Cancer-Related Depression

Excerpt:

“Being diagnosed with cancer is a stressful, life-changing event that can evoke feelings of fear, worry, sadness, and anger. Depression gives one feelings of hopelessness and helplessness, disinterest in previously enjoyable activities, and a consistently down and sad mood. Depression often interferes with one’s ability to work, sleep, eat, and enjoy life. Patients with cancer are especially at risk for depression because of the physical changes and limitations from symptoms and treatment as well as of the uncertainty their treatment holds on their lives.”

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Psychological Effects From ADT a Growing Challenge in Prostate Cancer

Excerpt:

“Androgen-deprivation therapy (ADT) can be associated with significant psychological effects in patients with prostate cancer.

“Additionally, these side effects—which include depression, Alzheimer disease, and coronary disease—are often underreported by patients, according to Heather Jim, MD.

“ ‘It is really important for the clinician to let [patients] know that a lot of men experience this. Let’s get them help and try to help them feel better,’ said Jim, who discussed these significant events in her lecture at the 2016 OncLive State of the Science Summit on Genitourinary Cancers.”

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Hormone Therapy for Prostate Cancer Tied to Depression

Excerpt:

“Hormone therapy for prostate cancer may increase the risk for depression, a new analysis has found.

“Hormone therapy, or androgen deprivation therapy, a widely used prostate cancer treatment, aims to reduce levels of testosterone and other male hormones, which helps limit the spread of prostate cancer cells.

“From 1992 to 2006, researchers studied 78,552 prostate cancer patients older than 65, of whom 33,382 had hormone therapy.”

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End of Life Planning Does Not Make Cancer Patients Hopeless or Anxious

“For a small group of advanced cancer patients, using an online tool for learning about end-of-life medical decisions and developing an advance directive document did not lead to psychological distress, according to a new study.

“ ‘One thing we noticed is that many patients with advanced cancer had not had these conversations,’ said lead author Dr. Michael J. Green of the humanities and medicine departments at Penn State College of Medicine in Hershey, Pennsylvania.

“ ‘When we talked to the oncologists about it, a response we heard again and again is, “it’s not appropriate at this time, it’s going to make them anxious, take away their hope”,’ Green told Reuters Health.

“He and his team set out to see if it was true that working through end of life planning took away cancer patients’ hope or raised their anxiety levels.

“They used an interactive decision aid with audio and video elements called ‘Making Your Wishes Known: Planning Your Medical Future, (MYWK) which is available online.”


Worse Anxiety/Depression Symptoms in Patients Adopting ‘Helper’ Role in Breast Cancer Internet Support Group

“In a study reported in the Journal of Clinical Oncology, Lepore et al found that patients assigned a helper role in a breast cancer Internet support group had worse anxiety/depression symptoms after completion of the intervention than those not assigned a helper role…

“In the study, 183 women diagnosed in the past 36 months with nonmetastatic breast cancer who reported elevated anxiety or depression were randomly assigned to a standard Internet support group condition (n = 95) or an enhanced prosocial condition (n = 88). Both conditions included professionally facilitated live 90-minute weekly chat sessions for 6 weeks and access to a discussion board…

“The investigators concluded: ‘Despite the successful manipulation of supportive behaviors, the [prosocial Internet support group] did not produce better mental health outcomes in distressed survivors of breast cancer relative to [a standard Internet support group]. The prosocial manipulation may have inadvertently constrained women from expressing their needs openly, and thus, they may not have had their needs fully met in the group.’ ”


Women with Breast Cancer Demonstrate Elevated Long-Term Risk for Depression

“Women with breast cancer demonstrate increased risk for depression several years after diagnosis, according to study results.

“Nis P. Suppli, MD, of the Danish Cancer Society Research Center in Copenhagen, Denmark, and colleagues used Danish national registries to obtain data on nearly 2 million women who had no diagnosis of cancer and no major psychiatric disorder.

“Researchers followed the cohort from 1998 to 2011 and tracked incidence of breast cancer diagnoses. They also monitored for two outcome measures, first hospital contact for depression and redeemed prescriptions for antidepressants.

“Suppli and colleagues identified 44,494 women diagnosed with breast cancer during the study period.

“During the first year after diagnosis, the rate ratio for first hospital contact for depression was 1.7 (95% CI, 1.41-2.05), and the ratio remained significantly elevated after 3 years of diagnosis. The rate ratio for redemption of prescriptions for antidepressants was 3.09 (95% CI, 2.95-3.22), and the ratio remained significantly elevated 8 years after diagnosis.”


Men Who 'Monitor' Their Prostate Cancers Have High Quality of Life

“Men who decide with their doctors to keep a close eye on their prostate cancer – instead of treating it right away – tend to have physical and mental wellbeing equal to or better than men who opt for immediate treatment, suggests a new analysis.

“Additionally, the men who decided to track their cancers in a process known as “active surveillance” did not appear to suffer added emotional stress, researchers found.

” ‘The men in our study did not appear to suffer from any major negative psychological impacts, including anxiety and depression,’ said Dr. Lara Bellardita, the study’s lead author from the IRCCS Foundation’s National Cancer Institute in Milan, Italy.

“Prostate cancer usually grows very slowly. Men often opt for active surveillance to avoid or delay the side effects that can come with treatment, such as erectile dysfunction, urinary incontinence, and gastrointestinal problems, said Bellardita.

” ‘These slow growing tumors do not necessarily need aggressive local treatment and can be safely followed with active surveillance,’ said Dr. Marc A. Dall’Era, who wasn’t involved with the new study but is a urologist at the University of California, Davis.”


Evolution: Breast Reconstruction After Mastectomy

“Women who want breast reconstruction after mastectomy have several options with respect to timing, type of procedure, and materials used. Here, plastic surgeon M. Whitten Wise, MD, reviews the options and discusses considerations relevant to each procedure.

“Breast cancer remains a key women’s health issue. When presented with the diagnosis of breast cancer women face the choice of lumpectomy (usually accompanied by breast radiation) versus mastectomy. And while lumpectomy rates remain high, mastectomy numbers are climbing. This is driven in part by several distinct subsets of women: those seeking to avoid radiation therapy, those looking to reduce their risk for disease recurrence, and by a dramatic increase in women seeking prophylactic mastectomy.

“Prophylactic mastectomy may be performed in the contralateral breast or prophylactically in both breasts to help prevent the development of breast cancer (especially among those patients with one of the genetic mutations predisposing women to breast cancer, such as the BRCA gene mutations).

“The majority of patients choosing mastectomy are candidates for immediate reconstruction at the time of mastectomy. This allows them to avoid additional surgeries and recovery times. It provides significant psychological benefits by allowing women to feel ‘whole,’ with reduced incidences of depression, anxiety and low self-esteem. Importantly, immediate surgery improves the aesthetic result of the reconstruction by preserving the breast skin envelope to reduce the extent of scarring and to maintain the natural breast shape. This allows the breast reconstruction to replace only the missing breast tissue under the preserved breast skin.”


Report Card on Complementary Therapies for Breast Cancer

“Over eighty percent of breast cancer patients in the United States use complementary therapies following a breast cancer diagnosis, but there has been little science-based guidance to inform clinicians and patients about their safety and effectiveness. In newly published guidelines from the Society for Integrative Oncology, researchers at Columbia University’s Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center with colleagues at MD Anderson Cancer Center, University of Michigan, Memorial Sloan Kettering, and other institutions in the U.S. and Canada, analyzed which integrative treatments appear to be most effective and safe for patients. They evaluated more than 80 different therapies.

“Meditation, yoga, and relaxation with imagery were found to have the strongest evidence supporting their use. They received an “A” grade and are recommended for routine use for anxiety and other mood disorders common to breast cancer patients. The same practices received a “B” grade for reducing stress, depression, and fatigue, but are also endorsed for most breast cancer patients. Acupuncture received a “B” grade for controlling chemotherapy induced nausea and vomiting and can be recommended to most patients. More than 30 interventions, including some natural products and acupuncture for other conditions, had weaker evidence of benefit due to either small study sizes or conflicting study results, and received a “C” grade. Seven other therapies were deemed unlikely to provide any benefit and are not recommended. One therapy was found to be harmful: acetyl-l-carnitine, which is marketed to prevent chemotherapy-related neuropathy, and actually increased risk for the condition.”