Despite guidelines recommending screening for depression in cancer patients, it's been unclear whether interventions designed to treat this depression are effective. A study by the University of Colorado Cancer Center and other institutions, published in the Journal of the National Cancer Institute, changes that. This meta-analysis of 10 studies encompassing 1362 patients shows that especially cognitive behavioral therapy and pharmacologic interventions decrease depressive symptoms in cancer patients.
"In the past, we had looked at interventions as a whole - most of which were designed to help cancer patients cope generally with stress but not specifically with depression - and found moderate effects. This study shows not only that interventions specific to depression in cancer patients can improve symptoms, but shows which interventions are likely to offer the most benefit," says Kristin Kilbourn, PhD, CU Cancer Center investigator and assistant professor of psychology at the University of Colorado Denver.
The recent study is the culmination of a five-year effort during which Kilbourn and collaborators combed the literature for studies that met stringent criteria specifying that studies were randomized control trials in which cancer patients reported a significant number of depressive symptoms prior to starting the intervention.
"Still, many questions exist," Kilbourn says. "For example, which interventions are best in early cancers versus metastatic disease? Do we find similar effectiveness if patients were diagnosed with depression before their cancer? And which interventions are most effective with different cultural and ethnic subpopulations?" Likewise, Kilbourn hopes further study will explore the durability of gains patients experience with these interventions.
Finally, "This study supports the notion that screening for depression in cancer patients is important because if we could identify people early in the process and intervene, we now know definitively that we can affect the trajectory of this depression," Kilbourn says.