Cancer and Depression

A patient perspective

BACKGROUND

Depression is a comorbid disabling syndrome known to affect between 10 to 20% of cancer patients[1] [2]. Some estimates indicate that rates could be as high as 58%.[3] Depression in individuals with cancer has been associated with poorer health outcomes and when left untreated, an increased likelihood of early death.[4] Cancer patients suffering from depression are also at heightened risk of suicide, particularly those with head and neck cancers, who have the highest incidence of suicide across all oncology populations. [5] [6] [7] [8]

The type of treatment therapy (i.e., surgery, chemotherapy, radiotherapy, etc.) also have an impact on a patient’s psychological functioning as they can incur physical changes such as amputations, hair loss, etc., or symptoms such as fatigue, pain and nausea.[9]Today, only around 20 to 30% of cancer patients with psychiatric disturbances are recognised as having such conditions and receive adequate treatment.[10] Depression has been found to be one of the most difficult psychiatric problems to diagnose in cancer patients. Indeed, many symptoms of cancer and side effects of treatment may be confused with the symptoms of depression, such as weight loss, sleep problems, fatigue/anergia, and difficulty concentrating. Depressive symptoms may also be difficult to distinguish from other difficulties associated with cancer such as pain, or adjustment to the cancer diagnosis. [11] [12]

Cancer patients with a pre-existing depression diagnosis also face significant challenges. Despite the heterogeneity of the available studies, the evidence for the role of mental disorders in tumor progression and cancer-related mortality has been rapidly accumulating[13]. Cancer can be poorly treated or overlooked, with the symptoms misattributed as an expression of the mental disorder due to ignorance, stigma or discrimination.[14] [15] Their cancer diagnosis and side-effects of treatment also often lead to a worsening of depressive symptoms, which is often not adequately addressed.  [16]

It is a spiral of decline and suffering that needs to be broken. Proper preventative measures, diagnosis, treatment and monitoring that address and respects both the physical and the mental conditions are essential for the well-being of cancer patients and their quality of life. This requires that patients, their caregivers and practitioners have the proper attitudes and knowledge to identify depression in cancer patients and vice versa. National health services need to adapt to the fact that physical conditions and depression do not exist in isolation but are interrelated. Awareness needs to be raised about the specific symptoms of these illnesses to help patients recognize early signs. Lastly, cooperation between the different stakeholders involved in the interface between mental and physical disorders is essential.

References 

 

OBJECTIVES

Through the proposed project, GAMIAN-Europe will aim to achieve the following:

Raise awareness on the issue of depressions as a cancer co-morbidity. In particular relating to:

  • The importance of early intervention for identifying and treating depression in cancer patients (cancer associated or pre-existing)
  • The specificities of symptom display in cancer patients (as opposed to non-cancer patients)

Gather in-depth patient accounts on the issue of co-morbidity, with an emphasis on:

  • Negative experiences of care for patients suffering from both cancer and depression as well as the views of caregivers
  • Success life stories of people who managed and dealt with comorbidity.

Gather information from relevant stakeholders such as patients, clinicians, researchers and EU and national policy makers regarding the challenges of comorbidity, focusing particularly on:

  • The obstacles to detection and diagnosis of depression in cancer patients, and cancer in depressed patients
  • The risk factors associated with developing depression in cancer patients
  • The main barriers to accessing adequate treatment for depression in people with cancer

Encourage a dialogue between patients, clinicians and other stakeholders to be used as a basis for policy recommendations for EU and national policy makers

 

If you are interested in supporting this project, please contact us at executive.director@gamian.eu

If you want to help GAMIAN-Europe, please donate by transfering your gift on the GAMIAN- Europe account

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