Cancer Therapy AdvisorHelp Wanted, Help Needed: Anxiety and Depression in Patients with Cancer

Unmasking the Silent Suffering: The Prevalence and Management of Anxiety and Depression in Cancer Patients

The mental health of cancer patients is a critical aspect of their overall well-being that often goes unnoticed. The prevalence of anxiety and depression among these patients is significantly higher than in the general population, and these disorders can occur at any point along the cancer trajectory. This article sheds light on this important issue and discusses the latest guidelines for management.

Key Points

• The chaotic first year of the COVID-19 pandemic triggered a 25% increase in the global prevalence of anxiety and depression, according to a scientific brief prepared by the World Health Organization.
• Anxiety, depression, and other mental health disorders are significantly more prevalent in people with cancer than in the general population.
• These disorders can occur at any point along the cancer trajectory—from diagnosis to initial treatment, from active treatment to follow-up, from remission to recurrence, and from long-term survivorship to end-of-life care.
• In a study of more than 20,000 patients with cancer in Scotland, 7.5% were diagnosed with major depressive disorder. Among them, 73% did not receive any potentially effective treatment.
• The oncology community is acting on the need to pay better attention to the mental health needs of patients living with and survivors of cancer.
• In April 2023, the American Society of Clinical Oncology (ASCO) issued a comprehensive update to its guidelines for management of anxiety and depression in adult survivors of cancer.
• The guideline emphasizes that identifying and treating patients with cancer and comorbid psychiatric disorders, “either pre-existing or newly arising, remains imperative”.

Data show that anxiety and depression in cancer survivors is associated with diagnostic and treatment delay, non-adherence to therapy, diminished efficacy of chemotherapy, increased symptom burden and diminished function, rising rates of suicide among survivors, greater burden on families, increased cost of care, and shorter survival.
— Julia Rowland, PhD, co-chair of the ASCO guideline panel and Senior Strategic Advisor at the Smith Center for Healing and the Arts in Washington, DC

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