Study Finds Survival Benefit for Lung Cancer Patients Whose Depression Improves

By Trevor Willingham
Monday, January 30, 2017

Improving symptoms of depression in lung cancer patients is associated with longer survival, according to a recent study. The findings highlight the need for oncology physicians to address mental health issues their patients may be facing, experts say.

Approximately 15–25 percent of all cancer patients experience symptoms of depression at some point, according to the National Cancer Institute.

A study published in the Journal of Clinical Oncology suggests that resolving depression symptoms tends to lengthen survival in patients who have lung cancer, the leading cause of cancer deaths among men and women alike.

Researchers followed 1,790 patients newly diagnosed with lung cancer who participated in the Cancer Care Outcomes Research & Surveillance Consortium study. Assessed on the eight-item version of the CES-D depression symptom scale five months after diagnosis, 681 participants (38 percent) had symptoms of depression at the baseline survey. At the time of the follow-up survey seven months later, an additional 105 patients had new-onset depression symptoms.

Researchers found the odds of dying from lung cancer within a year of diagnosis were 42 percent greater among patients with depression symptoms at baseline compared with those who had no symptoms, and 50 percent greater for patients who had new-onset symptoms after seven months.

“A surprising finding was that people who had remission of their depression from the baseline visit to follow-up had the same mortality rate as those who were never depressed,” says lead author Donald Sullivan, MD, MA, Assistant Professor in the Division of Pulmonary & Critical Care Medicine at Oregon Health & Science University.

The findings have additional relevance in light of the frequency of depression among lung cancer patients. They have depression or symptoms of depression at higher rates than people with any other cancer type, Dr. Sullivan points out.

Among possible explanations for that, he says, is the social perspective that lung cancer is often a self-inflicted disease. In consequence, patients may generate less sympathy, and research funding may suffer. That combination, Sullivan adds, results in inferior screening techniques that hinder early detection and lead to more deaths.

“Empathetic listening is what I talk about among lung cancer providers. You may ask how they are doing, but really ask how they’re doing overall.”
— Donald Sullivan, MD, MA, Assistant Professor in the Division of Pulmonary & Critical Care Medicine at Oregon Health & Science University

Treating the Whole Disease

It is crucial that physicians be alert to the psychological as well as physiological effects of cancer, says Paul Duberstein, PhD, Professor of Psychiatry, Medicine and Family Medicine at the University of Rochester Medical Center.

“If you are an oncologist and think that it isn’t part of your job to listen to your patients talk about their inner lives, their depression, their sadness, I urge you to reconsider,” Duberstein says. “As Sullivan and colleagues show, depression can be lethal.”