Mental illness and emotional distress in patients with advanced cancer are often overlooked by oncologists but, if screened for, can be adequately managed to improve a patient's quality of life.
In an article published in the October 15, 2007 issue of CANCER, a peer-reviewed journal of the American Cancer Society, Dr. Michael Miovic and Dr. Susan Block from the Dana Farber Cancer Institute and Brigham and Women's Hospital in Boston review the published literature of psychiatric illnesses in cancer patients.
They found that 50 percent or more of patients with advanced or terminal cancer suffer from at least one of three major psychiatric disorders: adjustment disorders, anxiety disorders and depressive disorders. These disorders have distinct symptoms that oncologists can screen for and manage through medications or referral to mental health professionals and/or support groups.
Though medical management of cancer has significantly improved in the last decade, integrating the management of related mental health issues has lagged. Studies demonstrate those depressive symptoms impact patients' attitudes toward life and death, as well as quality of life, even more so than pain. Despite available effective therapies, less than half of patients with advanced cancer under the care of oncologists receive treatment.
More than 30 percent of patients with advanced disease and almost 20 percent of patients with terminal disease suffer from an adjustment disorder, consisting of symptoms of emotional distress such as irritability, mood swings, anxiety, or sleep disturbance. Additionally, up to 30 percent of patients with advanced disease and 20 percent of patients with terminal cancer are affected by a depressive disorder, such as major depression. Also, anxiety disorders affect nearly 10 percent of patients with advanced disease and 14 percent of patients with terminal cancer.