Depression Among Cancer Patients–A Reality Where Therapeutic Nihilism Cannot be Accepted

Abstract

Introduction

Cancer is a life-threatening disease, characterized by a great deal of uncertainty and unpredictability. Thus, several stressors and emotional upheavals pervade the everyday life of cancer patients and can lead to the development of depression.

Objectives

To review the recent research related to depression in cancer patients.

Methods

Literature review based on PubMed/MEDLINE, using the keywords “cancer” and “depression”.

Results

It is estimated that 20–25% of cancer patients meet the criteria for major depressive syndrome at some point in their illness. Depression is associated with a negative impact on treatment adhesion, cancer progression and quality of life, besides increasing suicide risk. However, it is often unrecognized and untreated. Importantly, the mistaken belief that depressive symptoms are expected in this group, the overlap between the neurovegetative symptoms of depression, the somatic symptoms of cancer and its treatment, as well as the effects of comorbid diseases make the diagnosis of major depression so complex in these patients. Some of the most helpful diagnostic indicators are feelings of hopelessness, worthlessness, excessive guilt, loss of self-esteem, and wishes to die. The several risk factors for the development of depression in cancer patients can be divided into four broad categories, namely cancer-related factors, cancer treatment-related factors, psychiatric history, and social factors. Effective management of depression consists in a combination of psychotherapy and psychopharmacology.

Conclusion

Depression in cancer patients has serious consequences, however appropriate psychiatric intervention can do it over. Thus, its early recognition and appropriate management is imperative.

Disclosure of interest

The authors have not supplied their declaration of competing interest.