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Many Cancer Patients Have Untreated Depression

NEW YORK (Reuters Health) - One in 12 cancer patients may have depression, which often goes untreated, new research shows. After screening more than 5,000 cancer patients, UK investigators estimated that 8 percent were depressed. However, only half of diagnosed patients had ever discussed their low mood with their doctors, and only 15 percent were receiving proper treatment for depression.

Depression is often tackled with a combination of therapy and prescription drugs. In an accompanying study, however, the researchers demonstrate that many cancer patients with depression also appeared to benefit from weekly visits with a specially trained nurse who encouraged them to adopt a positive and proactive approach to their problems and to seek help for their depression. Although doctors may be well aware that cancer patients are at risk of depression, many factors can prevent them from focusing their attention on that aspect of care, study author Dr. Michael Sharpe of the University of Edinburgh told Reuters Health. For instance, patients may hesitate to mention their mood, oncologists may be too busy to ask, and general practitioners may believe a cancer patient's needs are all being met by a cancer doctor, Sharpe explained.

Furthermore, even when doctors notice a patient is depressed, they may consider it to be an "understandable" side effect of cancer, and fail to take it seriously, the authors write in the British Journal of Cancer. "The common factor is that the focus of all concerned is on the cancer - and the depression gets ignored," Sharpe said. He added that he and his colleagues hope that, one day, treatment for depression will become a standard aspect of cancer patients' care, receiving the same attention as other symptoms like pain and fatigue. During the studies, Sharpe and his colleagues screened 5,613 patients attending an oncology clinic for depression, and asked those diagnosed with the condition about the care they had received. Most of the participants were outpatients with inactive cancer, who were no longer receiving treatment for their disease. In addition, Sharpe's team asked 30 cancer patients diagnosed with depression to participate in weekly discussions with a nurse about depression and how they can get treatment, and compared their progress to another 30 depressed cancer patients treated by their general practitioners.

Over the course of six months, 90 percent of nurse-treated patients but only half of the others were prescribed an antidepressant. By the end of the study, the researchers found that only 5 percent of patients who participated in weekly sessions still had depression, compared with 57 percent of patients whose treatment was left up to their general practitioners. Although there are many possible reasons why patients benefited from speaking with a nurse about their depression, Sharpe suggested that the most important factor may stem from being encouraged to take charge of their lives and problems. “Being helped to get back a feeling of being in control of their lives is a key factor in their recovery," Sharpe noted.