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Understanding PSA Anxiety

Understanding PSA Anxiety

Are you one of the 1 in 4 men that might be struggling with PSA anxiety? 1

Is PSA anxiety real?

Yes, PSA anxiety is very real, and for those who experience it, it could be very overwhelming. PSA anxiety is defined as ‘a state of physical or emotional distress (intense worry) due to an elevated PSA level, felt on a chronic basis, and often accompanied with feelings of depression and fatigue’.1-3 This does not mean that PSA anxiety cannot be managed and reduced.

Most men who went for Prostate Cancer screening said they did it to obtain peace of mind – it is better to know than not to know.2

 

The benefits of early diagnosis and treatment is very important to offer you the best chance of good outcomes and even completely taking control of the disease, so do not let stress and anxiety over getting screened take away that chance at control.2
 

The reality is that anxiety is something that might stay with you during your journey with Prostate Cancer, to a certain extend. Even after treatment, you could still feel anxious, which is completely understandable.2


What we do know is that it will get better. Studies have shown that most men with Prostate Cancer that require ongoing monitoring, do learn to cope with and manage this anxiety. After a few years, you may be able to learn to adapt, and experience a lot less anxiety.2

Can stress and anxiety cause higher PSA levels?

The answer to this question is not straightforward, as studies have given varying results.4,5 What we do know is that the way every person’s body responds to stress is different. Some men with high levels of stress may develop more aggressive disease over time, but that is not necessarily true for all men.5
The good thing is that proper disease management with a healthy diet coupled with stress management has shown to slow down any progression, or even reversing the disease.3

What can you do to manage PSA anxiety?

When you are anxious or stressed, you usually also experience several other issues, such as difficulty sleeping, feeling irritable, and recurrent intrusive thoughts.6 Let’s look at some practical tips on how you can manage these problems.

Talk to your healthcare team
Talk to your healthcare team7

 

If you feel worried or anxious about your PSA results, take some extra time to discuss this with your healthcare provider/s. Don’t be afraid to address the following:

  • Ask questions about the PSA testing itself – how accurate it is, how the results should be interpreted.
  • Ask what the results could mean.
  • Enquire about all the reasons why your PSA levels could be higher that it should be.
  • If you do not understand the explanation, as the healthcare provider to explain it in a simpler way.
  • Ask your healthcare provider to explain what the next step is and what to expect.

Focus on what you can control
Focus on what you can control5-7

 

Men that have been through the process found it helpful to focus on the things you can control rather the things that you cannot. Focus on daily tasks, stay busy to keep your mind occupied.
 

Find a daily routine that you are comfortable with and helps you feel in control. Plan ahead when going for appointments – prepare questions and make sure you have something to record what was said during your appointment to refer to later. Remember to ask permission first before doing any audio recordings.

Healthy choice in diet
Healthy choice in diet6

 

Limit your alcohol intake. Increase fruit, vegetables, wholegrains and healthy fats as these stabilise blood sugar levels and lowers the likelihood of mood swings. Avoid refined carbohydrates and processed foods.

Stay active
Stay active5,6,8

 

Physical exercise reduces stress and help you manage anxiety. It releases endorphins which is the “feel-good” chemical of the body.

Get enough sleep
Get enough sleep8

 

Good sleep is important for good mental health. Try the following to help you to get good quality sleep:

  • Read, listen to calming music or meditate a few minutes before trying to sleep.
  •  Try a few breathing exercises. 
  • Maintain a good sleep routine – go to bed and get up at around the same time each day.
  •  Avoid drinking too much alcohol before bedtime, or caffeine or large meals late in the day.
  •  Avoid “screen-time” before bed – no smartphones, tablets or computer use.

Spend time with friends, consider getting a pet
Spend time with friends, consider getting a pet5

 

Spending some down-time with others in person can go a long way to improve your mental health, while owning or just interacting with a pet has shown to improve symptoms of stress and can reduce depression.


If you feel anxious about your tests or disease, reach out to one of the many organisations that offer support groups or information that can help you deal with PSA Anxiety.

References:
  1. James C, Brunckhorst O, et al. Fear of cancer recurrence and PSA anxiety in patients with prostate cancer: a systematic review. Supportive Care in Cancer 2022;30:5577–5589.

  2. Dale W, Bilir P, et al. The Role of Anxiety in Prostate Carcinoma. Cancer. 2005;104(3):467–478.

  3. Saxe GA, Major JM, et al. Potential Attenuation of Disease Progression in Recurrent Prostate Cancer With Plant-Based Diet and Stress Reduction. Integrative Cancer Therapies 2006;5(3):206-213.

  4. Gidron Y, Fabre B, et al. (Abstract) Life events, cortisol and levels of prostate specific antigen: A story of synergism. Psychoneuroendocrinology 2011;36(6):874-880.

  5. Stress and Prostate Cancer. Prostate Cancer Foundation [Online] no date. Available from https://www.pcf.org/c/stress-and-prostate-cancer/. Accessed 2024/05/27.

  6. Riley B. PSA levels after treatment: All you need to know. Prostate Cancer Foundation of Australia. 11 May 2023. Available from https://www.pcfa.org.au/news-media/news/psa-levels-after-treatment-all-you-need-to-know/. Accessed 2024/05/27.

  7. Biddle C, Brasel A, et al. Experiences of Uncertainty in Men With an Elevated PSA. American Journal of Men’s Health, 2017;11(1):24–34.

  8. Tips on dealing with anxiety and stress. Prostate Cancer UK. Available from https://prostatecanceruk.org/prostate-information-and-support/get-support/wellbeing-hub/tips-on-dealing-with-anxiety-and-stress. Accessed 2024/05/27.