Depression in cancer patients is common, is often untreated, but can be significantly improved with a new, integrated approach to care, NIHR CLAHRC Oxford part-funded research in The Lancet has revealed.

This trial shows that we can effectively treat depression in patients with poor prognosis cancers like lung cancer and really improve patients’ lives.”
- Dr Jane Walker, Senior Clinical Researcher, University of Oxford and NIHR CLAHRC Oxford comorbidity theme researcher.

Researchers from the Universities of Oxford and Edinburgh looked at the prevalence of major depression in more than 20,000 Scottish cancer patients through three separate studies.

They found that depression was substantially more common in cancer patients than the general population, yet only around a quarter of patients were receiving treatment.

The researchers also found that depressed cancer patients receiving a new treatment programme (Depression Care for People with Cancer, DCPC) had a ‘strikingly’ increased response to treatment compared with those who were given usual care.  

Other cancer-related symptoms - including anxiety, pain and fatigue - were also improved by the treatment, as was quality of life. The cost of the treatment programme was modest in comparison with other treatments. 

Lung cancer patients were the most affected, with around one in eight patients being diagnosed with depression. Depression was also more common in women, younger patients and those from socially deprived backgrounds.

One of the three studies looked at 500 people with a positive cancer prognosis who also suffered from major depression. Doctors found that after six months, 62 per cent of patients who received the integrated care programme responded to treatment compared with just 17 per cent of those who received standard care. This benefit was also seen 12 months after treatment.

In a separate study of 142 lung cancer patients, patients who received the integrated care programme had a significantly greater improvement in depression compared with those receiving existing treatments, enhancing their quality of life.

The new programme, DCPC, is an intensive approach. All patients are offered both antidepressants and psychological therapy.

The treatment is delivered by a team of specialist cancer nurses and supervising psychiatrists, who work in collaboration with the patient’s oncology team and GP. Most sessions are delivered face-to-face.

Michael Sharpe, Professor of Psychological Medicine, University of Oxford and NIHR CLAHRC Oxford comorbidity theme lead, who led the study, commented:

“The huge benefit that DCPC delivers for patients with cancer and depression shows what we can achieve for patients if we take as much care with the treatment of their depression as we do with the treatment of their cancer.”

Co-author Dr Jane Walker, Senior Clinical Researcher, University of Oxford and NIHR CLAHRC Oxford comorbidity theme researcher, said:

“Patients with lung cancer often have a poor prognosis. If they also have major depression that can blight the time they have left to live. This trial shows that we can effectively treat depression in patients with poor prognosis cancers like lung cancer and really improve patients’ lives.”

The findings of the three studies are published in journals The Lancet, The Lancet Oncology and The Lancet Psychiatry. The research was funded by Cancer Research UK, The Chief Scientist Office of the Scottish Government and the NIHR CLAHRC Oxford.

Podcast

In The Lancet's podcast, Naomi Lee discusses the research with Michael Sharpe and Jane Walker. 

Michael Sharpe interview on BBC Radio 4 Today programme.

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