Pancreatic cancer and depression: myth and truth

Mayr, Martina; Schmid, Roland M.

doi:10.1186/1471-2407-10-569

Cited by 68 publications

(45 citation statements)

References 64 publications

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“…Currently, the most cost effective and efficient method is the use of a brief screening questionnaire to identify cancer patients with depressive symptoms, a variety of which are available. 14,19,22,25,32,33,35,38,39,41,46,47 Once identified, patients with depression should be treated with a multidisciplinary approach. Psychiatric or psychological consultation should be sought to optimize the patient’s mental health.…”

Section: Discussionmentioning

confidence: 99%

The effect of depression on stage at diagnosis, treatment, and survival in pancreatic adenocarcinoma

Boyd

Benarroch‐Gampel

Sheffield

et al. 2012

Surgery

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Background Depression has been associated with delayed presentation, inadequate treatment, and poor survival in patients with cancer. Methods Using Surveillance, Epidemiology and End Results and Medicare linked data (1992–2005), we identified patients with pancreatic adenocarcinoma (N = 23,745). International Classification of Diseases, 9th edition, Clinical Modification codes were used to evaluate depression during the 3 to 27 months before the diagnosis of cancer. The effect of depression on receipt of therapy and survival was evaluated in univariate and multivariate models. Results Of patients with pancreatic cancer in our study, 7.9% had a diagnosis of depression (N = 1,868). Depression was associated with increased age, female sex, white race, single or widowed status, and advanced stage disease (P < .0001). In an adjusted model, patients with locoregional disease and depression had 37% lower odds of undergoing surgical resection (odds ratio, 0.63; 95% confidence interval, 0.52–0.76). In patients with locoregional disease, depression was associated with lower 2-year survival (hazard ratio, 1.20; 95% confidence interval, 1.09–1.32). After adjusting for surgical resection, this association was attenuated (hazard ratio, 1.14; 95% confidence interval, 1.04–1.26). In patients who underwent surgical resection, depression was a significant predictor of survival (hazard ratio, 1.34; 95% confidence interval, 1.04–1.73). Patients with distant disease and depression had 21% lower odds of receiving chemotherapy (odds ratio, 0.79; 95% confidence interval, 0.70–0.90). After adjusting for chemotherapy for distant disease, depression was no longer a significant predictor of survival (hazard ratio, 1.03; 95% confidence interval, 0.97–1.09). Conclusion The decreased survival associated with depression appears to be mediated by a lower likelihood of appropriate treatment in depressed patients. Accurate recognition and treatment of pancreatic cancer patients with depression may improve treatment rates and survival.

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Section: Discussionmentioning

confidence: 99%

The effect of depression on stage at diagnosis, treatment, and survival in pancreatic adenocarcinoma

Boyd

Benarroch‐Gampel

Sheffield

et al. 2012

Surgery

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“…As noted earlier in the section on risk factors, patients with pancreatic cancer sometimes present with new‐onset diabetes mellitus or with signs and symptoms of chronic pancreatitis. Of interest, depression is common in patients with pancreatic cancer, and in some instances the diagnosis of depression is established before the patient is found to have the cancer . This observation suggests that the cancers are producing a factor that induces the depression.…”

Section: Signs and Symptomsmentioning

confidence: 99%

“…Of interest, depression is common in patients with pancreatic cancer, and in some instances the diagnosis of depression is established before the patient is found to have the cancer. 103 This observation suggests that the cancers are producing a factor that induces the depression. The radiologic diagnosis of pancreatic cancer has improved significantly with enhancements in the sensitivity of imaging technologies.…”

Section: Signs and Symptomsmentioning

confidence: 99%

Recent progress in pancreatic cancer

Wolfgang

Herman

Laheru

et al. 2013

CA A Cancer J Clinicians

793

654

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Pancreatic cancer is currently one of the deadliest of the solid malignancies. However, surgery to resect neoplasms of the pancreas is safer and less invasive than ever, novel drug combinations have been shown to improve survival, advances in radiation therapy have resulted in less toxicity, and enormous strides have been made in our understanding of the fundamental genetics of pancreatic cancer. These advances provide hope but they also increase the complexity of caring for patients. It is clear that multidisciplinary care that provides comprehensive and coordinated evaluation and treatment is the most effective way to manage patients with pancreatic cancer.

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“…Later symptoms are related liver metastasis and/or invasion of adjacent organs (stomach, colon) or of the peritoneal cavity, which may lead to ascites [126]. Jaundice and liver function abnormalities may also indicate that cancer has metastasised to the liver [126] Occasionally, patients present with acute pancreatitis, migratory thrombophlebitis, or hypercalcaemia [3]Depression is also common in patients with pancreatic cancer [127].…”

Section: Clinical Historymentioning

confidence: 99%

Scientific rationale for integrative and personalised strategies for pancreatic ductal adenocarcinoma management

Korhan¹,

Verkerk²,

Critchley³

2017

Integr Mol Med

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Pancreatic ductal adenocarcinoma (PDAC) arises from epithelia of pancreas. Despite its low incidence, it is the most lethal cancer type. Although the poor outcome is largely secondary to the high proportion of patients who are diagnosed with advanced disease, the prognosis of PDAC is also influenced by the inherent biological aggressiveness and the high metastatic potential of this malignancy. Treatment options remain limited with little progress over the last decades. Some improvements in surgical outcome occur in patients who also receive chemotherapy and/or radiotherapy, however, the impact on long-term survival has been minimal owing to the intense resistance of PDAC to all extent treatments regimen. Hence, there is an urgent need to 1) gain better understanding of the biology of PDAC; 2) to develop early detection and prevention programs; 3) to identify new therapeutic strategies to improve quality of life and survivorship. In this review, first, we will summarise the state of knowledge of PDAC pathogenesis with a particular the focus on the molecular characteristics causing therapeutic resistance. Then, we will briefly review current and emerging approaches in the PDAC care. Lastly, we will highlight the integrative approaches in the light of new experimental and clinical research conducted with the aim of moving towards personalised therapy in patients with PDAC.

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Pancreatic cancer and depression: myth and truth

Cited by 68 publications

References 64 publications

The effect of depression on stage at diagnosis, treatment, and survival in pancreatic adenocarcinoma

The effect of depression on stage at diagnosis, treatment, and survival in pancreatic adenocarcinoma

Recent progress in pancreatic cancer

Scientific rationale for integrative and personalised strategies for pancreatic ductal adenocarcinoma management

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