An Analysis of Depression in Lung Cancer Patients

By Kaitlyn D’Onofrio - Last Updated: December 6, 2019

More than a quarter of patients with newly diagnosed advanced-stage non-small cell lung cancer (NSCLC) have moderate depressive symptoms, a new study has discovered, while 8% of patients experience severe depressive symptoms.

“This is more than having a ‘low mood.’ When severe, the depression rarely gets better without treatment,” said lead study author Barbara Andersen, PhD, professor of psychology at The Ohio State University, in a press release.

Although the results of the study may not come as a surprise to clinicians, they indicate a need for treatment among these patients, Dr. Anderson noted.

“Some oncologists may have a mindset that ‘of course, you’re depressed, you have lung cancer.’ This may show an under-appreciation of the breadth of depressive symptoms and other difficulties which accompany it,” she said.

The observational study, published in Lung Cancer, included 186 stage IV NSCLC patients who completed the American Society of Clinical Oncology-recommended screening measure for depression (Patient Health Questionnaire-9 [PHQ-9]). Depressive symptoms were ranked as either none/mild (n?=?119; 64%), moderate (n?=?52; 28%), or severe (n?=?15; 8%). Patients also self-reported measures of hopelessness, generalized anxiety disorder (GAD) symptoms, stress, illness perceptions, functional status, and symptoms.

Severely depressed patients were more likely to report concomitant feelings of hopelessness, anxiety symptoms suggestive of GAD, and traumatic stress specific to their cancer diagnosis. These patients were more likely to believe that their disease was consequential for their lives and could not be treated. Moderately depressed patients had lower disturbance levels, but they were still significant. Patients with moderate symptoms of depression had low GAD symptom severity and fewer functional impairments.

“GAD worry or fear can be particularly toxic for lung cancer patients,” Dr. Andersen noted. “It can impede decision-making and participation in treatment. Moreover, a common symptom of lung cancer, shortness of breath, can worsen with anxiety and even induce panic for some.”

A key takeaway from the study is that NSCLC patients with depressive symptoms are experiencing more than just those, Dr. Andersen explained.

“Depression is just part of what these patients are dealing with. It comes with this whole package of worse functioning, more physical symptoms, stress, anxiety and more,” she said. “All of these can have negative effects on treatment, overall health, quality of life and disease progression.”

With new therapies improving and extending patients’ lives, it is that much more important to make sure these symptoms are treated, said Dr. Anderson: “Patients are living longer, and we need to make similar efforts and advancements to treat symptoms such as these and help patients maintain their quality of life going forward.”