**5. PTSD: Men with malignant disease**

While a plethora of studies have assessed prevalence rates for women breast cancer and/or mixed gender studies, a paucity of research exists as to the prevalence rates in strictly male

treatment. Cross-sectional data prohibits clinical understanding of the development as well as the trajectory patterns of PTSD in those with cancer. The relative lack of prospective or longitudinal data is needed to inform clinicians early in the disease process so that highly distressed patients may be identified and helped as early as possible with this lifethreatening illness. Lastly, cross-sectional research does little in the way of determining risk factors relevant to later survival time or predicting the delayed onset of posttraumatic stress. Attention now turns to investigations assessing PTSD in strictly male samples with

Study Design Sample Time Period PTSD

n = 209; males/ females; mixed cancer diagnosis

n = 160 females;

females; breast

males/females head, neck, lung cancer

breast

n = 82;

n = 71;

n = 127; females; breast

n = 37;

n = 102;

n = 50; females; breast recurrence

females; breast

males/females; cancer not specified

While a plethora of studies have assessed prevalence rates for women breast cancer and/or mixed gender studies, a paucity of research exists as to the prevalence rates in strictly male

sectional n = 82 females; breast 37 months post-

Prevalence

0% (only 100 participants assessed)

2.4% current

5% current

25 months post-

6.5 months post-

1-6 months post-

15 days post-dx of initial cancer

1-6 months post-

dx/surgery – 18

20.4 month postbone marrow transplant

(77%) ; or recurrent malignancy (23%), 0-67 days

females; breast > 100 days post-tx 0% current

treat 6% current

treat 2.5% current

6 months post-dx 22% current

dx 3% current

dx recurrence 2% current

months 1.6% current

dx

sectional n = 144; female; breas 1-3 years post-dx 4.9% current

diagnosed malignancy.

Crosssectional

Cross-

Cross-

Crosssectional

Crosssectional

Crosssectional

Crosssectional

Crosssectional

et al., (2008) Longitudinal n = 74;

Crosssectional

Table 3. Summary of select cancer studies

**5. PTSD: Men with malignant disease** 

et al., (2005) Longitudinal

Akechi et al. (2004)

Andrykowski et al., (1998)

Gandubert et al., (2009)

Green et al., (1998)

Kangas

Luecken et al., (2004)

Mehnert & Koch, (2007)

Mundy et al., (2000)

Okamura et al., (2005)

Shelby

Widows et al., (2000) samples with malignant processes. This is surprising since survivors of prostate cancer continue to grow as well as the fact that psychological distress in response to receiving a prostate cancer diagnosis is a recognized phenomenon (Anastasiou et al., 2011; Gwede et al., 2005; Namiki et al., 2007). Furthermore, psychological distress in prostate cancer patients has been found to be related to the following: stage of disease, shorter time since diagnosis, and treatment options or decisions (Gwede et al., 2005). For men, receiving the diagnosis of malignant disease has been found to be associated with responses that include anxiety, denial or distress (Kronenwetter et al., 2005).

Distress related to decision-making is a common experience among men after the diagnosis of prostate cancer; specifically, reports indicate that around 63% report high decision-related distress persisting the first year after treatment for 42% of all men (Steginga et al., 2008). Also, an increased manifestation of traumatic stress symptoms has been found in some cases of newly diagnosed men with localized prostate cancer before the beginning of treatment (Bisson, 2007); on the other hand, low emotional distress has been documented as being present even 2 years after a radical prostatectomy (Perez et al., 2002). Follow-up of males during the disease course of their prostate cancer show that males with prostate cancer may suffer with long-term physical and psychological consequences---to the point of affecting their quality of life (Penson, 2007; Sanda et al., 2008). Indeed, accumulating data within the past 15 years has produced a body of literature investigating health related quality of life (HRQOL) outcomes pertaining to localized prostate cancer (Penson, 2007). This stands in contrast to empirical exploration regarding adjustment in such male cancer survivors. Unfortunately, the literature does not demonstrate ample descriptive investigations as to the course of psychological adjustment for men who have been diagnosed with and treated for prostate cancer (Steginga et al., 2004). No studies could be identified that specifically assessed PTSD in men with testicular or lung cancer.

A recent study by Anastasiou and colleagues (2011), believed to be the only study that has focused on investigating the presence of acute posttraumatic stress disorder (PTSD) in men with malignant disease necessitating a radical prostatectomy, assessed symptoms in 15 men one month after surgery. The men completed the Davidson Trauma Scale rather than being assessed by interview. Analyses determined that 26.7% of the men's scores met scale criteria for acute PTSD, which was found to be independent of the patient's educational level. In sum, despite the fact that prostate cancer is the second most frequently diagnosed cancer in developed countries, and the third most common cause of death in men (Damber & Aus, 2008), little is known about the psychological ramifications for prostate cancer patients after surgery (Burns & Mahalik, 2008; Namiki et al., 2007; Steginga et al., 2004).
