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Depression and Lung Cancer Often Go Hand in Hand

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Oct. 12, 2000 -- Depression -- which is common in lung cancer patients -- doesn't always end after successful surgery, say Japanese researchers. Despite what might be expected as good news, many survivors successfully treated for a particular type of lung cancer still experience depression up to three months after surgery.

The lead author of this new study, Yosuke Uchitomi, MD, PhD, tells WebMD that this is important because many studies show that even when surgery is successful, survival rates are below average if the patient suffers from psychosocial problems such as depression. "Sometimes, even if a surgeon says surgery is successful," the reduced quality of life in these patients often goes unrecognized, and this may ultimately shorten lives, according to Uchitomi, who is with the National Cancer Center Research Institute East in Chiba, Japan.

Uchitomi adds that the five-year survival rate is still only about 50% after successful surgery whether or not the cancer comes back. He says he doesn't know why survivors still suffer from depression. "It may be, at least partially, that patients don't feel very confident that they're cured."

According to the American Lung Association (ALA), lung cancer is the second most commonly occurring cancer among men and women. The ALA estimates there will be over 160,000 new cases of lung cancer in the U.S. in 2000. While the rate of lung cancer cases appears to be declining among white and black men in the U.S., it continues to increase among both white and black women. An estimated 157,000 Americans are expected to die of lung cancer in 2000.

In the study, researchers interviewed over 220 lung cancer patients with non-small cell lung cancer to determine the prevalence of depression at the time of surgery and monthly for three months afterwards.

Reporting in the Sept. 1 edition of the journal Cancer, the researchers discovered that almost 15% were depressed at some point over the three-month period. The prevalence of depression was 9% after one month, nearly 9.5% after two months, and just under 6% at three months. And the researchers report that slightly more that 6% of the patients had a history of depression prior to their lung cancer diagnosis.

Uchitomi says preventive psychological and social interventions might be beneficial for improving survival time as well as quality of life both before and after surgery. "As a safeguard, social support and behavior counseling should be offered to lung cancer patients with depression after successful treatment," he says.

Katherine Bruss, PhD, a clinical psychologist with the American Cancer Society (ACS), says some degree of depression in people dealing with cancer and its aftermath is common. "It is not caused by the cancer."

Bruss says clinical depression, which affects the body, feelings, thoughts, and behaviors, occurs in about 25% of those dealing with cancer. She says depression can cause patients to ignore needed treatment schedules, which will only make things worse.

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