Breast Cancer Depression Common

Nov. 13, 2006 -- The emotional distress of a breast cancer diagnosis can trigger serious depression, which is often undertreated.

The finding comes from a study of 236 consecutive patients who had just learned that they had breast cancer. The women's mental health was evaluated before they spoke with a surgeon at Dartmouth-Hitchcock Medical Center in Lebanon, N.H.

Nearly half the women reported emotional distress that interfered with their daily lives. More than one in 10 had major depression -- even though most already were taking a psychiatric medication.

Patients may not tell their doctors about their emotional distress, note psychologist Mark T. Hegel, PhD, and colleagues. They are afraid of distracting the doctors from curing their cancer and afraid of being stigmatized as difficult patients.

Oncologists, on the other hand, may not have the skills needed to recognize emotional problems.

And these problems are difficult to deal with. The 47% of women who reported emotional stress suffered worry, fear, nervousness, sadness, and depression.

Nearly all of these women were troubled by uncertainties about treatment and physical symptoms. Most suffered distress from practical life problems and family problems. About one in 10 suffered a spiritual crisis.

Hegel and colleagues suggest that doctors should do a better job of evaluating and treating the emotional consequences of a breast cancer diagnosis.

But there is something else doctors can do that is just as important.

"We need to do a better job of getting the word out about how well we can treat breast cancer," Hegel says in a news release. "These emotional disorders are almost certainly due in part to the fear and helplessness that continues to result from a cancer diagnosis."

Hegel and colleagues report the findings in the Dec. 15 issue of Cancer.