Depression, mental illness and cancer

In the United States, about half a million people die from cancer. The diagnosis itself contributes to the emergence of sadness, disability, fear of death. Some chemotherapy drugs affect mood. In the terminal stage of the disease, stress increases due to pain, the desire for quick death, disability, and the inability to actively participate in the lives of loved ones. 

 Depression in cancer patients is observed from 3 to 38% of cases. 12% of patients with various oncological diseases have mental disorders. But only 17% of patients go to a psychiatrist.

Although all patients with cancer need the help of a psychiatrist to improve their quality of life.

Studies have shown that patients with breast tumors and lung cancer combined with depression are less likely to survive than patients without depression.

Scientists have found that cancer patients respond to both drug treatment and psychotherapy. But pharmacological treatment is recognized as the primary treatment for depression in cancer patients. With an adequate dose of the drug and the duration of administration, improvement is observed in 65-70% of patients. 

But there are barriers to wider use of antidepressants in cancer patients. So the board of physicians-members of the American Society of the Internal Consensus Group found that both the patient and the doctors consider psychological discomfort to be the norm in grade IV cancer. Oncologists refuse to recognize depression as an important illness that worsens the patient’s condition.

In patients with mental disorders, cancer mortality is 30% higher, although the incidence is generally not higher than in the population. There is anecdotal evidence that people with mental illness are less likely to develop cancer than the general population. But the percentage of tumors with metastases is higher in patients with mental disorders than in the rest of the population. An imbalance between morbidity and mortality from cancer in mental disorders is characteristic of patients with prostate and rectal cancer. 

The researchers also found that patients with schizophrenia and dementia had less cancer than the rest of the population. Perhaps this is due to the protective effect of an increased level of dopamine, an increase in the activity of killer cells, an increase in apoptosis, the effect of antipsychotics on cytochrome P450, which is involved in the elimination of the mutagen.

The above data indicate that in the treatment of both mental and oncological diseases, it is necessary to integrate treatment methods based on new data on the biological basis of diseases. The data of genetics and molecular biology already now allow a holistic approach to human disease, and not “squeeze” the patient into the narrow framework of the specialization of doctors.

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