Depression untreated in many cancer patients, new approach could help

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Recent papers have revealed that nearly three quarters of depressed cancer patients do not receive any form of treatment for their depression. However, a new integrated treatment program, found to be distinctly more effective than current forms of care, could change things.

The papers, published in The Lancet Psychiatry, The Lancet and The Lancet Oncology, have examined the prevalence of depression within cancer sufferers and assessed a new program of integrated treatment that could revolutionize the care of depression.

Depression is a serious mental illness that can severely affect a person’s daily routine and quality of life. About 6.7% of American adults have the condition. Although there is no proof of a causal link between depression and cancer, the strong emotions associated with a cancer diagnosis can develop into depression over time.

Untreated depression

The paper published in The Lancet Psychiatry reports on a data analysis from over 21,000 cancer patients attending clinics in Scotland, UK. The researchers found that major depression was much more likely to be found in cancer patients than in the general population.

Major depression was most common in lung cancer patients (13%) and least likely to be found in genitourinary cancer patients (6%). Most worrying, however, was the finding that 73% of depressed cancer patients in the study were found to be not receiving treatment for their depression.

This fact is particularly distressing as the National Institute for Mental Health (NIMH) report that depression can affect the course of a patient’s cancer as well as their ability to receive treatment.

A new treatment program

A new program for treating depression was assessed in a paper published in The Lancet, which could go some way to addressing the issue of depressed cancer patients not receiving the optimum levels of care.

Common symptoms of depression

  • Constant feeling of sadness and emptiness
  • Irritability and restlessness
  • Loss of interest in activities or hobbies that were previously enjoyed
  • Fatigue
  • Disturbed sleep patterns
  • Increased or loss of appetite
  • Aches and pains
  • Suicidal thoughts.

The Depression Care for People with Cancer program (DCPC) is a systematic treatment program delivered by a team of specialist cancer nurses and psychiatrists working together with the patient’s cancer team and doctor. The delivery utilizes both antidepressants and psychological therapy.

The study, led by Prof. Michael Sharpe, examined 500 adults who had both major depression and cancer with a good prognosis and randomly assigned them to receive either DCPC or the standard form of care: support from a doctor who may prescribe antidepressants or refer patients to mental health services.

After 6 months, the researchers found that the patients receiving DCPC were faring significantly better.

Of the 253 patients receiving DCPC, 62% responded to treatment (defined as experiencing at least a 50% reduction in the severity of their depression), compared with only 17% of patients receiving usual care.

The researchers found that this benefit was also maintained after 12 months and led to improvements in most depression symptoms.

Improving patients’ lives

DCPC was also trialed in patients with poor prognosis cancer and reported on in The Lancet Oncology. Researchers tested a specially adapted version of DCPC against the usual form of care with 142 patients with lung cancer and major depression.

As in the previous study, the patients who received DCPC experienced a significantly better improvement in their depression than those receiving usual care, during a follow-up period of 32 weeks. Again, DCPC also improved the patients’ anxiety, functioning and overall quality of life.

Dr. Jane Walker, leader of the study, said results indicated that the new integrated treatment program could achieve great improvements:

“Patients with lung cancer often have a poor prognosis. If they also have major depression that can blight the time they have left to live. This trial shows that we can effectively treat depression in patients with poor prognosis cancers like lung cancer and really improve patients’ lives.”

This collection of research, conducted by teams from the Universities of Oxford and Edinburgh in the UK, could prove to be greatly beneficial for depressed cancer patients. Prof. Sharpe stated that the findings illustrate “what we can achieve for patients if we take as much care with the treatment of their depression as we do with the treatment of their cancer.”

 

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