Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2010

Open Access 01-12-2010 | Debate

Pancreatic cancer and depression: myth and truth

Authors: Martina Mayr, Roland M Schmid

Published in: BMC Cancer | Issue 1/2010

Login to get access

Abstract

Background

Various studies reported remarkable high incidence rates of depression in cancer patients compared with the general population. Pancreatic cancer is still one of the malignancies with the worst prognosis and therefore it seems quite logical that it is one of the malignancies with the highest incidence rates of major depression.
However, what about the scientific background of this relationship? Is depression in patients suffering from pancreatic cancer just due to the confrontation with a life threatening disease and its somatic symptoms or is depression in this particular group of patients a feature of pancreatic cancer per se?

Discussion

Several studies provide evidence of depression to precede the diagnosis of pancreatic cancer and some studies even blame it for its detrimental influence on survival. The immense impact of emotional distress on quality of life of cancer patients enhances the need for its early diagnosis and adequate treatment. Knowledge about underlying pathophysiological mechanisms is required to provide the optimal therapy.

Summary

A review of the literature on this issue should reveal which are the facts and what is myth.
Literature
1.
Bultz BD, Carlson LE: Emotional distress: the sixth vital sign in cancer care. J Clin Oncol. 2005, 23 (26): 6440-6441. 10.1200/JCO.2005.02.3259.CrossRefPubMed
2.
Group RFA: A position paper: Screening key indicators in cancer patients--Pain as a 5th vital sign and emotional distress as a 6th vital sign. Canadian Strategy for Cancer Control Bulletin. 2005, 7 (4 suppl):
3.
Newell SA, Sanson-Fisher RW, Savolainen NJ: Systematic review of psychological therapies for cancer patients: overview and recommendations for future research. J Natl Cancer Inst. 2002, 94 (8): 558-584.CrossRefPubMed
4.
Pinquart M, Duberstein PR: Depression and cancer mortality: a meta-analysis. Psychol Med. 1-14.
5.
Hinz A, Krauss O, Hauss JP, Hockel M, Kortmann RD, Stolzenburg JU, Schwarz R: Anxiety and depression in cancer patients compared with the general population. Eur J Cancer Care (Engl). 2010, 19 (4): 522-529. 10.1111/j.1365-2354.2009.01088.x.CrossRef
6.
Stordal E, Bjartveit Kruger M, Dahl NH, Kruger O, Mykletun A, Dahl AA: Depression in relation to age and gender in the general population: the Nord-Trondelag Health Study (HUNT). Acta Psychiatr Scand. 2001, 104 (3): 210-216. 10.1034/j.1600-0447.2001.00130.x.CrossRefPubMed
7.
Osborne RH, Elsworth GR, Sprangers MA, Oort FJ, Hopper JL: The value of the Hospital Anxiety and Depression Scale (HADS) for comparing women with early onset breast cancer with population-based reference women. Qual Life Res. 2004, 13 (1): 191-206. 10.1023/B:QURE.0000015292.56268.e7.CrossRefPubMed
8.
Groenvold M, Fayers PM, Sprangers MA, Bjorner JB, Klee MC, Aaronson NK, Bech P, Mouridsen HT: Anxiety and depression in breast cancer patients at low risk of recurrence compared with the general population: a valid comparison?. J Clin Epidemiol. 1999, 52 (6): 523-530. 10.1016/S0895-4356(99)00022-0.CrossRefPubMed
9.
Derogatis LR, Morrow GR, Fetting J, Penman D, Piasetsky S, Schmale AM, Henrichs M, Carnicke CL: The prevalence of psychiatric disorders among cancer patients. JAMA. 1983, 249 (6): 751-757. 10.1001/jama.249.6.751.CrossRefPubMed
10.
Massie MJ: Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr. 2004, 57-71. 10.1093/jncimonographs/lgh014. 32
11.
Angelino AF, Treisman GJ: Major depression and demoralization in cancer patients: diagnostic and treatment considerations. Support Care Cancer. 2001, 9 (5): 344-349. 10.1007/s005200000195.CrossRefPubMed
12.
McDaniel JS, Musselman DL, Porter MR, Reed DA, Nemeroff CB: Depression in patients with cancer. Diagnosis, biology, and treatment. Arch Gen Psychiatry. 1995, 52 (2): 89-99.CrossRefPubMed
13.
Carlson LE, Angen M, Cullum J, Goodey E, Koopmans J, Lamont L, MacRae JH, Martin M, Pelletier G, Robinson J, et al: High levels of untreated distress and fatigue in cancer patients. Br J Cancer. 2004, 90 (12): 2297-2304.PubMedPubMedCentral
14.
Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S: The prevalence of psychological distress by cancer site. Psychooncology. 2001, 10 (1): 19-28. 10.1002/1099-1611(200101/02)10:1<19::AID-PON501>3.3.CO;2-Y.CrossRefPubMed
15.
Fras I, Litin EM, Pearson JS: Comparison of psychiatric symptoms in carcinoma of the pancreas with those in some other intra-abdominal neoplasms. Am J Psychiatry. 1967, 123 (12): 1553-1562.CrossRefPubMed
16.
Holland JC, Korzun AH, Tross S, Silberfarb P, Perry M, Comis R, Oster M: Comparative psychological disturbance in patients with pancreatic and gastric cancer. Am J Psychiatry. 1986, 143 (8): 982-986.CrossRefPubMed
17.
Lin J, Shu-Man J, Yuan-Yuan S, Yao-Xing H, De-Rong X, Kai-Hong H, Fa-Cao Z: Investigation of the incidence of pancreatic cancer-related depressin and ist relationship with the quality of life of patients. Digestion. 2009,
18.
Makrilia N, Indeck B, Syrigos K, Saif MW: Depression and pancreatic cancer: a poorly understood link. JOP. 2009, 10 (1): 69-76.PubMed
19.
Yaskin J: Nervous symptoms at earliest manifestations of cancer of the pancreas. JAMA. 1931, 96: 1664-1668.CrossRef
20.
Carney CP, Jones L, Woolson RF, Noyes R, Doebbeling BN: Relationship between depression and pancreatic cancer in the general population. Psychosom Med. 2003, 65 (5): 884-888. 10.1097/01.PSY.0000088588.23348.D5.CrossRefPubMed
21.
Fras I, Litin EM, Bartholomew LG: Mental symptoms as an aid in the early diagnosis of carcinoma of the pancreas. Gastroenterology. 1968, 55 (2): 191-198.PubMed
22.
Jacobsson L, Ottosson JO: Initial mental disorders in carcinoma of pancreas and stomach. Acta Psychiatr Scand Suppl. 1971, 221: 120-127. 10.1111/j.1600-0447.1971.tb02144.x.CrossRefPubMed
23.
Joffe RT, Rubinow DR, Denicoff KD, Maher M, Sindelar WF: Depression and carcinoma of the pancreas. Gen Hosp Psychiatry. 1986, 8 (4): 241-245. 10.1016/0163-8343(86)90004-6.CrossRefPubMed
24.
Passik SD, Roth AJ: Anxiety symptoms and panic attacks preceding pancreatic cancer diagnosis. Psychooncology. 1999, 8 (3): 268-272. 10.1002/(SICI)1099-1611(199905/06)8:3<268::AID-PON369>3.0.CO;2-W.CrossRefPubMed
25.
Griffeth BT, Mehra A: Panic as a harbinger of pancreatic cancer. Psychosomatics. 2008, 49 (6): 538-539. 10.1176/appi.psy.49.6.538.CrossRefPubMed
26.
Green AI, Austin CP: Psychopathology of pancreatic cancer. A psychobiologic probe. Psychosomatics. 1993, 34 (3): 208-221.CrossRefPubMed
27.
Labori KJ, Hjermstad MJ, Wester T, Buanes T, Loge JH: Symptom profiles and palliative care in advanced pancreatic cancer: a prospective study. Support Care Cancer. 2006, 14 (11): 1126-1133. 10.1007/s00520-006-0067-0.CrossRefPubMed
28.
Clark KL, Loscalzo M, Trask PC, Zabora J, Philip EJ: Psychological distress in patients with pancreatic cancer-an understudied group. Psychooncology. 2010,
29.
Hopko DR, Bell JL, Armento ME, Robertson SM, Hunt MK, Wolf NJ, Mullane C: The phenomenology and screening of clinical depression in cancer patients. J Psychosoc Oncol. 2008, 26 (1): 31-51. 10.1300/J077v26n01_03.CrossRefPubMed
30.
Chochinov HM, Wilson KG, Enns M, Lander S: "Are you depressed?" Screening for depression in the terminally ill. Am J Psychiatry. 1997, 154 (5): 674-676.CrossRefPubMed
31.
Bottomley A: Depression in cancer patients: a literature review. Eur J Cancer Care (Engl). 1998, 7 (3): 181-191. 10.1046/j.1365-2354.1998.00100.x.CrossRef
32.
Barlow DH, Brown TA, Craske MG: Definitions of panic attacks and panic disorder in the DSM-IV: implications for research. J Abnorm Psychol. 1994, 103 (3): 553-564. 10.1037/0021-843X.103.3.553.CrossRefPubMed
33.
Hamilton M: Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol. 1967, 6 (4): 278-296.CrossRefPubMed
34.
Miller IW, Bishop S, Norman WH, Maddever H: The Modified Hamilton Rating Scale for Depression: reliability and validity. Psychiatry Res. 1985, 14 (2): 131-142. 10.1016/0165-1781(85)90057-5.CrossRefPubMed
35.
Montgomery SM: Depressive symptoms in acute schizophrenia. Prog Neuropsychopharmacol. 1979, 3 (4): 429-433. 10.1016/0364-7722(79)90058-4.CrossRefPubMed
36.
Passik SD, Lundberg JC, Rosenfeld B, Kirsh KL, Donaghy K, Theobald D, Lundberg E, Dugan W: Factor analysis of the Zung Self-Rating Depression Scale in a large ambulatory oncology sample. Psychosomatics. 2000, 41 (2): 121-127. 10.1176/appi.psy.41.2.121.CrossRefPubMed
37.
Kathol RG, Mutgi A, Williams J, Clamon G, Noyes R: Diagnosis of major depression in cancer patients according to four sets of criteria. Am J Psychiatry. 1990, 147 (8): 1021-1024.CrossRefPubMed
38.
Massie MJ, Gagnon P, Holland JC: Depression and suicide in patients with cancer. J Pain Symptom Manage. 1994, 9 (5): 325-340. 10.1016/0885-3924(94)90192-9.CrossRefPubMed
39.
Passik SD, Breitbart WS: Depression in patients with pancreatic carcinoma. Diagnostic and treatment issues. Cancer. 1996, 78 (3 Suppl): 615-626.CrossRefPubMed
40.
Tuinman MA, Gazendam-Donofrio SM, Hoekstra-Weebers JE: Screening and referral for psychosocial distress in oncologic practice: use of the Distress Thermometer. Cancer. 2008, 113 (4): 870-878. 10.1002/cncr.23622.CrossRefPubMed
41.
Kelsen DP, Portenoy RK, Thaler HT, Niedzwiecki D, Passik SD, Tao Y, Banks W, Brennan MF, Foley KM: Pain and depression in patients with newly diagnosed pancreas cancer. J Clin Oncol. 1995, 13 (3): 748-755.PubMed
42.
Cornelius JR, Soloff PH, Miewald BK: Behavioral manifestations of paraneoplastic encephalopathy. Biol Psychiatry. 1986, 21 (7): 686-690. 10.1016/0006-3223(86)90131-9.CrossRefPubMed
43.
Gultekin SH, Rosenfeld MR, Voltz R, Eichen J, Posner JB, Dalmau J: Paraneoplastic limbic encephalitis: neurological symptoms, immunological findings and tumour association in 50 patients. Brain. 2000, 123 (7): 1481-1494. 10.1093/brain/123.7.1481.CrossRefPubMed
44.
Spoletini I, Gianni W, Repetto L, Bria P, Caltagirone C, Bossu P, Spalletta G: Depression and cancer: an unexplored and unresolved emergent issue in elderly patients. Crit Rev Oncol Hematol. 2008, 65 (2): 143-155. 10.1016/j.critrevonc.2007.10.005.CrossRefPubMed
45.
Clark K, Bardwell WA, Arsenault T, DeTeresa R, Loscalzo M: Implementing touch-screen technology to enhance recognition of distress. Psychooncology. 2009, 18 (8): 822-830. 10.1002/pon.1509.CrossRefPubMed
46.
Musselman DL, Miller AH, Porter MR, Manatunga A, Gao F, Penna S, Pearce BD, Landry J, Glover S, McDaniel JS, et al: Higher than normal plasma interleukin-6 concentrations in cancer patients with depression: preliminary findings. Am J Psychiatry. 2001, 158 (8): 1252-1257. 10.1176/appi.ajp.158.8.1252.CrossRefPubMed
47.
Talar-Wojnarowska R, Gasiorowska A, Smolarz B, Romanowicz-Makowska H, Kulig A, Malecka-Panas E: Clinical significance of interleukin-6 (IL-6) gene polymorphism and IL-6 serum level in pancreatic adenocarcinoma and chronic pancreatitis. Dig Dis Sci. 2009, 54 (3): 683-689. 10.1007/s10620-008-0390-z.CrossRefPubMed
48.
Shakin EJ, Holland J: Depression and pancreatic cancer. J Pain Symptom Manage. 1988, 3 (4): 194-198. 10.1016/0885-3924(88)90030-9.CrossRefPubMed
49.
Brown JH, Paraskevas F: Cancer and depression: cancer presenting with depressive illness: an autoimmune disease?. Br J Psychiatry. 1982, 141: 227-232. 10.1192/bjp.141.3.227.CrossRefPubMed
50.
Fazal S, Saif MW: Supportive and palliative care of pancreatic cancer. JOP. 2007, 8 (2): 240-253.PubMed
51.
Petitto JM, Evans DL: Treatment of Depression in Individuals With Cancer: Implications of Antidepressant Pharmacotherapy. Semin Clin Neuropsychiatry. 1998, 3 (2): 131-136.PubMed
52.
Cankurtaran ES, Ozalp E, Soygur H, Akbiyik DI, Turhan L, Alkis N: Mirtazapine improves sleep and lowers anxiety and depression in cancer patients: superiority over imipramine. Support Care Cancer. 2008, 16 (11): 1291-1298. 10.1007/s00520-008-0425-1.CrossRefPubMed
53.
Croom KF, Perry CM, Plosker GL: Mirtazapine: a review of its use in major depression and other psychiatric disorders. CNS Drugs. 2009, 23 (5): 427-452. 10.2165/00023210-200923050-00006.CrossRefPubMed
54.
Kim SW, Shin IS, Kim JM, Kim YC, Kim KS, Kim KM, Yang SJ, Yoon JS: Effectiveness of mirtazapine for nausea and insomnia in cancer patients with depression. Psychiatry Clin Neurosci. 2008, 62 (1): 75-83. 10.1111/j.1440-1819.2007.01778.x.CrossRefPubMed
55.
Torta R, Berra C, Binaschi L, Borio R: Amisulpride in the short-term treatment of depressive and physical symptoms in cancer patients during chemotherapies. Support Care Cancer. 2007, 15 (5): 539-546. 10.1007/s00520-006-0194-7.CrossRefPubMed
56.
Auret KA, Schug SA, Bremner AP, Bulsara M: A randomized, double-blind, placebo-controlled trial assessing the impact of dexamphetamine on fatigue in patients with advanced cancer. J Pain Symptom Manage. 2009, 37 (4): 613-621. 10.1016/j.jpainsymman.2008.03.016.CrossRefPubMed
57.
Kerr TA, Schapira K, Roth M: he relationship between premature death and affective disorders. Br J Psychiatry. 1969, 115 (528): 1277-1282. 10.1192/bjp.115.528.1277.CrossRefPubMed
58.
Steel JL, Geller DA, Gamblin TC, Olek MC, Carr BI: Depression, immunity, and survival in patients with hepatobiliary carcinoma. J Clin Oncol. 2007, 25 (17): 2397-2405. 10.1200/JCO.2006.06.4592.CrossRefPubMed
59.
Sheibani-Rad S, Velanovich V: Effects of depression on the survival of pancreatic adenocarcinoma. Pancreas. 2006, 32 (1): 58-61. 10.1097/01.mpa.0000191643.17173.d3.CrossRefPubMed
60.
Kissane D: Beyond the psychotherapy and survival debate: the challenge of social disparity, depression and treatment adherence in psychosocial cancer care. Psychooncology. 2009, 18 (1): 1-5. 10.1002/pon.1493.CrossRefPubMed
61.
Petticrew M, Bell R, Hunter D: Influence of psychological coping on survival and recurrence in people with cancer: systematic review. BMJ. 2002, 325 (7372): 1066-10.1136/bmj.325.7372.1066.CrossRefPubMedPubMedCentral
62.
Coyne JC, Palmer SC: More claims about depression, immune function, and survival that exceed the evidence. J Clin Oncol. 2007, 25 (33): 5328-5329. 10.1200/JCO.2007.13.8594. author reply 5329-5331CrossRefPubMed
63.
Levy S, Herberman R, Lippman M, d'Angelo T: Correlation of stress factors with sustained depression of natural killer cell activity and predicted prognosis in patients with breast cancer. J Clin Oncol. 1987, 5 (3): 348-353.PubMed
64.
Pettingale KW, Philalithis A, Tee DE, Greer HS: The biological correlates of psychological responses to breast cancer. J Psychosom Res. 1981, 25 (5): 453-458. 10.1016/0022-3999(81)90071-4.CrossRefPubMed
65.
Faller H, Schmidt M: Prognostic value of depressive coping and depression in survival of lung cancer patients. Psychooncology. 2004, 13 (5): 359-363. 10.1002/pon.783.CrossRefPubMed
66.
Nakaya N, Saito-Nakaya K, Akechi T, Kuriyama S, Inagaki M, Kikuchi N, Nagai K, Tsugane S, Nishiwaki Y, Tsuji I, et al: Negative psychological aspects and survival in lung cancer patients. Psychooncology. 2008, 17 (5): 466-473. 10.1002/pon.1259.CrossRefPubMed
Metadata
Title
Pancreatic cancer and depression: myth and truth
Authors
Martina Mayr
Roland M Schmid
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2010
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-10-569

Other articles of this Issue 1/2010

BMC Cancer 1/2010 Go to the issue

Research article

Evaluation of mammographic density patterns: reproducibility and concordance among scales

Study protocol

Rationale and design of the Exercise Intensity Trial (EXCITE): A randomized trial comparing the effects of moderate versus moderate to high-intensity aerobic training in women with operable breast cancer

Research article

Incidence of chemotherapy-induced amenorrhea associated with epirubicin, docetaxel and navelbine in younger breast cancer patients

Research article

Demethylation by 5-aza-2'-deoxycytidine in colorectal cancer cells targets genomic DNA whilst promoter CpG island methylation persists

Research article

Fractal dimension of chromatin is an independent prognostic factor for survival in melanoma

Research article

Determinants of participation in colonoscopic screening by siblings of colorectal cancer patients in France
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits