Anxiety and depression a major issue for cancer survivors

December 17, 2016, European Society for Medical Oncology

Cancer has a major impact on mental and physical wellbeing, researchers report at the ESMO Asia 2016 Congress in Singapore.

Results from a Malaysian study of 1,362 patients found more than four in five survivors were suffering from anxiety and a similar number had depression a year after diagnosis.

Lead author Shridevi Subramaniam, a research officer at the National Clinical Research Center, Ministry of Health Malaysia, Kuala Lumpur, Malaysia, said: "We urgently need new ways of supporting survivors and addressing wider aspects of wellbeing.

"Instead of just focusing on clinical outcome, doctors must focus equally on quality of life for cancer patients especially psychologically, financially and socially."

Researchers included Malaysian patients from the ACTION study (ASEAN Cost in Oncology Study) and nearly a third (33%) had breast cancer. They filled in questionnaires to assess health-related quality of life (HRQoL). Anxiety and depression levels were also included in the survey.

A patient's satisfaction with their physical health and mental wellbeing- or health-related quality of life—is an important end result in cancer care. But the study showed that patients' mental and physical wellbeing was low overall 12 months after diagnosis. The more advanced the cancer, the lower the HRQoL.

The type of cancer was also a factor because disease severity differs. Women with reproductive system cancers, for example, had higher wellbeing scores than lymphoma patients. This could be explained by the fact that lymphoma is often aggressive and progresses quickly while reproductive system cancers, such as cervical, can spread slowly over a number of years. "The key message is to focus more on supporting patients throughout their whole cancer 'journey' especially in their lives after treatment," added Subramanian.

Young pay high mental and social 'cost' for cancer diagnosis

Cancer also has a significant impact on the lives and wellbeing of adolescents and young adults, as reported in a separate ongoing study.

Researchers set out to identify the extent of wellbeing issues and other problems in this group who not only are at major milestones in their lives but also do not expect to develop the disease. The study included patients who were newly diagnosed with cancer (n=56) and with an average age of 28. They completed a survey including questions on occupation and lifestyle, and were also asked about problems around physical symptoms, mental wellbeing and financial issues

Results showed more than a third (37%) were suffering distress at diagnosis of cancer. Nearly half identified the top cause as treatment decisions, followed by family health issues, sleep and worry.

Senior author Associate Professor Alexandre Chan, Department of Pharmacy, National University of Singapore and Specialist Pharmacist, National Cancer Center, Singapore, said: "The young differ from older people because they don't expect to be ill, and certainly not with cancer. They're also at a stage when they're facing many social responsibilities and family burdens. "That's why they need effective supportive care and help in managing the physical, psychological and emotional side-effects that come with both and treatment."

Commenting on these studies, Ravindran Kanesvaran, assistant professor, Duke-NUS Medical School, and Consultant Medical Oncologist, National Cancer Center, Singapore, said: "There is a critical need to find ways of addressing the high levels of distress among in general as highlighted by the Malaysian study.

"The psycho-social impact of cancer on adolescents and young adults also clearly needs further evaluation. This is to assess the impact on quality of life at the time of diagnosis as well as throughout and after treatment.

"What's required are specific interventions to meet the needs of this age group, as well as specially tailored survivorship programmes and supportive care.

"While it's not surprising that the young adult cancer population has a higher risk of suicide, conducting studies like this help us find new ways to address this issue effectively."

Explore further: High rate of antidepressant use after cancer

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