Depression, quality of life and breast cancer: a review of the literature

Abstract

Depression is misdiagnosed and undertreated among breast cancer population. Risk factors for depression in the 5 years after diagnosis are related more to the patient rather than to the disease or its treatment. The breast cancer stage (early and advanced) is not statistically significant in terms of rates of psychosocial distress except for recurrence. Risk factors of depression might impair quality of life such as fatigue, past history or recent episode of depression after the onset of cancer, cognitive attitudes of helplessness/hopelessness, resignation. Body image impairment from mastectomy and sexuality aftermath generates higher rates of mood disorders. The link between increased risk of breast cancer and depression is controversial among the literature. Some studies suggest a protective factor, others find a relation between stress, immunity and cancer occurrence or even mortality. Breast cancer survivors report a higher prevalence of mild to moderate depression with a lower quality of life in all areas except for family functioning. Treatment of depression in breast cancer women improves their quality of life and may increase longevity. Antidepressant medications remain the cornerstone of depression treatment. The hypothetical link between their prescription and increased breast cancer risk is not supported by literature's data.

Women's Perceived Benefits of Exercise During and After Breast Cancer Treatment

“…Post-treatment women shared personal stories illustrating their perceptions that exercise was an empowering endeavor that moved them forward into the next phase of their lives and helped them manage their fears and other emotions related to their cancer diagnosis. These findings are important because depression among cancer survivors has been associated with poor adherence to treatment regimens (Fann et al, 2008) decreased quality of life (Reich et al, 2008) and inability to return to pre-cancer roles and responsibilities (Steiner et al, 2008). If exercise can enhance psychological health in the specific ways described by women in this study, it is possible that depression symptoms may be lessened and health outcomes improved.…”

Course of depression, mental health service utilization and treatment preferences in women receiving chemotherapy for breast cancer

“…The recognition and treatment of depression is of paramount importance given its effects on quality of life, level of physical and cognitive functioning, adherence to treatment, distress from physical symptoms and possibly survival [2,14,[38][39][40]. Basic science research suggests that the neurohormonal milieu associated with psychological distress may influence the biological activity of breast cancer cells and reduce the efficacy of chemotherapy [41,42].…”

“…Prevalence estimates of depression in breast cancer patients range from 5 to 40%, with most falling between 10 and 25% [1,2]. The variability of these findings is likely due to the range of populations observed, screening methods used and timing of assessments.…”

Depression and cancer: the point of view of the oncologist

“…L'impact des traitements mutilants comme la mastectomie ou la laryngectomie totale sur la dépression n'est pas clairement établi dans la littérature, les publications portant surtout sur l'évaluation globale de la qualité de vie et non spécifiquement sur la dépression. Cela dit, les traitements modifiant l'image corporelle entraînent plus volontiers des désordres de l'humeur, comme le démon-tre la revue de Reich et al à propos des femmes traitées pour un cancer du sein [21].…”