Researchers develop a SMaRT method of improving major depression in cancer patients

New research from the Universities of Oxford and Edinburgh (UK), published this week in The Lancet Psychiatry, The Lancet and The Lancet Oncology, has found that three-quarters of cancer patients suffering from major depression do not currently receive the support they need.

The study also demonstrates that a new treatment programme is significantly more effective at reducing depression and improving quality of life than current care.

The collaborative team analyzed data obtained from 21,000 cancer patients attending cancer clinics in Scotland. The results indicate that major depression is significantly more common in cancer patients when compared with the general population. It was most prevalent in patients with lung cancer (13%) and lowest in those suffering from genitourinary cancer (6%).

Furthermore, the study established that 73% of cancer patients with major depression were not receiving treatment for their depression. Investigating a potential method of overcoming the problem of inadequate treatment, the team went on to evaluate a new treatment programme termed ‘Depression Care for People with Cancer’ (DCPC) in the randomized SMaRT Oncology-2 trial.

DCPC incorporates both antidepressants and psychological therapy, delivered by specially trained cancer nurses and psychiatrists who work in collaboration with the patient’s cancer team. To evaluate its effectiveness, the trial included 500 adult cancer patients with major depression, and compared DCPC with the current standard care. These patients all had a good prognosis with a predicted survival of >12 months.

“The huge benefit that DCPC delivers for patients with cancer and depression shows what we can achieve for patients if we take as much care with the treatment of their depression as we do with the treatment of their cancer,” commented Michael Sharpe of the University of Oxford.

After 6 months of DCPC treatment, 62% of patients had responded to the treatment with at least a 50% reduction in the severity of their depression. This improvement was sustained for 12 months. Seventeen percent of patients who received the current standard of care for major depression responded to treatment.

As a follow-up to this trial, DCPC was investigated as a therapeutic option for cancer patients with a poor prognosis who were suffering from major depression in the SMaRT Oncology-3 trial. This involved 142 lung cancer patients and established that those who received a version of DCPC tailored for lung cancer had a significantly greater improvement in depression during 32 weeks of follow-up.

“Patients with lung cancer often have a poor prognosis. If they also have major depression that can blight the time they have left to live. This trial shows that we can effectively treat depression in patients with poor prognosis cancers like lung cancer and really improve patients’ lives,” commented Jane Walker also of the University of Oxford.

DCPC was noted to improve anxiety, pain, fatigue, functioning and overall quality of life in the trials, all at a cost of £613 per patient. The researchers suggest that DCPC may be a cost-effective way to improve cancer patients’ quality of life.

Source: University of Oxford press release