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We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: Early intervention may lower risk for cancer-specific mortality among older adults with depression. Those who received psychotherapy soon after diagnosis had lower risk than those prescribed medication. Early intervention may mitigate elevated risk for cancer-specific mortality observed among people with pre-existing depression, according to retrospective findings. Individuals with pre-existing major depressive disorder appeared significantly more likely than those without it to die of their cancer within 1 year or 5 years; however, receipt of psychotherapy within 4 weeks of cancer diagnosis considerably reduced that risk, an analysis of Medicare data presented at American Society for Radiation Oncology Annual Meeting showed.
Data derived from Qiao M, et al. Abstract 195. Presented at: ASTRO Annual Meeting; Sept. 26-30, 2026; Boston.
\u201cThese findings emphasize the importance of early recognition, and they show mental health screening at the first clinic visit is essential to optimize depression management and cancer management,\u201d lead author Edmund M. Qiao, MD, radiation oncology resident at University of California, San Diego, told Healio. \u201cThere are well-established treatments for this comorbidity \u2014 which is associated with increased risk for dying of cancer \u2014 and this study shows the longer we wait to help our patients get those interventions, the less impact those interventions have on cancer mortality.\u201d Underrecognized, undertreated Up to one-quarter of people with cancer experience depression, according to NCI. That prevalence is four to five times higher than the general population, based on WHO estimates. Although prior research has linked the condition to poorer cancer outcomes, it often is underrecognized and undertreated in oncology settings, according to study background. \u201cIt is likely that one, two or maybe three patients during every clinic day are dealing with depression but, unfortunately, it doesn\u2019t always get talked about,\u201d Qiao said. \u201cIn a time-stressed situation like a clinic consult \u2014 when we\u2019re focusing on cancer therapies, the logistics of radiation and survival \u2014 the mental health component sometimes gets lost. Patients who are already facing an overwhelming burden from their cancer care are not necessarily connected to the right resources.\u201d Depression symptoms \u2014 such as fatigue or problems with concentration \u2014 also can mirror the effects of cancer and its treatments, which compounds the challenge. Qiao and colleagues evaluated associations between pre-existing depression and cancer-specific mortality among older adults with common malignancies. They also assessed whether early intervention with two common depression treatment approaches \u2014 psychotherapy or antidepressant medications \u2014 affected cancer-specific mortality. The researchers used SEER-Medicare data and ICD codes to identify 265,639 people aged 66 years or older diagnosed with one of six cancer types \u2014 bladder, breast, colorectal, kidney, non-small cell lung or prostate \u2014 between 2010 and 2017. Investigators used ICD codes to identify those with depression. \u2018A great opportunity\u2019 Approximately one in five (22%) people in the cohort had a diagnosis of major depressive disorder, with the highest prevalence among individuals with NSCLC (27%) and the lowest among those with prostate cancer (13%). A higher percentage of those with depression than without it died of their cancer within 1 year (29% vs. 21%) or 5 years (43% vs. 35%) of diagnosis. Patients with preexisting major depressive disorder exhibited significantly higher risk for cancer-specific mortality (subdistribution HR = 1.11; 95% CI, 1.09-1.12). Elevated risks reached statistical significance for people with prostate cancer (subdistribution HR = 1.34; 95% CI, 1.26-1.43), bladder cancer (subdistribution HR = 1.2; 95% CI, 1.12-1.28) and colorectal cancer (subdistribution HR = 1.14; 95% CI, 1.1-1.17). Researchers used CPD codes and Medicare Part D claims to identify individuals with depression who underwent psychotherapy or received antidepressants within 1, 2, 4 or 8 weeks of cancer diagnosis. Results showed 3% had a psychotherapy session within 4 weeks of cancer diagnosis and 4.6% had a session within 12 weeks of diagnosis. Individuals who received any psychotherapy had a lower rate of 5-year cancer-specific mortality than those who did not (31% vs. 44%). The association between psychotherapy within 4 weeks of cancer diagnosis and cancer-specific mortality reached statistical significance for the overall cohort (subdistribution HR = 0.79; 95% CI, 0.73-0.87), as well as for those with breast cancer (subdistribution HR = 0.77; 95% CI, 0.59-0.997), kidney cancer (subdistribution HR = 0.37; 95% CI, 0.19-0.71) or prostate cancer (subdistribution HR = 0.68; 95% CI, 0.47-0.98). Analyses adjusted with propensity score matching showed the value of early intervention. Psychotherapy delivered at later time points still offered benefit, although reductions in risk for cancer-specific mortality appeared lower for those who received it 8 weeks (subdistribution HR = 0.87; 95% CI, 0.85-0.88) or 12 weeks (subdistribution HR = 0.88; 95% CI, 0.83-0.94) after cancer diagnosis. Nearly one-third (32.5%) of patients with depression received medication within 4 weeks of cancer diagnosis. Results showed no significant association between pharmacotherapy and cancer-specific mortality in the overall cohort (subdistribution HR = 0.99; 95% CI, 0.97-1.02), although a significant association with reduced cancer-specific mortality emerged in the subgroup of adults with prostate cancer (subdistribution HR = 0.84; 95% CI, 0.74-0.95). Qiao said he was struck by the magnitude of difference in cancer-specific mortality between patients who received psychotherapy and those who did not. \u201cA cancer diagnosis is very stressful, and it places a tremendous burden on a person\u2019s mental health,\u201d Qiao said. \u201cPsychotherapy is a little bit more dynamic than pharmacotherapy, so it makes sense that psychotherapy may have a more significant effect in that cohort and stand out as a potentially better first-line option.\u201d However, the low rate of utilization for both psychotherapy and antidepressant medications is \u201ctroubling,\u201d Qiao said. \u201cThis isn\u2019t like a new form of cancer or an<\/p>\n","protected":false},"author":1,"featured_media":3889,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3888","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/3888","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3888"}],"version-history":[{"count":0,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/3888\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/media\/3889"}],"wp:attachment":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3888"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3888"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3888"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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