Cancer Survivors Not Seeking Help for Depression

Head and neck cancer survivors reported not seeking mental health services

(RxWiki News) Long-term treatment can affect how cancer survivors manage in the world. The fancy phrase for this is “psychosocial functioning.”  A recent study looked at how head and neck cancer survivors get along after treatment.

Depression is not uncommon among head and neck cancer survivors, researchers found in this new study.

However, not many of the survivors in the study sought help for their depression with either antidepressants or therapy.

Physicians could assist by screening for psychosocial problems because depression is very treatable, according to one expert.

"If you’re feeling blue, ask for help."

Allen M. Chen, MD, of the University of California, Davis, and now of the David Geffen School of Medicine at the University of California, Los Angeles, led this study.

Dr. Chen and colleagues were looking at the rates of depression among head and neck cancer survivors who had received radiation therapy to treat the disease.

“The treatment of head and neck cancer can lead to devastating impact on psychosocial functioning due to the many important structures located in the head and neck region," Tobenna Nwizu, MD, a solid tumor oncologist with the Taussig Cancer Institute at Cleveland Clinic, told dailyRx News.

“Functions like speech, swallowing, taste and salivation can all be affected,” said Dr. Nwizu, who was not involved in this study.

Treatment can also affect appearance, cause dry mouth and increase the risk of aspiration (sucking food into the airway), according to the authors.

For this study, the researchers asked 211 head and neck cancer survivors to complete a questionnaire. The University of Washington Quality of Life instrument was used to assess the rates of depression.

Study members were all disease-free, and none had a history of mental health issues prior to their cancer diagnosis.

One year after treatment was completed, 17 percent of survivors reported being “somewhat depressed” or “extremely depressed.”  Among three-year survivors, 15 percent said they felt depressed, as did 13 percent of those who were five years out from treatment.

Of those who reported depression, 6 percent of one-year survivors, 11 percent of three-year survivors and 0 percent of five-year survivors reported taking antidepressants.

Very few survivors reported receiving psychotherapy and/or counseling. Only 3 percent of one-year survivors, 6 percent of three-year survivors and 0 percent of five-year survivors said they were getting help from mental health professionals for their depression.

“This study shows the need to screen for depression in patients treated for head and neck cancer, as depression can adversely affect a patient’s quality of life, and is easily treatable,” said Dr. Nwizu, who is a dailyRx Contributing Expert.

He added that economic factors, social support and other medical conditions, "...which could all have an effect on a patient’s psychosocial well-being, were not accounted for in the study.”

The authors said a number of things may have influenced the survivors’ choices not to seek help for their depression, including lack of insurance, financial barriers, lack of follow-up care, not having a primary care physician, as well as the perceived social stigma of mental illness.

This study was published August 15 in JAMA Otolaryngology–Head & Neck Surgery.

No outside funding or conflicts of interest were reported.

Review Date: 
August 15, 2013