Prostate cancer is the most diagnosed cancer in Australian men, with over 26,000 new cases each year. Among these, around 4,000 men face advanced stages of the disease, often requiring androgen deprivation therapy (ADT) as a crucial treatment option. Recent studies reveal disturbing findings regarding the psychological effects of ADT. The urgent nature of this find emphasizes the need for greater awareness and advocacy on behalf of those affected.
Two men’s experiences have brought these issues to light, highlighting the need for improved communication and support systems in prostate cancer treatment. Western Australian farmer Craig Heggaton was diagnosed with prostate cancer at the age of 56. After surgery, he started ADT and shockingly died by suicide while on treatment. His wife, Liz Heggaton, holds the treatment responsible for his growing mental deterioration.
Tim Baker, renowned surfing author, surfer and former pro surfer who was diagnosed with advanced prostate cancer at 50. Read on as he recounts his inspiring walk through the disease and its treatment. Baker’s challenges were tremendous while going through his ADT regimen. Today, he is a shining example of an engaged, patient advocate who is educating the community about the important necessity to incorporate mental health into cancer care.
Understanding Prostate Cancer and ADT
Prostate cancer is one of the most deadliest diseases facing men in Australia, killing thousands each year and affecting many more. Given the disease’s high prevalence, particularly among children, effective treatment options – both pharmacological and behavioral – are crucial. Androgen deprivation therapy (ADT) is the standard of care in advanced prostate cancer to have the disease not progress. It achieves this by decreasing testosterone in the body.
Unfortunately, while ADT has the potential to be life-saving, it has its downsides. International studies have found that the treatment can cause violent mood swings and depression so acute that it caused suicides. Anne Savage, a prominent advocate for prostate cancer awareness, states that “we are aware of a number of cases where ADT is believed to have played a role in the deterioration of men’s mental health, leading to suicide.”
Although these findings are alarming, most patients are still not informed of the increased mental health risks that can accompany ADT. Savage emphasizes that “overall, around 12 percent of men impacted by prostate cancer will experience suicidal ideation, which is significantly associated with hormonal treatment.”
Personal Stories of Struggle
Both Craig and Tim’s stories exemplify the profound impact that ADT can have on a patient’s quality of life. Former Ohio House Speaker Cliff Rosenberger sits for a portrait on March 15, 2016 at the Ohio Statehouse in Columbus, Ohio. He outlines a cascade of physical and emotional consequences from the treatment: “It meant loss of libido, loss of erectile function, loss of bone density, and it causes breast swelling, genital shrinkage and loss of muscle mass.”
Baker reflects on the emotional toll the treatment took on him: “I remember thinking, ‘I’ll never be whole again, and I’m not sure how I survive this. The treatment, let alone the disease.’” His honest testimonials speak to legions of folks who have fought the same fight but find themselves alone in their fight.
Liz Heggaton’s testimony about her husband’s deterioration illustrates the need for stronger support systems, as well. She recalls how Craig seemed to fall into despair: “And it was like he just fell into the abyss.” Liz had only limited success warning Craig’s doctors of the dangers of ADT side effects. She found it patronizing when the physician told her that very few patients had experienced an adverse reaction.
Advocating for Change
That’s why advocates like Baker and Liz Heggaton are working hard to raise awareness around prostate cancer treatment options and their potential side effects. They are motivated by their own heart-breaking journeys. They’re hoping to ensure that future patients receive full counsel about the risks of ADT. They will not allow any patients to go through treatment on their own.
Baker stresses the importance of informed consent: “He should have been told that the drug carries the very real risk of inducing depression and mood swings, and that it carries an increase in your risk of suicide.” He sees the lack of warnings about ADT as an incomplete diagnosis and even medical malpractice. He calls for a more robust support network for patients undergoing this treatment.
Professor Declan Murphy, a specialist in prostate cancer at Melbourne’s Peter MacCallum Cancer Centre, concedes that ADT remains an important part of treating advanced prostate cancer. One area that Dr. Cormican is especially passionate about addressing is supporting patients throughout their treatment. He states, “What we must do, though, is ensure that men don’t walk alone with the disease or its treatment.” Murphy highlights that “I think it’s likely that the burden of being diagnosed with metastatic prostate cancer itself is contributing to depression and suicide risk.”
