Mental and emotional distress among patients with cancer

A new study just published yesterday in the Journal of Clinical Oncology provides some interesting insights into the risk for various types of mental and emotional distress associated with diagnosis and treatment of cancer among > 2,100 patients with cancer interviewed according to a standardized protocol in Germany. The bottom line was that there were some relatively predictable findings as well as some relatively surprising ones.

Mehnert et al. interviewed a total of 2,141 patients at a variety of different types of treatment center in Germany, including hospitals, outpatient cancer care centers, and rehabilitation centers. About half of the patients (49 percent) were male, and 15 percent of the patients (i.e., about 320) had prostate cancer. The study is the the largest conducted to date that was designed to assess the mental and emotional health of cancer patients through the use of a fully standardized, diagnostic face-to-face interview. Additional information is available in a media release issued by the American Society for Clinical Oncology (ASCO, the publisher of the Journal of Clinical Oncology).

The authors found that, among these patients:

  • The total 4-week prevalence for any mental disorder was 31.8 percent.
  • The types of mental disorder noted included
  • The prevalence for mental disorders by cancer type included data on
    • Breast cancer (41.6 percent)
    • Head and neck cancer (40.8 percent)
    • Malignant melanoma (39.0 percent)
    • Prostate cancer (22.0 percent)
    • Pancreatic cancer (20.3 percent)
    • Stomach/esophageal cancers (21.2 percent)

Mehnert et al. conclude, unsurprisingly, that these findings “provide evidence for the strong need for psycho-oncological interventions” among many types of cancer patient.

The odd thing about these data is the high degree mental distress of breast cancer patients, for what is a very manageable condition for the majority of those patients, by comparison with the relatively low mental distress of patients with a disorder like pancreatic cancer, which is essentially a terminal disease, with most patients having a survival of much less than 5 years. One is tempted to wonder whether the high level of mental distress of breast cancer patients is a direct consequence of the way that breast cancer has been “demonized” by the cancer advocacy community over the past 30-odd years. Experienced advocates tend to be well aware that there is a serious potential “down side” to certain types of advocacy.

The mental health levels observed for prostate cancer patients in this study appear to reflect those that we have observed among men with prostate cancer over the past 25 years: for something like 20 to 25 percent of prostate cancer patients, there are very real mental health issues related to diagnosis, initial treatment, and long-term survival with a diagnosis of prostate cancer.

Although this study was conducted in Germany, the authors themselves seem to believe that their data

can likely be generalized to patients in the United States because the prevalence of mental health diagnoses is similar between the two countries.

And, on behalf of ASCO, Dr. Don Dizon (a medical oncologist at Massachussetts General Hospital in Boston) is quoted as stating:

We have always assumed that the diagnosis of cancer is hard on our patients, but these findings indicate how common these feelings may be. They also stress the importance that providers keep in mind that mental health issues are common across cancer types. Patients should be offered support as appropriate. It’s also important that our patients be aware of just how common distress is, and that help in managing a challenging situation is available for them and their families.


One Response

  1. I do not find the results surprising at all. It is more of a fear of loss of identity, or self-image, than death itself.

    Not unlike the fear of loss and stress associated with a loss of a job, even if the job loss itself is without a true financial risk.,

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