1. Health
Send to a Friend via Email

Lung Cancer and Depression

Importance, Symptoms, Causes, and Treatment

By

Updated June 23, 2013

Not surprisingly, depression is a common problem for those living with lung cancer. Overall, depression affects at least 15-25% of people with cancer, and that number appears to be even higher with lung cancer. Symptoms of shame and guilt, especially in those who have smoked, can add a sense of loneliness and isolation to an already difficult struggle. What should you know as you go through lung cancer treatment, so you can get the help you need?

Depression vs. Grief

The first step is to understand the difference between grief and depression. It is normal and expected that you will experience sadness following a diagnosis of lung cancer. This disease is devastating, and it is important to go through the grieving process as you adjust to your new life as a lung cancer survivor. But grief differs from clinical depression. Those who are grieving still find it possible to cope with daily life during cancer treatment. With clinical depression, a sense of feeling overwhelmed, hopelessness, and even thoughts of suicide can interfere with your ability to cope.

Symptoms of Depression

Studies suggest that physicians do not screen adequately for depression in cancer patients, so it is important to be aware of some of the more common symptoms. That said, the rigors of cancer treatment and symptoms caused by the cancer itself can cause many of the symptoms often attributed to depression. Some of the more common symptoms are listed below:
  • persistent feelings of sadness
  • feelings of helplessness, worthlessness or hopelessness
  • loss of interest in activities you usually enjoy
  • decreased energy
  • poor concentration
  • difficulty falling asleep or sleeping too much
  • loss of appetite
  • thoughts of death or suicide

Our About.com Guide to Depression discusses the criteria for a diagnosis of Major Depression. She also lists online screening tests to evaluate your symptoms. Remember that these tests are not a substitute for professional advice, but can alert you to concerns you should bring to your health care team.

Causes of Depression in People With Cancer

There are many causes of depression for those living with lung cancer. Some of these include:

Risk Factors

Certain conditions that occur either before your diagnosis, or due to your cancer, can raise your risk of developing depression. Some of these include:
  • Functional limitations – One of the biggest risk factors for depression during cancer treatment is an inability to perform the tasks you were able to prior to your diagnosis
  • Symptoms related to cancer – Symptoms, especially pain, add to the risk of depression
  • The type of cancer – Those with small cell lung cancer are more likely to experience depression than those with non-small cell lung cancer
  • A personal or family history of depression
  • Social isolation/lack of support
  • History of alcohol or drug abuse

Importance of Depression During Cancer Treatment

Untreated depression is concerning enough on its own – denying those who experience it the opportunity to live life as fully as they should, but with lung cancer, the consequences of depression extend even further and can affect:
  • Quality of life – Studies have shown that depression affects well-being and quality of life in those with lung cancer, even more than physical symptoms do.
  • Survival – For patients diagnosed with non-small cell lung cancer, depression is associated with poorer survival at 6 months. One recent study found that for people with stage 3B and stage 4 lung cancer, median survival was twice as long for people without depression compared to those who suffered from depression.
  • Suicide risk – The suicide risk in those living with cancer is estimated to be as much as 2 to 10 times higher than the general population. Suicide risk is highest in men, in the first few months after a diagnosis of cancer, and in those that have thought through a plan for how they would kill themselves.

Cancer and Suicide

Treatment

Treating depression can take the back seat in the midst of cancer treatment, but from what we know about quality of life and survival, it is very important to address this openly and at each visit with your oncologist. He or she may refer you to a psychologist or a psychiatrist who can work with you to help you feel better and adjust to your diagnosis. Counseling (psychotherapy) has been shown to make a significant difference for those with cancer-related depression. In some cases, medications may also be recommended to help you through your depression.

When to Call

It is important to talk to your cancer team about any symptoms of depression you are having at each visit. Any change in your symptoms, or comments from others that you appear depressed, should prompt you to call sooner. If you feel overwhelmed, or have thoughts of suicide – especially if you have thought about how you might hurt yourself, call your doctor, therapist, or call 911 immediately.

A Special Note for Caregivers

As we talk about those living with lung cancer, we can’t forget about the caregivers – those caring for their loved one with lung cancer. Caregivers also experience an increased rate of depression. As you care for your loved one, make sure to seek help if you notice symptoms of depression in your own life.

Sources:

Arrieta, O. et al. Association of Depression and Anxiety on Quality of Life, Treatment Adherence, and Prognosis in Patients with Advanced Non-small Cell Lung Cancer. Annals of Surgical Oncology. 2012 Dec 22. (Epub ahead of print).

Chen, M. et al. Depressive symptoms during the first chemotherapy cycle predict mortality in patients with advanced non-small cell lung cancer. Supportive Care in Cancer. 2011. 19(11):1705-11.

Cho, J. et al. Association between cancer stigma and depression among cancer survivors: a nationwide survey in Korea. Psychooncology. 2013 June 20. (Epub ahead of print)

Giannousi, Z. et al. Nutritional status, acute phase response and depression in metastatic lung cancer patients: correlations and association prognosis. Supportive Care in Cancer. 2011 Oct 1. (Epub ahead of print).

Hamer, M. et al. Psychological distress and cancer mortality. Journal of Pscyhosomatic Research. 2009. 66(3):255-8.

Hopwood, P. et al. Depression in Patients With Lung Cancer: Prevalence and Risk Factors Derived From Quality-of-Life Data. Journal of Clinical Oncology. 2000. 18(4):893.

Jones, L. and C. Doebbeling. Suboptimal depression screening following cancer diagnosis. General Hospital Psychiatry. 2007. 29(6):547-54.

National Cancer Institute. Depression (PDQ). Health Professional Version. Suicide Risk in Cancer Patients. Updated 06/30/11. http://www.cancer.gov/cancertopics/pdq/supportivecare/depression/HealthProfessional/page4

National Cancer Institute. Depression (PDQ). Patient Version. Overview. Updated 08/19/11. http://www.cancer.gov/cancertopics/pdq/supportivecare/depression/Patient/page2

Pirl, W. et al. Depression after diagnosis of advanced non-small cell lung cancer and survival: a pilot study. Psychosomatics. 2008. 49(3):218-24.

Sama, L. et al. Quality of life of long-term survivors of non-small-cell lung cancer. Journal of Clinical Oncology. 2002. 20(13):2920-9.

Walker, J. et al. Treatment of depression in people with lung cancer: A systematic review. Lung Cancer. 2013. 79(1):46-53.

©2014 About.com. All rights reserved.

We comply with the HONcode standard
for trustworthy health
information: verify here.