Anxiety, Depression Plague Cancer Survivors

Results from a new study show that more than four in five cancer survivors suffer from anxiety and a similar number had depression a year after diagnosis.

“We urgently need new ways of supporting cancer survivors and addressing wider aspects of wellbeing,” said lead author Shridevi Subramaniam, a research officer at the National Clinical Research Center, Ministry of Health Malaysia, Kuala Lumpur, Malaysia. “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 1,362 Malaysian patients from the ACTION study (ASEAN Cost in Oncology Study). Nearly a third — 33 percent — had breast cancer, researchers noted.

All the patients 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’s findings showed that patients’ mental and physical wellbeing was low overall 12 months after diagnosis. The more advanced the cancer, the lower the HRQoL, according to the findings.

The type of cancer was also a factor, because disease severity differs, the researchers noted.

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 researchers hypothesized.

“The key message is to focus more on supporting patients throughout their whole cancer ‘journey,’ especially in their lives after treatment,” added Subramanian, who presented the research at the European Society for Medical Oncology (ESMO) Asia 2016 Congress.

Cancer also has a significant impact on the lives and wellbeing of adolescents and young adults, as reported in a separate ongoing study at the ESMO Asia 2016 Congress.

Researchers set out to identify the extent of wellbeing issues and other problems among patients in this age group, who not only are at major milestones in their lives, but do not expect to develop the disease.

The study included patients who were newly diagnosed with cancer and with an average age of 28. They completed a survey that included questions on occupation and lifestyle, and were also asked about problems around physical symptoms, mental wellbeing, and financial issues.

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

“The young differ from older people because they don’t expect to be ill, and certainly not with cancer,” said senior author Associate Professor Alexandre Chan of the Department of Pharmacy at the National University of Singapore and a Specialist Pharmacist at the National Cancer Center in Singapore.

“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 cancer diagnosis and treatment.”

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

“The psycho-social impact of cancer on adolescents and young adults also clearly needs further evaluation. What’s required are specific interventions to meet the needs of this age group, as well as specially tailored survivorship programs 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,” he concluded.

Source: European Society for Medical Oncology