PC is placed on the VA system. Specific to the VA, a cross-sectional evaluation of 4,461,208 veterans seen in Patient Aligned Care Teams noted that 25.7 percent had at least one diagnosis of depression, PTSD, substance abuse disorder, anxiety disorder or serious mental illness. Many men with PC will be treated (and cured) of their disease. However, 60 percent of men with PC experience mental health distress, with 10-40 percent having clinically significant depression. We have previously demonstrated that PC patients are significantly at risk of suicidal death even up to 15 years after diagnosis. Considering this and the paucity of studies in the VA system assessing the relationship between PC and MHI, our intention is to explore several MHI/PC aims using the nationwide VA health database. Major Findings: During the last year, we have been able to make substantial headway on this grant, primarily secondary to the alleviation of many previous COVID-19 pandemic restrictions placed on the team at the Durham VA. We have used the Standard Operation Procedures (SOP) developed during the first year of the grant, to build several iterations of the database assessing the impact of MHI on PC in the national VA dataset. This included twice-monthly remote meetings with the research team to first finalize the SOP, and subsequently to develop the initial iteration of the database.
Document Details
- Document Type
- Technical Report
- Publication Date
- Mar 01, 2023
- Accession Number
- AD1200742
Entities
People
- Zachary Klaassen
Organizations
- Augusta University