A new study has found the prevalence of depression in patients with bowel cancer for up to five years after surgery to treat their cancer. More than a third of the patients suffered from clinically significant depression during the study, with one in seven still showing symptoms five years after undergoing surgery.
A research team, led by the University of Southampton and funded by Macmillan Cancer Support, interviewed 872 adult patients with non-metastatic colorectal cancer before surgery and conducted follow-up surveys at regular intervals for up to 60 months after surgery. The results were published in the journal Colorectal disease.
Lead author Dr Lynn Calman, associate professor of nursing at the University of Southampton, said: “Depression in people with colorectal cancer is a significant clinical problem. Our study shows that the level of depression exceeds that of the general population over time. The research has also helped us identify important times when some patients are at high risk for depression, which can inform recognition and referral strategies for appropriate support. “
The results of the survey showed that before surgery, more than a fifth of participants (21%) reported clinically significant levels of depression, which decreased to 14% at 5 years. Risk factors identified before surgery that predicted subsequent depression were pre-existing clinically significant depression and anxiety, previous use of mental health services, low confidence in dealing with illness-related issues, poor health, and low social support.
Further analysis of the results suggests that people with bowel cancer who have reduced levels of social support are almost 2.5 times more likely to experience depression as well. Among participants with the highest levels of social support at diagnosis, 16% developed clinical levels of depression within five years of their cancer treatment, compared with 37% of those with lower levels of social support. .
Although the above results are based on the experiences of people before Covid, the evidence suggests that the social isolation linked to the pandemic could further worsen the mental health of people with cancer. The research team is currently conducting another study on the impact of COVID-19, also funded by Macmillan Cancer Support; interim results revealed that four in five cancer patients (81%) surveyed stayed home at all times during the pandemic, and nearly half (45%) of them experienced at least two severe psychological impacts of pandemic, such as feeling scared, depressed, or helpless.
Dany Bell, Strategic Advisor for Treatment, Drugs and Genomics at Macmillan Cancer Support, said: “We know that for many people, being diagnosed with cancer and undergoing treatment is one of the scariest things about life. ‘they have never encountered, and this can often have a serious impact on people’s mental health.
“Cancer affects people differently and at Macmillan we’re here to make sure all people living with cancer get the support they need. We invite anyone in need of assistance – or just someone to talk to – to contact the trained nurses and counselors on our helpline who are available at the end of the phone, seven days a week.
“Anyone in need of cancer support can call the Macmillan Hotline on 0808 808 00 00, which is open 7 days a week, 8 am to 8 pm. “
The new findings also showed that people with bowel cancer who had undergone neoadjuvant chemotherapy were also more likely to experience depression, which may be because these patients typically experience more complex treatment, side effects and longer treatment duration.
Dr Calman continued, “In this study, we looked at risk factors for depression at two key points in time: near diagnosis before surgery and two years after surgery, when routine oncologic examinations end.
“Depression in people living with cancer can lead to poor health and well-being, which impacts long-term outcomes. Recognizing patients with colorectal cancer who are at higher risk and referring them to the appropriate support services could therefore lead to an overall improvement in patient outcomes. “
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Prevalence and determinants of depression up to 5 years after colorectal cancer surgery: results of the ColoREctal Wellbeing (CREW) study
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