Understanding the Mental Health Impact of Brain Cancer Patients
Espinosa-Sánchez A
Every year, thousands of people receive a cancer diagnosis, and beyond the physical struggle, the impact on mental health is significant. Beyond the physical challenge, cancer significantly affects the mental health, with patients facing a considerable psychological burden that requires attention as urgently as the disease itself.
The high prevalence of mood disorders among cancer patients is highlighted by figures that double or triple those seen in the general population. Rates of depression and anxiety are notably elevated among oncology patients, suggesting that a cancer diagnosis not only affects physical health but also has a substantial impact on emotional well-being. Specifically, between 20% and 30% of individuals diagnosed with brain tumors experience depression or anxiety during the course of their illness, negatively impacting treatment adherence and quality of life [1, 2]. Furthermore, mood disorders can manifest in various forms, including adjustment disorders and post-traumatic stress disorder (PTSD) in patients facing an aggressive or advanced cancer diagnosis.
Tumor location may also play a crucial role: patients with tumors in areas near the limbic system, such as those with diffuse gliomas, have a significantly higher risk of developing severe depressive symptoms [3, 4]. This not only exacerbates quality of life but also negatively affects treatment outcomes. In a study of glioma patients, the prevalence of depression ranged from 16% to 41%, while anxiety affected 24% to 48% of patients, according to self-reported questionnaires [5]. The impact of these symptoms is substantial, as they not only diminish health-related quality of life but can also negatively influence overall survival. It has been suggested that the shorter survival times in patients with depressive symptoms may be related to tumor progression as well as treatments that can, at times, induce depressive symptoms. Thus, cancer treatments also significantly impact patients’ mental health, affecting both recovery and quality of life.
Conversely, in other types of brain tumors, such as intracranial meningiomas, anxiety is present in 40% of patients, compared to 6.67% exhibiting depression. Many patients expressed how the uncertainty surrounding their illness and the wait for medical results generated anxiety and stress. However, some patients also demonstrated a capacity for maintaining a positive outlook, which appears to aid their recovery [6].
In some cases, depression may even be the only initial symptom, potentially delaying the oncological diagnosis until a significant deterioration in overall health and cognitive function occurs, at which point more in-depth neurological studies are performed [7]. This underscores the necessity for rapid evaluation when clinical presentations change and emphasizes the importance of a comprehensive approach that includes regular neuropsychiatric assessments to identify and treat these disorders at an earlier stage.
Inflammation, a link between cancer and depression
The interrelationship between cancer and depression can be attributed to underlying pathophysiological mechanisms, such as chronic systemic inflammation. Chronic inflammation, common in many types of cancer, has been identified as exacerbating both depressive symptoms and tumor development. A considerable percentage of cancer patients may present depressive symptoms associated with elevated inflammatory markers, although this percentage can vary across different groups and studies [8]. This finding suggests that modulating the inflammatory response may play a key role in the therapeutic approach to both cancer and associated depressive disorders.
However, it is essential to note that while an association between inflammation and depression has been observed across various cancer types, not all oncology patients suffering from depression exhibit elevated inflammation [9]. In healthy individuals with depression, around 28% show signs of inflammation, defined by a C-reactive protein (CRP) level exceeding 3 mg/L. This data rises to nearly 50% in patients with treatment-resistant depression [10, 11].
A multidisciplinary approach integrating oncology, neuropsychiatry, and palliative care can significantly enhance the quality of life and prognosis for these patients. Regular mental health assessments should be an integral part of oncological management, aimed at proactively identifying and treating mood disorders.
Today, on World Mental Health Day, it is crucial to remember that cancer affects not only the body but also the mind.
#WorldMentalHealthDay #MentalHealth #Oncology #Depression #ComprehensiveCare
Asunción Espinosa Sánchez,
PhD in Biomedicine & Clinical Research. STRATUM project
10/10/2024
References
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