Is depression a common symptom of prostate cancer?

Depression can occur in men with prostate cancer, but it is generally not a core biological symptom of the tumor itself; rather, it often arises from the stress of the diagnosis, treatment side effects (especially hormonal therapy), and life changes associated with cancer care. [PM20] Depression affects a meaningful minority of men with prostate cancer about 1 in 6 may experience clinical depression so it is common enough to warrant routine attention and screening. [PM20] Depression can negatively affect overall cancer outcomes and quality of life, making recognition and management important parts of care. [PM20]

Why depression happens

• Emotional and practical stressors: Worry about the future, treatment processes, changes to body image and sexual function, financial concerns, and fear of dying can trigger or worsen depression. ^[1] Persistent sadness that interferes with daily life may be clinical depression, which is treatable. ^[2]

• Treatment side effects:

  • Androgen deprivation therapy (ADT): Lowering testosterone can increase the risk of depression and other neuropsychiatric effects in some men, particularly with long-term use. [PM20] Evidence linking ADT to depression and suicide risk is mixed but suggests clinicians should monitor mood closely during therapy. [PM19]
  • Surgery (prostatectomy): After surgery, some individuals report depression alongside physical side effects and sexual changes. ^[3]

• Ongoing management approach (active surveillance): For men with low‑risk cancer monitored over time, anxiety and depressive symptoms are not necessarily higher than with surgery or radiation, but emotional responses vary, so screening remains helpful. [PM11]

What depression looks like

Common symptoms include feeling sad or hopeless, loss of interest, sleep and appetite changes, fatigue, slowed thinking or movement, trouble concentrating, guilt or worthlessness, anxiety, and, in severe cases, thoughts of self-harm. ^[2] Physical symptoms like pain or nausea can also be part of the picture or related to medications. ^[4] If sadness disrupts daily functioning, it may be depression and merits evaluation and treatment. ^[5]

How depression is managed

• Professional support: Psychotherapy (talk therapy) is often a key step; referral to a mental health professional can provide coping strategies and support. ^[6] Cancer centers offer individual and family counseling to address cancer‑related emotional health and adjustment. ^[7]

• Medications: Although randomized trials of antidepressants in prostate cancer populations are limited, antidepressants are commonly used in practice and can help when clinically indicated. [PM20]

• Structured interventions:

  • Nurse‑led group programs during radiotherapy have reduced depressive symptoms compared with usual care. [PM29]
  • Online or technology‑based psychosocial interventions can improve distress, anxiety, depression, and health‑related quality of life for some men. [PM30] [PM32]
  • Systematic reviews suggest cognitive and education‑based psychological approaches can meaningfully reduce depression and anxiety. [PM31]

• Ongoing screening: Routine identification of depression especially in older adults with cancer improves timely treatment and outcomes. ^[8]

• Practical coping tips: Open communication with your care team about mood changes, maintaining activity as tolerated, connecting with peer support, and involving partners or family in counseling can help day-to-day functioning. ^[9] Psychotherapy for couples can address shared coping and relationship impacts. ^[6] For cancer survivors, exercise, social support, and enjoyable activities can reduce lingering depression and anxiety; seek referral if symptoms persist. ^[10]

Special considerations

• Risk monitoring with ADT: Given the potential for increased depression risk during androgen deprivation, clinicians often monitor mood, sleep, cognition, and suicidality at regular intervals and coordinate care promptly if concerns arise. [PM19] Observational data in men treated with radiation show ADT use is associated with higher rates of diagnosed depression and mental health service utilization, underscoring the need for vigilance. [PM18]

• Suicide risk: Prostate cancer populations have higher suicide rates than the general male population; screening for depression, erectile dysfunction, and suicidal ideation is recommended to reduce risk. [PM22] Suicidal thoughts can occur even without other classic depressive symptoms, so direct, compassionate assessment is important. [PM20]

When to seek help urgently

If you have thoughts or plans of suicide or self‑harm, contact emergency services or a crisis line immediately and inform your healthcare team the same day. ^[2] Persistent sadness, loss of interest, or functional decline lasting two weeks or more should prompt clinical evaluation, as effective treatments are available. ^[2] Depression in the context of cancer is common and treatable, and early support can improve quality of life and outcomes. ^[2] [PM20]