Cancer patients require better treatment for depression

By Sally Robertson, B.Sc.Aug 28 2014

Findings from three research studies have shown that around three quarters of cancer patients who suffer from major depression do not receive treatment for their depression and that a newly developed medical programme has proven more effective than standard care at reducing depression in these patients.

As reported in The Lancet Psychiatry, a data analysis of more than 21,000 patients across clinics in Scotland, UK, found that the frequency of major depression among cancer patients ranged from 6% in those with genitourinary cancer to 13% among those with lung cancer. However, almost three quarters of patients with major depression were not receiving any treatment to address the problem.

"Major depression is really quite common in people with cancer and the perhaps surprising finding is that most of it goes untreated,” says lead author Michael Sharpe from Oxford University, who adds that “the outcome with usual care is poor.”

A second paper published in The Lancet, reports on findings form the SMaRT Oncology-2 randomised trial which examined the effects of a new medical programme called “Depression Care for People with Cancer” (DCPC). This systematic programme integrates care from specialist cancer nurses and psychiatrists with the patient’s cancer care and involves the use of both antidepressants and psychological therapy.

The trial, which involved 500 patients with major depression but a good cancer prognosis, showed that DCPC was significantly more effective at treating depression than standard care. At 6 months, the severity of depression was at least halved in 62% of those who received DCPC, as compared with only 17% of those who received standard care.

Sharpe said:

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

A further study published in The Lancet Oncology describes a version of the DCPC that was adjusted for lung cancer patients with major depression who had a poor rather than good cancer prognosis. During a 32-week follow-up of 142 patients, the adjusted DCPC was found to be significantly more effective at improving patients’ depression than usual care was.

"We've described a new approach to managing depressed cancer patients that is based on the shortcomings of usual care, and integrated with cancer care, that really has quite spectacular effects in the good-prognosis patients and also has efficacy in the poor-prognosis patients," concludes Sharpe.