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 About 19 percent of adult cancer survivors take drugs for
depression, anxiety, or both, compared to roughly 10 percent of
other adults, the study found.
“Survivors can have uncertainty about the future, worries about
recurrence, altered self-image, concerns about relationships,
financial hardships, unwanted physical changes, or new physical
impairments,” said lead study author Nikki Hawkins, a behavioral
scientist at the U.S. Centers for Disease Control and Prevention in
Atlanta.
“The cumulative effect of these worries and changes can take a toll
on survivors’ long-term emotional wellbeing – a likely reason why we
see a higher rate of medication use in this group,” Hawkins added by
email.
To assess use of psychiatric medications after cancer, researchers
examined survey data collected from 2010 to 2013 from 3,184 people
with a history of tumors and 44,997 adults without any history of
malignancies.
Almost 14 percent of cancer survivors took antidepressants, compared
to 8 percent of the other adults in the study, researchers report in
the Journal of Clinical Oncology.
The difference was a little more pronounced for anti-anxiety
medications, which were used by 17 percent of cancer survivors and 9
percent of other adults.
These findings suggest that 2.5 million cancer survivors take these
psychiatric medications, the researchers estimate.
Cancer survivors were more likely to use drugs for anxiety when they
were younger than 65, female, white, living with multiple chronic
health problems and insured by government health programs such as
Medicaid.
The profile of survivors most likely to use antidepressants was
similar, but the type of insurance patients had didn’t seem to
influence whether they used medication. Being divorced or
experiencing the death of a spouse did, however, make cancer
survivors more likely to take depression medication.
One limitation of the study is that medication use is self-reported
by survey participants, not verified by prescription data or medical
records, the authors note. Researchers also couldn’t determine
whether people started taking antidepressants or anxiety medications
before or after their cancer diagnosis. Plus, they didn’t know if
people received counseling or psychotherapy, or whether cancer
survivors were being routinely screened for mental health problems.
Even so, the findings point to the need for cancer survivors to pay
as much attention to mental health as physical health, Hawkins said.
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“Depression and other types of distress can weaken the body’s immune
system, lead to poorer health habits, and has been linked with lower
odds of survival after cancer,” Hawkins said. “In other words,
survivors’ emotional health and physical health go hand-in-hand.”
While not every cancer survivor needs to see a mental health
specialist or take medication, patients should be aware that
emotional symptoms could interfere with physical function, ability
to participate in treatment, work, education, family life or quality
of life in general, noted Dr. Alan Valentine, chairman of psychiatry
at the University of Texas MD Anderson Cancer Center in Houston.
“We would not want a cancer survivor to be in untreated emotional
pain any more than we would want them to be in physical pain,”
Valentine, who wasn’t involved in the study, said by email.
When cancer survivors do take medications for depression and
anxiety, they should also be aware that certain drugs have the
potential to make cancer treatment less effective or heighten the
risk of side effects, Valentine added.
Certain antidepressants, for example, are thought to make the breast
cancer drug tamoxifen less effective, previous research has found.
And, some psychotropic medicines can increase the odds that certain
cancer drugs cause heart damage.
“Some studies have found interactions between antidepressants and
specific cancer-fighting drugs that make the cancer treatments less
effective, but we don’t have answers about all the possible
drug-to-drug interactions,” Hawkins said.
“A knowledgeable health care provider can help develop a plan that
includes mental health support that will not take away from cancer
therapies and treatments,” Hawkins added.
SOURCE: http://bit.ly/2dLdIlb Journal of Clinical Oncology, online
October 26, 2016.
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