DEPRESSION IN PATIENTS WITH PANCREATIC-CARCINOMA - DIAGNOSTIC AND TREATMENT ISSUES

BACKGROUND. Cancer of the pancreas is a highly malignant illness with a very poor prognosis. Unfortunately there has been little in the way of improvement in prognosis over the past 20 years. It is feared by pa tients because of its reputation as a deadly and often painful disease . Given these realities, it is not surprising that depression and canc er of the pancreas often occur co-morbidly. Depression and anxiety occ ur more frequently in patients with cancer of the pancreas than they d o in patients with other forms of cancer. The etiology of depression i n patients with cancer of the pancreas may be traced to more than the disease's poor prognosis, the pain it causes, or existential issues re lated to death and dying. METHODS. Clinical and research data on the c onnection between depression and cancer of the pancreas were reviewed. RESULTS. In many instances, symptoms of depression and anxiety may ev en precede knowledge of the diagnosis; one of several observations tha t have raised speculation that mood and anxiety syndromes are related to disruption in one of the physiologic functions of the pancreas (i.e ., secretion of hormones, neurotransmitters, digestive enzymes, or bic arbonate). CONCLUSIONS. Whatever its etiology, the identification and treatment of depression associated with cancer of the pancreas is an i mportant way in which oncologists and mental health professionals can collaborate to enhance quality of life in this unfortunate population of patients. Diagnosis and treatment of depressive disorders as they a pplied to patients with cancer of the pancreas were reviewed, and psyc hologic and pharmacologic treatment strategies to deal with these issu es were outlined. (C) 1996 American Cancer Society.