Three-Quarters of Depressed Cancer Patients do not Receive Treatment for Depression; New Approach Could Transform Care

“Three papers published in The Lancet Psychiatry, The Lancet, and The Lancet Oncology reveal that around three-quarters of cancer patients who have major depression are not currently receiving treatment for depression, and that a new integrated treatment program is strikingly more effective at reducing depression and improving quality of life than current care.

“An analysis of data from more than 21,000 patients attending cancer clinics in Scotland, UK, published in The Lancet Psychiatry, found that major depression is substantially more common in cancer patients than in the general population. Major depression was most common in patients with lung cancer (13%) and lowest in those with genitourinary cancer (6%). Moreover, nearly three quarters (73%) of depressed cancer patients were not receiving treatment.

“To address the problem of inadequate treatment the SMaRT Oncology-2 randomised trial, published in The Lancet, evaluated the effectiveness of a new treatment program called ‘Depression Care for People with Cancer’ (DCPC). DCPC is delivered by a team of specially trained cancer nurses and psychiatrists, working in collaboration with the patient’s cancer team and general practitioner, and is given as part of cancer care. It is a systematic treatment program that includes both antidepressants and psychological therapy.”


Depression Associated With Less Definitive Therapy and Poorer Survival in Men With Clinically Localized Prostate Cancer

“In a population-based cohort study reported in the Journal of Clinical Oncology, Prasad et al found that men with depressive disorder prior to prostate cancer diagnosis were significantly less likely to undergo definitive therapy and had worse overall survival across all risk strata compared with their nondepressed counterparts…

“The study involved Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data from 41,275 men diagnosed with clinically localized prostate cancer between 2004 and 2007 and 1,894 men with a depressive disorder in the 2 years before prostate cancer diagnosis.

“Men with depression were older (48% vs 44% ≥ 75 years) and had more comorbidities (Charlson score ≥ 2 in 24% vs 12%) and were more likely to be white (84% vs 80%), unmarried (33% vs 22%), and to reside in nonmetropolitan areas and areas of lower median income (all P < .05). Men with depression were also somewhat more likely to have poorly differentiated/undifferentiated disease (61% vs 59%, P = .03), but did not differ from nondepressed patients in clinical stage or Gleason score. Depressed patients had more physician visits in the 2 years prior to prostate cancer diagnosis (mean, 43 vs 27, P < .001).”


Depressed Men with Prostate Cancer are Diagnosed Later Stage, Get Less Effective Therapies

“Depressed men with localized prostate cancer were more likely to be diagnosed with more aggressive prostate cancer, received less effective treatments and survived for shorter times than prostate cancer patients who were not depressed, a UCLA study has found.

“The negative outcomes may be the result of several factors such as bias against the mentally ill, depression’s impact on biological cancer processes, the depressed man’s lack of investment in his general health and disinterest in receiving more effective care, and missed opportunities by physicians to educate patients about prostate cancer screening and treatment, said study lead author Dr. Jim Hu, UCLA’s Henry E. Singleton Professor of Urology and director of robotic and minimally invasive surgery at the David Geffen School of Medicine at UCLA.

“The population-based observational study using patients from the Surveillance, Epidemiology and End Results (SEER) Medicare database focused on 41,275 men diagnosed with localized prostate cancer between 2004 and 2007 and observed through 2009. Of those, researchers identified 1,894 men with a depressive disorder discovered in the two years before the cancer was diagnosed.”


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.”


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.”


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.”


Cancer Patients Need Anxiety, Depression Screening

“It is important to recognize and treat anxiety or depression among cancer patients, according to a clinical guideline published online April 14 in theJournal of Clinical Oncology

“The panel recommends that all patients with cancer be evaluated for symptoms of depression and anxiety periodically throughout care. Validated, published measures and procedures should be used for assessments. Different treatment pathways are recommended depending on symptom level. The risk for poor quality of life and potential disease-related morbidity and mortality is increased by the failure to identify and treat anxiety and depression.”


Cancer Patients Need Anxiety, Depression Screening

“It is important to recognize and treat anxiety or depression among cancer patients, according to a clinical guideline published online April 14 in theJournal of Clinical Oncology

“The panel recommends that all patients with cancer be evaluated for symptoms of depression and anxiety periodically throughout care. Validated, published measures and procedures should be used for assessments. Different treatment pathways are recommended depending on symptom level. The risk for poor quality of life and potential disease-related morbidity and mortality is increased by the failure to identify and treat anxiety and depression.”


Cancer Patients Need Anxiety, Depression Screening

“It is important to recognize and treat anxiety or depression among cancer patients, according to a clinical guideline published online April 14 in theJournal of Clinical Oncology

“The panel recommends that all patients with cancer be evaluated for symptoms of depression and anxiety periodically throughout care. Validated, published measures and procedures should be used for assessments. Different treatment pathways are recommended depending on symptom level. The risk for poor quality of life and potential disease-related morbidity and mortality is increased by the failure to identify and treat anxiety and depression.”