Helping cancer patients cope with depression
Publication Date:09/07/2008
Finding out you have cancer can be devastating. Not surprisingly, many people with cancer get seriously depressed, which can make coping during this difficult time even harder. Now new research has found that a one-to-one, short-term counselling programme may help improve depression among cancer patients.
What do we know already?
The word depression is used to describe a range of emotions. We often say we're depressed when we're down in the dumps or feel a bit sad. But if you have what's called clinical depression, you feel depressed or uninterested in doing anything nearly every day, for at least two weeks. You may also have several other symptoms, including changes in sleep, appetite and concentration.
People with cancer are especially likely to have clinical depression. Although we don't know the exact figure, serious depression is estimated to affect between 10 and 25 percent of cancer patients.
Now researchers have looked at whether one-to-one counselling sessions with specially trained nurses might help improve depression for patients with cancer. The advantage of this type of counselling, researchers say, is that it can be added into the treatment and follow-up care that cancer patients already receive.
What does the new study say?
The new study included 200 men and women with cancer who'd been clinically depressed for at least a month. They had a variety of cancers, including breast cancer, bowel cancer and ovarian cancer. Around 70 percent had finished their cancer treatment and were having regular follow-up with their doctors.
The researchers divided patients into two groups. One group received the standard NHS treatment for depression from their GP or hospital specialist. This often involved treatment with antidepressants and some people saw a psychiatrist. The other group got treatment, but they also received a number of counselling sessions over three months with cancer nurses trained to help patients cope with depression. The sessions included:
- Information about depression and its treatments, including information about antidepressants
- Therapy to teach patients ways to cope with feelings of helplessness
- Monthly calls from a nurse for three months after the counselling had ended
- Optional "booster" counselling sessions for patients needing extra support.
The study found that depression got better for both groups of patients, but those who had counselling improved more. Nearly one third (29 percent) of patients who had counselling no longer had clinical depression after 3 months, compared with 14 percent of those who had only the normal treatment.
Patients who had counselling also felt less anxious and tired, and they continued to do better than other patients 6 months and 12 months later.
Where does the study come from?
The study was done by researchers at the universities of Edinburgh, Oxford and Glasgow. It was published in a medical journal called The Lancet and sponsored by Cancer Research UK, a charity that funds cancer research.
How reliable are the findings?
The study was carefully carried out, but we don't know for sure whether the improvement was definitely due to seeing a specially trained counsellor, or if getting more support from other sources such as family and friends would have had the same effect on people's depression. And we don't know whether it was the actual content of the counselling sessions, or simply getting regular time and attention, that made the difference.
Also, the study did not include people who had very severe depression or more advanced cancer, so we don't know if counselling might also help these patients.
What does this mean for me?
Depression is a disabling illness, which can keep you from enjoying life and isolate you from friends and family. This can be especially devastating if you're trying to cope with a serious illness such as cancer.
But depression is also treatable. And people who get extra support for their depression from specially trained counsellors may have more chance of their depression getting better.
What should I do now?
If you or someone close to you has cancer, be alert to any signs of depression. This is important not only during diagnosis and treatment, but also later on, as many people get depression after their cancer treatment has finished.
You may have depression if you:
- Feel sad most of the time (you might feel a little better in the evenings). You may be tearful a lot of the time
- Lose interest in doing things you used to enjoy
- Find it harder to make decisions
- Feel you can't cope with things the way you used to
- Have no energy
- Feel restless and agitated
- Lose your appetite and lose weight (or the reverse happens and you put on weight)
- Have trouble sleeping. For example, it may take you one to two hours to get to sleep, and then you wake up earlier than usual
- Lose interest in sex
- Lose your self-confidence
- Feel useless or worthless
- Feel guilty for no reason
- Avoid other people
- Feel irritable
- Feel worse at a particular time each day, usually in the morning
- Think about suicide.
If you have five or six of these symptoms for two weeks or longer, talk to your doctor. If you do have depression, there are treatments that can help. It might be worth asking your doctor if there is any special counselling for cancer patients in your area.
From:
Strong V, Waters R, Hibberd C, et al. Management of depression for people with cancer (SMaRT oncology 1): a randomised trial. The Lancet. 2008; 372: 40-48.
To learn more, see our information on depression.
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This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
