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Lung cancer: never underestimate depression
ONE-third of patients with a diagnosis of cancer of the lung suffers from depression moderate-severe and of a toxic concoction of anxiety, stress, loss of ability to perform activities of every day, in addition to pain and other physical symptoms. It is the conclusion of a study published in Lung Cancer carried out by a team of psychologists and doctors of the Ohio State University. The researchers used questionnaires telephone to collect information on 186 men and women who had recently been diagnosed with a carcinoma, non-small cell lung in the advanced stage of a disease which alone accounts for 85% of all lung cancer cases in our country every year, affecting more than 41mila people.
"of Course you're depressed, you have a cancer" "doctors may think that it is normal that the patient is depressed: he has cancer. But this is an attitude that is indicative of an underestimation of the extent of depressive symptoms and of the problems that those symptoms are associated," stresses Barbara Andersen, first author of the publication, professor of psychology and a member of the Cancer Prevention and Control Program of the university. Yes, because - remember the authors - the results of the treatments that you get on people with depression, moderate-to-severe are worse than those that are observed on those who suffer from a form of depression, mild-to-moderate equal of pathology and treatment.
A package of symptoms Back to the search. 8% of patients enrolled in the survey reported symptoms of severe depression and 28% of mild depression. 93% of the depressed serious has stated that the emotional state interfered considerably with the work, made it difficult to take care of the house and get along with others. Reported also high levels of despair, and one-third reported having suicidal thoughts. Always the more depressed they reported very high levels of stress directly related to the disease and the lack of trust in care, and more often than the other physical symptoms severe, with 73% of respondents feel "somewhat" or "very much" pain, for example, and all of them have difficulty in carrying out normal activities: work, study, housework, and so on. A “package of symptoms - it was the reflection of Andersen - which can have a negative impact on the treatments, the general health, quality of life and on the progression of the disease". And patients with mild depression? They also have reported negative effects, less intense but still significant. However, differences were detected between the two groups. The first is related to the anxiety.
A huge stress and the disorder of generalized anxiety, or DAG (excessive concern and constant for any thing significant reduction of quality of life) was recorded in 11% of the depressed moderate, 73% of the depressed serious the reported. Another difference relates to the alteration of self-care: detected in 8% of patients with depressive symptoms moderate and in 33% of those with major depression. Differences between the two groups have been highlighted, and finally, in alterations of the mobility (33% versus 73%) and difficulty in routine activities (38% versus 100%). Andersen said that she was “struck by the levels extremely high stress related to the disease reported by the patients with severe depressive symptoms”.
Treat cancer and depression The authors ' conclusion? Anyone who has a cancer of the lungs should be screened for the depression and cared for if they need because, she explained, the psychologist, is “difficult for those who suffer from forms of depression moderate-severe will come out without any treatment”. “A world submerged in the state anxious-depressive patients, a state they share in common, although to a different extent, all the sick of cancer, but that probably covers more and more often, someone who is suffering from cancer of the lung. And it is a problem”, says Cesare Gridelli, director of the Department of Onco-Hematology of the hospital Giuseppe Moscati of Avellino. “It's not a problem – enter in to the specific the oncologist – for a variety of reasons: first, because the anxiety and depression worsen the physical symptoms of the disease, for example pain and dyspnoea in the case of the lung. Second, because an emotional condition very compromised acts negatively on adherence to treatment, and, finally, because, since the clinical conditions of a depressed appear worse than they are, the doctor can be confusing and can be misled in the choice of the type and intensity of care”.
The guilt and the anger, But if this is true and is a risk for all cancer patients, because it may be more for those affected by lung cancer? “Because often these patients have a poor prognosis, and at the time of diagnosis of their situation is already compromised. Why feel a sense of guilt to be smoking (as in 80% of cases, ndr). A sense of guilt, sometimes fed by the family, which becomes anger. That does not help,” reflects Gridelli. “For a smoker, that is a bronchitico chronic, the diagnosis comes very often late, because the patient underestimates the symptoms. And also this increases the sense of anger and frustration. And then there is the question of surgical intervention: in 80 percent of cases those with a carcinoma of the lung, because of the diagnostic delay due to underestimation of signs of disease, is not subject to intervention, the nth element – ends Gridelli - that impacts negatively on the perception of their own perspective of life.”

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