COPING WITH CANCER

Lives shortened by depression

Anxiety and depression shorten the lives of people diagnosed with advanced lung cancer, according to new research from the University of B.C. and the B.C. Cancer Agency.

The finding underlines the need for doctors to focus not just on tumours, but the “full emotional experience of the patient,” said the study’s lead author, Andrea Vodermaier, a post-doctoral research fellow in the department of psychology.

“This is really important because 26 per cent of patients have anxiety after diagnosis and 39 per cent show signs of depression,” she said. “A significant proportion of patients really suffer (with mentalhealth issues) on top of coping with cancer treatments.”

The study followed the progress of 684 patients who were treated for Stage 3 non-small-cell lung cancer at the B.C. Cancer Agency in Vancouver between 2004 and 2010, charting their survival until 2012.

Five years after diagnosis, 82 per cent of patients who showed anxiety and 86 per cent who reported symptoms of depression had died, compared with 81 per cent who reported no symptoms of either.

Stage 3 non-small-cell lung cancer has a one-year survival rate of 30 to 46 per cent.

“Patients who were not anxious or depressed lived longer than those who were distressed,” she said.

This is the second study by Vodermaier showing a link between mental health and mortality in cancer patients. In 2014, she found depression is strongly associated with mortality in young patients with early-stage breast cancer.

Why depression and anxiety affect survival in lung-cancer pa- tients isn’t entirely clear.

“Stress might affect the immune system and inflammatory responses,” study co-author Wolfgang Linden said. “However, it might also occur because being preoccupied with anxiety can make it harder for patients to adhere to treatments and fully engage in the treatment process.”

Poor mental health may make it more difficult to quit smoking after a cancer diagnosis and so many patients continue to smoke, which hastens death. The study didn’t try to determine whether subjects quit smoking, but such data would be of limited use because cancer patients often lie when asked if they have successfully stopped smoking, Vodermaier said.