Depression Common For Cancer Patients, But Rarely Treated

The researchers also found that serious depression is more common for cancer patients than for the general population, and varies by type of cancer.

They also tested a new treatment program, with mental health care integrated into cancer treatment, which was much more effective at reducing depression and improving quality of life than current treatments, they found.

Cancer doctors focus on the cancer, but depression deserves attention and treatment too, said Dr. Michael Sharpe of Psychological Medicine Research at the University of Oxford Department of Psychiatry, who co-wrote all three papers.

He and his team analyzed data from more than 21,000 patients attending outpatient cancer clinics in Scotland who had been routinely screened for depression between 2008 and 2011. 

Depression was most common in people with lung cancer, affecting 13 percent of patients, followed by gynecological, breast and colorectal cancer and finally genitourinary cancer, for which six percent of patients were diagnosed as depressed. 

In the U.S. between 2007 and 2010, eight percent of people age twelve and older had experienced depression symptoms in any two-week period, according to the Centers for Disease Control and Prevention. 

 

A depression diagnosis was more likely for patients who were younger, and among those with lung or colorectal cancer, women.

Nearly three quarters of depressed cancer patients were not receiving treatment for depression, according to results in The Lancet Psychiatry.

Twenty-four percent were taking antidepressants and five percent were seeing a mental health professional, with a few doing both.

The researchers tested a new treatment program called 'Depression Care for People with Cancer' (DCPC) on 500 adults with clinical depression and a cancer with a good prognosis. 

The program requires a team of specially trained cancer nurses and psychiatrists. 

Working in collaboration with the patient's cancer team and general practitioner, they screen for depression and try different treatments, including antidepressants and therapy.

After six months, the severity of depression was reduced by at least half in 62 percent of patients who had mental health care integrated into cancer treatment, compared with 17 percent of patients who received their usual care, according to results in The Lancet.

“For the ones that were randomized to usual care, we made sure the patient understood that they had major depression, wrote to (the) primary care doctor to tell them that they had major depression, but the outcome was terrible,” Sharpe told Reuters Health by phone.

The researchers estimate DPCP would cost about $1,000 per patient.

“We made sure they did actually get and use antidepressants and psychological treatment,” Sharpe said. 

With cancer nurses continuing to see patients in a proactive way, if depression wasn’t improving, the treatment was continually changed, he said. MORE

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