Cancer Patients’ Depression Often Goes Untreated

As if cancer alone were not a big enough burden to bear, people with depression on top of cancer often aren’t treated for their mental problem.

A recent study of 21,000 cancer patients showed that the vast majority of clinically depressed cancer patients receive no treatment for their depression.

The study, published in The Lancet Psychiatry, analyzed patients with breast, lung, colorectal, genitourinary or gynecological cancer. All had participated in routine screening for depression in cancer clinics, where the results indicated major depression ranging in as many as 11 in 100 people in each cancer group. The majority were not receiving potentially effective treatment.

According to one study by the National Institutes of Health (NIH), solid evidence shows that as many as half of patients diagnosed with solid tumors have depression. The American Cancer Society pegs the depression ratio of cancer patients at 1 in 4.

That these patients aren’t being treated for a serious, underlying disorder in addition to their cancer is not just careless medicine, but short-sighted: Clinically depressed cancer patients, as explained by MedPage, have higher rates of suicidal thoughts and are less likely to adhere to their cancer treatment.

“Comorbid depression,” which means that it occurs in addition to the primary disease, often makes treating the cancer more difficult, due to anxiety, pain, fatigue and the fact that depression compromises one’s general ability to function.

Two companion articles to the Lancet study showed that people who received treatment for their depression as an integral part of their cancer treatment improved. (One study was in The Lancet, and one in The Lancet Oncology.)

As of 2015, in a better-late-than-never response, the American College of Surgeons’ Commission on Cancer will require U.S. cancer centers to screen patients for psychosocial distress, including depression.

Treating a diagnosed problem, of course, is another matter. Effective treatment requires caregivers to appreciate the magnitude of the problem. Many ill people have the blues, but clinical depression is life-threatening. As MedPage Today noted, current data are insufficient to address basic questions regarding depression in cancer patients, and even the few high-quality studies that looked at the situation didn’t adequately assess how common depression is in cancer patients. That’s what the Lancet study did.

Of the 21,151 patients with complete clinical data and who had been screened for depression:

  • 1,599 were diagnosed of major depression;
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