75% of Cancer Patients With Depression Are Not Treated

Approximately 75% of cancer outpatients who experience major depression do not receive treatment for their depressive symptoms, according to a recent study published in 3 papers. However, researchers have developed an integrated treatment program to reduce symptoms and improve life quality.

After evaluating over 21,000 cancer patients in various clinics, researchers at the Universities of Oxford and Edinburgh discovered heightened depressive symptoms in cancer patients compared to the general public. They noted that depression was most associated with lung cancer (13%).
________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
The Role of Exercise for Patients With Cancer
Depression in the Elderly: How to Treat
________________________________________________________________________________________________________________________________________________________

In order to remedy the ineffective depression treatment, investigators developed Depression Care for People with Cancer (DCPC), which consists of trained oncology nurses and psychiatrists working collaboratively with the patient’s general practitioner to administer psychological therapy and antidepressants.

For the randomized, SMaRT Oncology-2 trial, researchers evaluated 500 cancer patients with depression (with a good prognosis) and compared the newly designed DCPC program to patients receiving regular care.

“The huge benefit that DCPC delivers for patients with cancer and depression shows 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,” said Michael Sharpe, MD, an author of the study and professor of psychiatry at the University of Oxford.

After 6 months, the results showed that 62% DCPC patients yielded a 50% decrease in their depressive symptoms compared to 17% of individuals receiving regular care.

Researchers noted that the benefits were maintained at 12 months.

Investigators also discovered that those under DCPC care had reduced levels of anxiety, fatigue, and pain.

Another trial was conducted including 142 participants (with a poor prognosis) with lung cancer and serious depression symptoms. Investigators noted that after a 32-week follow-up period, those receiving DCPC treatment showed a vastly heightened reduction in depression symptoms than those with typical care.

The researchers further noted that patients undergoing DCPC demonstrated a better overall quality of life.

The complete study is published in the August issue of The Lancet Psychiatry, The Lancet, and The Lancet Oncology.

-Michelle Canales

References:

Sharpe M, Walker J, Hansen CH, et al. Integrated collaborative care for comorbid major depression in patients with cancer (SMaRT Oncology-2): a multicenter randomized controlled effectiveness trial. Lancet. 2014 August [epub ahead of print] doi: 10.1016/S0140-6736(14)61231-9.

Walker J, Hansen CH, Martin P, et al. Prevalence, associations, and adequacy of treatment of major depression in patients with cancer: a cross-sectional analysis of routinely collected clinical data. Lancet Pyschaitry. 2014 August [epub ahead of print] doi: 10.1016/S2215-0366(14)70313-X.

Walker J, Hansen CH, Martin P, et al. Integrated collaborative care for comorbid with a poor prognosis cancer (SMaRT Oncology-3): a multicenter randomized controlled s trial with patients with lung cancer. Lancet Oncol. 2014 August [epub ahead of print] doi: 10.1016/S1470-2045(14)70343-2

University of Oxford. New approach could transform treatment of depression in cancer patients. August 27, 2014. www.ox.ac.uk/news/2014-08-28-new-approach-could-transform-treatment-depression-cancer-patientsAccessed. August 29, 2014.