Positive Health Online

Abstract

WILLIAMSand DALE, Division of Health in the Community, Centre for Primary Health Care Studies, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK, have reviewed (68 references) the effectiveness of treatment for depression in cancer patients.   

Background

Depression is common in cancer patients, and this often remains undetected and untreated. Depression has been associated with poorer quality of life, in addition to increased impairment of immune response and poorer survival in cancer patients. Previous systematic reviews and meta-analyses of the efficacy of interventions for cancer patients with depression have failed to distinguish between depression and depressive symptoms.

Methodology

Systematic literature review.

Results

There is limited trial data on the efficacy of prescribed antidepressants in reducing the incidence of major depression and depressive symptoms in cancer patients. Contrary to previous reviews that failed to distinguish between depressive symptoms and depression, this review found very little data from clinical trials to demonstrate that psychotherapeutic interventions are effective in reducing depression in cancer patients. A number of small-scale, single-centre trials indicated that psychotherapeutic interventions (especially cognitive behavioural therapy) can have effects on depressive symptoms in cancer patients. However, given the methodological limitations of studies to date, lack of evidence should not be interpreted as implying lack of efficacy.

Conclusion

There is a need for adequately powered studies of pharmacological and psychotherapeutic interventions, which are targeted at cancer patients with a diagnosis of depression and include monitoring of the use of other pharmacological, psychotherapeutic and CAM interventions.

References

Williams S, Dale J. The effectiveness of treatment for depression/depressive symptoms in adults with cancer: a systematic review. British Journal of Cancer 94 (3): 372-390, Feb 13, 2006.

Comment

The above cancer research is a wonderful illustration of the axiom that perhaps the most important part of any research study is the question and how it is asked. Whereas the first question affirms that a psycho-social approach will enrich the effects complementary therapies, the second two studies have a condescending attitude, i.e. that physicians should lean more about CAM therapies so that they may make better recommendations, or that more research about depression should focus upon whether CAM treatments are effective, alongside psychotherapeutic approaches and pharmacological drugs. It is probably an unavoidable given that cancer patients will suffer some sort of depression. Such a diagnosis is after all, not a recipe for joy. Recognizing depression, accepting it and moving forward will inevitably be an individual story for each cancer patient.