Neuroticism Has A Negative Influence on Prostate Cancer Quality of Life Outcomes

In a presentation at the European Association of Urology Congress in Barcelona, Spain there was a report that showed that prostate cancer patients who had high levels of neuroticism (a broad personality trait in which a person experiences the world as distressing, threatening, and unsafe place) had significantly more adverse events following surgery, including sexual dysfunction and urinary incontinence.  The data was created from a survey of almost 1,000 men.

In self-reported responses to a validated questionnaire of men who on the average of 3 years after having had a radical prostatectomy, 22% of the men had higher levels of neuroticism which was associated with a 20% lower average score on a quality-of-life questionnaire, as compared with men who had low neuroticism scores. 

The high-neuroticism group had a significantly higher rate of erectile dysfunction, urinary incontinence, as well as bowel dysfunction.  The survey was conducted by Karol Axcrona, MD, of the University of Akershus in Lørenskog, Norway. 

According to Axcrona, the rate of neuroticism in the men was similar to rates in general populations of men in Norway and Western European countries, as shown in previous surveys. Treatment failure, or the need for additional salvage radiation therapy, hormonal therapy (ADT), or severe PSA elevation occurred in 21% of the men and did not have a significant association with reported symptoms of neuroticism.

"Neuroticism is not an illness, but a basic personality trait," Axcrona said in a statement. "What we found was that those men who show a greater tendency towards neuroticism have worse outcomes three years after prostate cancer surgery. This is a real effect, and doctors need to take account of this, in the same way, that we would take physical factors into account before and after cancer treatment. This means we may need better advance personality testing for identification and counseling, and perhaps a more specialized follow-up of these men who might be at risk of poorer outcomes."