The important role of mental health in cancer recovery

16 May 2016

New research shows colorectal cancer patients who have depression when they are diagnosed are significantly less likely to make a good recovery following surgery than patients without depression. The researchers say the groundbreaking study shows the important role mental health plays in cancer recovery and the need to cater for each patient's individual needs before, during, and long after their treatment has finished.

Depression affects patients' recovery

The new research is part of the largest study of its kind, by Macmillan Cancer Support and the University of Southampton - both in the United Kingdom - that is following the lives of over 1,000 colorectal cancer patients treated at 29 UK hospitals. The study covers the period from before surgery in 2010-2012 to at least 5 years afterward.

Prof. Jane Maher, joint chief medical officer of Macmillan Cancer Support, says people can live well after cancer, but only if they get the right support, and mental health can be a barrier to a good recovery. She notes: "We know that depression and anxiety often go hand in hand with cancer, but now we can see the extent to which people are struggling to live with these illnesses." Prof. Maher says the study shows depression affects patients' recovery more than whether or not their cancer is diagnosed early.

In a paper, the researchers described how they used health, quality of life, and well-being indicators to assess post-treatment recovery in the 2 years following colorectal cancer surgery.

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Depression linked with very poor quality of a patient’s life

The analysis shows that 1 in 5 colorectal cancer patients are depressed at the time of diagnosis. It also shows that patients depressed at time of diagnosis are 7 times more likely to be in very poor health 2 years after treatment has ended, compared with patients without depression. Indicators of this include, for instance, finding it very difficult to walk around, or being confined to bed.

Patients with depression are also 13 times more likely to have very poor quality of life, including, for example, experiencing problems with thinking and memory, or with sexual functioning, report the authors.

“Important mental health issues may get overlooked”

In their analysis, the researchers found that the patients fell into four different groups, each with its own recovery "journey." In particular:

  • Groups 1 and 2 fared "consistently well" and showed quality of health, quality of life, and well-being scores above or within normal range
  • Group 3 had some problems and
  • Group 4 fared consistently poorly. The team notes that "higher pre-surgery depression and lower self-efficacy were significantly associated with poorer trajectories" for health, quality of life and well-being after adjusting for other factors that could affect the outcomes such as "disease characteristics, stoma, anxiety and social support."

Macmillan warn that unless doctors ask cancer patients about other illnesses, concerns and worries, important mental health issues may get overlooked and they could miss out on vital support that affects their chances of making a good recovery.

Prof. Foster says their findings are just the beginning. She says there is now a need to assess how they apply to patients with different types of cancer and to make it easier for patients with depression to get help and access services.

Source: Medical News Today
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