How Depression Derails Cancer Outcomes

As if cancer patients didn’t have enough to deal with, now there’s research that says people should have a positive attitude about being sick. A study published in the Journal of Clinical Oncology reported that patients who develop depression symptoms during their cancer treatment have higher mortality rates than those who maintain a positive attitude.

Researchers at Oregon Health and Science University in Portland studied the health outcomes of 1,700 patients recently diagnosed with lung cancer. These patients completed two mental health assessments that tested them for any depressive symptoms at the beginning of their diagnosis and then a year later. Those who reported depression at the beginning of their diagnosis and during their treatment were between 17 and 50 percent more likely to die.

Strong support systems can influence patients’ mental health.

Lung cancer is the second most common type of cancer to afflict men and women in the United States (prostate cancer is more common for men, breast cancer more common for women). Close to 160,000 patients die each year from lung cancer — by far the leading cause of death from cancer. Certain types of the disease, especially small cell lung cancer, have proved especially difficult to treat. Still, the U.S. has about 430,000 lung cancer survivors.

Depression often afflicts these cancer patients, in part because of the stigma surrounding lung cancer and the belief that they somehow deserved it — especially if they smoked. But not all lung cancer is smoking-related. And the fact that the disease is so often diagnosed in a late stage with few available treatments that offer any real chance at long-term survival — all of this it takes an emotional toll.

About one in four patients reports clinical depressive symptoms, usually manifested through extreme agitation, feelings of emptiness, loss of interest and pleasure in activities, and frequent thoughts of death and suicide. Some of this correlation in the Oregon study could be explained by the fact that cancer patients have a 2.5 times increased risk for committing suicide.

“This study cannot prove causation, but it lends support to the idea that surveillance for depression symptoms and treatment for depression could [have a] significant impact on patient outcomes, perhaps even a mortality benefit,” Dr. Donald R. Sullivan, lead author on the study, told Reuters.

[lz_bulleted_list title=”Lung Cancer in U.S.” source=”http://www.cancer.org”]Lung cancer is by far the leading cause of cancer death among both men and women; about 1 out of 4 cancer deaths are from lung cancer. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined.[/lz_bulleted_list]

An upbeat attitude could help — but some of the depression could be a direct result of more dire circumstances. Those patients with depression at the outset may have had a more serious prognosis. Patients who develop depression during treatment may find the treatments aren’t working for them.

Strong support systems can also influence patients’ mental health. People who have to fight cancer without the help of a spouse, children, or friend will likely develop depressive symptoms simply from the heavy burdens they must shoulder alone. The patients who have access to good medical care, with supportive social workers, family members, and health insurance to alleviate financial worries, may not develop depressive symptoms and may have advantages when it comes to treatment.

Related: Warriors in the Fight Against Breast Cancer

“Most of all, I believe a positive attitude, fighting spirit, and coping ability significantly impact a patient’s ability to persevere in the face of a life-threatening illness,” said Sullivan. “This is likely why married patients and those with strong social support networks have better cancer outcomes — having a community to help share the emotional burden is essential.”

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