Depression and cancer: 10 things you should know

At first glance, the connection between a cancer diagnosis and depression might seem to be an obvious one. However, in patients battling this life-threatening disease, depression can have a serious impact, and even worsen the odds of survival. While the best approach to interrupting this vicious cycle is not fully understood, clinicians can help patients improve their odds by availing them of therapeutic resources and open communication.

HemOnc Today presents 10 “fast facts” about the correlation between depression and cancer.

1. Depression can decrease cancer survival.

In a study of 217 patients with newly diagnosed metastatic renal cell carcinoma, researchers found that patients demonstrating depressive symptoms had significantly poorer survival than those who were not depressed. Read more

2. Depression often goes unrecognized in patients with cancer.

According to the National Cancer Institute, depression occurs in roughly 25% of patients with cancer, but often goes undetected. This may be due to patient embarrassment about being depressed, or clinician discomfort about discussing mental health issues with patients. Read more

3. Depression may vary based on time and stage of cancer.

The time and stage of a cancer may cause a patient’s depression to recede or intensify. Patients are more susceptible to depression during advanced stages of cancer, and also when their pain is poorly controlled. Read more

4. Patients with head and neck cancer are especially vulnerable to depression.

Patients with head and neck cancer, especially those who are unmarried, are at particularly high risk of developing depression. However, a recent study has found that the use of the selective serotonin reuptake inhibitor citalopram, taken prior to treatment, may alleviate symptoms of depression in these patients. Read more

5. A combination of shortened telomeres and depressive symptoms is associated with a threefold increased mortality in patients with bladder cancer.

In a study published in 2012, researchers found a correlation between the combination of depression and shortened telomeres length caused a threefold increase in bladder cancer mortality. Depression was also independently linked to bladder cancer in these patients. Read more

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6. Children with cancer also suffer from depression.

The challenges of cancer treatment are difficult for patients of all ages, and children are not exempt. According to a study conducted by researchers across the United States, children become distressed not only by cancer diagnoses, but also by scarring, hair loss and other “disfigurements” incurred through cancer treatment. Read more

7. Depression treatment may not improve lung cancer survival.

Although a connection has been made between depression and metastatic lung cancer, a study found that patients using antidepressants and mental health visits did not derive survival benefits from this palliative care. Read more

8. Socioeconomic status is linked with depression, anxiety.

In women diagnosed with ductal carcinoma in situ, those with lower or medium socioeconomic status were more likely to experience depression and anxiety than women of high socioeconomic status, according to a study published in 2010. Read more

9. Telephone counseling may improve symptoms of depression and pain.

Patients with cancer who were involved in a telephone-based care management program, coupled with an automated, home-based symptom monitoring system, demonstrated significant improvements in both pain and depression, according to a study. Read more

10. It is important to ask patients with cancer about suicidal thoughts.

Some physicians advocate the use of “psycho-oncology,” the study of cancer’s psychological effects on patients. Because cancer patients reportedly commit suicide at twice the rate of the general population, it is incumbent upon the oncologist to ask patients about their mental state, and specifically about thoughts of suicide. Read more