Depression and Anxiety
This is a really interesting study from the British Journal of Cancer about the prediction of depression and/or anxiety in cancer patients. The hypothesis was that people with more serious diagnoses were more likely to be depressed. Although this was mostly true, it did not hold up for women with breast cancer. I have been thinking about this and have several rather vague ideas.
First, breast cancer is so public that almost all women have intense visceral reations to the diagnosis--even more they themselves are diagnosed. That is, information about breast cancer surrounds us, and some women assume that it will eventually get us all. The current figure of 1 in 8 for US women is certainly not good, but it is far from everyone. Second, it has been my experience that the stage of breast cancer at diagnosis makes little difference in the intensity of the response. Some women with DCIS are seemingly just as frightened as some women with Stage III cancer. The contributing factors seem to have more to do with the individual, her own history and issues, her assumptions/beliefs about cancer--and, of course, the experience with her medical team. Not that I would wish that anyone with a later stage diagnosis would be more frightened (would wish for just the opposite), but this does seem to indicate that we need to do a better job of educating and reassuring women who are much less at risk for recurrence. Unfortunately, we all know that no one gets a promise, but there is also no data to support panic and depression among some women who struggle with those feelings. And, remember, that most women who are properly treated for their particular situation do well.
Anyway, here is the abstract and then a link to read more:
Disease stage predicts post-diagnosis anxiety and depression only in some types of cancer
We hypothesised that patients with advanced disease or a cancer type that has a poor prognosis may be more likely to report anxiety and depressive symptoms after diagnosis; younger age and female gender may moderate these effects.
METHODS: Patients (n¼3850) were consecutively assessed with PSSCAN, a standardised, validated tool, at two large cancer centres between 2004 and 2009.
RESULTS: Female patients reported more anxiety and depressive symptoms (P¼0.003 to Po0.001) compared with men and a healthy
comparison group. Older age was associated with fewer anxiety (P¼0.033 to Po0.001) and fewer depressive symptoms (Po0.001), but this was not true for lung cancer. Presence of metastases was associated with more anxiety symptoms in patients with gastrointestinal (P¼0.044; R2D¼0.001), lung (P¼0.011; R2D¼0.016), and prostate (P¼0.032; R2D¼0.008) cancer, but this was not true for breast cancer. Furthermore, early disease stage was associated with fewer depressive symptoms among older
prostate cancer patients (P¼0.021; R2D¼0.008). Men with early lung cancer reported fewer anxiety (P¼0.020; R2D¼0.013) and depressive (P¼0.017; R2D¼0.016) symptoms than men with advanced disease or women.
CONCLUSION: As hypothesised, disease stage was directly associated with emotional distress, except for patients with breast cancer.
Furthermore, age and gender moderated some of these effects.
British Journal of Cancer (2011) 105, 1814-1817. doi:10.1038/bjc.2011.503 www.bjcancer.com
Published online 17 November
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