Depression passes, anxiety persists for cancer patients & partners

Cancer survivors face an increased risk of anxiety for 10 years or more following diagnosis, according to a study published June 5 in The Lancet Oncology. In addition, their partners face similar levels of depression but even higher rates of anxiety as cancer survivors themselves.

As cancer evolves into a chronic disease, the need to understand the long-term risk and incidence of mood disorders among cancer survivors and their spouses has emerged.

Alex J. Mitchell, MD, from the department of psycho-oncology at Leicester Partnership Trust in Leicester, U.K., and colleagues sought to assess whether depression and anxiety are more common in long-term survivors of cancer compared with their spouses and with healthy controls.

The researchers completed a systematic review and meta-analysis and identified 43 studies for analysis; 16 assessed depression and 10 assessed anxiety for comparison with healthy controls and 12 assessed depression and five assessed anxiety for comparison with spouses.

Among the studies evaluating the prevalence of depression in long-term cancer survivors vs. healthy controls, the prevalence of depression was 11.6 percent in the pooled sample of cancer survivors and 10.2 percent among people without cancer.

The studies focused on prevalence of depression in long-term cancer survivors vs. spouses indicated a prevalence of depression of 26.7 percent and 26.3 percent in survivors and spouses, respectively.

The studies focused on prevalence of anxiety in survivors vs. healthy controls indicated anxiety prevalence of 17.9 percent in cancer survivors and 13.9 percent in people without cancer. Meanwhile, the analyses that assessed prevalence of anxiety on survivors vs. spouses estimated anxiety prevalence at 28 percent in survivors and 40.1 percent in spouses.

The meta-analyses comparing depression and anxiety in long-term cancer survivors with healthy controls and spouses suggested after two years cancer patients had a level of depression on par with spouses and healthy controls. However, anxiety was higher in spouses.

For cancer survivors, the increased risk of anxiety disorders seems to persist for up to 10 years or more, according to Mitchell et al. “The burden of anxiety disorders should not be underestimated. Anxiety can hamper quality of life after cancer. Possible predictors of anxiety after cancer include poor social support, impaired quality of life, pain, and burden of disease.”

The researchers noted that cancer type and physical complications might affect emotional wellbeing.  However, they were unable to evaluate predictors of anxiety and depression such as functional performance, social support, past history or disease stage as these variables were often absent from studies.

They called for future studies to emphasize relative risk of depression and anxiety in palliative settings or in patients with advanced cancer.