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Depression Often Not Treated

Posted 9/12/2014

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  Without giving it much thought, most non-cancer people likely would assume that cancer and depression often go hand in hand.  Those of us who reside in Cancer World likely would dispute or at least not automatically accent that belief. Of course some cancer patients have major depression, but most studies have found that the incidence parallels that in the general population--meaning that the same percentage of cancer patients have major depression as a similar pool of people without cancer.

  Most certainly, virtually everyone who is diagnosed with cancer experiences at least a few "dark nights of the soul". This is very different from clinical depression and won't respond to medications that can be so helpful for those with that problem. Being sad or scared or sick is not the same as being clinically depressed--although it may look the same for a while or to someone who is less well informed.

  I have a still disturbing memory, from more than 25 years ago, of asking a psychiatrist to evaluate a patient whom I thought was depressed and in need of meds. The psychiatrist came out of the exam room shaking his head, saying: "If I had that diagnosis, I would be depressed, too." Not helpful. What this incident taught me is that depression in cancer patients can only be well assessed by clinicians with some experience with cancer patients. There is a very big difference between a normal sadness and anxiety vs. major depression, and it cab be tough to distinguish between them. In my experience, patients often know which is which and can accurately iagnose themselves. We need to ask and to listen.

  The flip side of assuming that many/most cancer patients are depressed is not recognizing those who truly are and need help to feel better. People who have a family or a personal history of depression are more at risk. This study from the UK suggests that many depressed cancer patients are not recognized and treated and suggests a way to change that. All good.

  Depression more common for cancer patients, but rarely treated
BY KATHRYN DOYLE (note from Hester: most studies do not support the "more common" part)

NEW YORK (Reuters Health) – Three new studies by researchers at the Universities of Oxford and Edinburgh in the U.K. reveal that three-quarters of depressed cancer patients are not receiving treatment for depression.

The researchers also found that serious depression is more common for cancer patients than for the general population, and varies by type of cancer.

They also tested a new treatment program, with mental health care integrated into cancer treatment, which was much more effective at reducing depression and improving quality of life than current treatments, they found.

Cancer doctors focus on the cancer, but depression deserves attention and treatment too, said Dr. Michael Sharpe of Psychological Medicine Research at the University of Oxford Department of Psychiatry, who co-wrote all three papers.

He and his team analyzed data from more than 21,000 patients attending outpatient cancer clinics in Scotland who had been routinely screened for depression between 2008 and 2011.

Depression was most common in people with lung cancer, affecting 13 percent of patients, followed by gynecological, breast and colorectal cancer and finally genitourinary cancer, for which six percent of patients were diagnosed as depressed.


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