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Minerva Psichiatrica 2008 March;49(1):61-70

Copyright © 2008 EDIZIONI MINERVA MEDICA

language: English

Depression and anxiety in metastatic cancer

Spiegel D., Giese-Davis J.

Stanford University School of Medicine Stanford, California, USA

Depression and anxiety affect a substantial minority of metastatic cancer patients, and complicate the course of their illness. These comorbid psychiatric disorders are frequently overlooked, often misattributed to cancer and its treatment and are therefore poorly managed. Effects of anxiety and depression on communication with physicians, adherence to medical treatment, social contact, and quality of life, are reviewed. Literature on the effects of psychiatric comorbidity on cancer prognosis will be reviewed. Mechanisms linking depression and anxiety to cancer progression include poorer treatment adherence and adverse effects on the hypothalamic-pituitary-adrenal axis and the immune system. Rapid and accurate assessment of comorbid anxiety and depression among cancer patients is an important component of good overall cancer care.