Living with Depression Before or After Diagnosis May Impact Breast Cancer Survival
Michelle Milliken
According to the National Cancer Institute, up to 25% of cancer patients have depression. Meanwhile, in the world's general population, the World Health Organization says 5% of adults are impacted. These higher rates of depression among cancer patients make sense, as they come during a time when there is uncertainty and a sense of loss, but they could also play a role in survival, according to a new study.
Research recently published in Cancer, the journal of the American Cancer Society, has found that depression in breast cancer patients is linked with a lower survival rate. This was found to be true whether the patient had depression before or after treatment.
The study, conducted by researchers at the University of Kentucky Markey Cancer Center, analyzed data from the Kentucky Cancer Registry, focusing on adult women diagnosed with primary invasive breast cancer between 2007 and 2011. Of the 6,054 patients whose data was included, 4.1% had persistent depression, 3.7% had depression before diagnosis, and 6.2% developed it post diagnosis. The team also looked at how many patients received guideline-recommended breast cancer treatments, finding that 29.2% did not.
After a median follow-up period of four years, 26.3% of patients died, and the likelihood of death was found to be higher in two groups: Those with pre-diagnosis depression had a 26% higher risk of death, and those who developed depression after diagnosis were 50% more likely to die. However, there was not a similar association for those with persistent depression.
Those who had depression before their diagnosis were also 25% less likely to receive guideline-recommended treatment compared to those without depression, while those with post-diagnosis depression had a similar rate of recommended care to those without depression. Among all patients who didn’t get such care, the risk of death was 118% higher.
The team says their findings suggest that increasing diagnosis and treatment for depression could lead to better breast cancer outcomes.
Dr. Bin Huang, study co-author and director of population-based cancer research at the Kentucky Cancer Registry, explains, “A surprising result from this study is that patients with persistent depression did not experience worse survival compared with patients with no depression. Given that under-diagnosis and under-treatment of depression are common among cancer patients, persistent depression could be an indication that patients’ depression may have been well managed. Hence, this particular result suggests the importance of depression screening and management throughout a cancer patient’s care.”
The American Cancer Society says there are a few signs of depression to look for. Those include an ongoing feeling of sadness or hopelessness, a loss of interest or pleasure in things that used to be a source of joy, major weight loss or weight gain, sleep changes, wide mood swings, feelings of guilt or worthlessness, and frequent thoughts of death or suicide.
To help manage the condition, ACS says patients can seek treatment, be open with their loved ones about their feelings, seek out support groups or counseling, try deep breathing and relaxation exercises, and if applicable, turn to means of spiritual support.
For more resources and tips for dealing with depression and cancer, visit the American Cancer Society’s website.
