Depression before and after uterine cervix and breast cancer neoadjuvant chemotherapy

Abstract

Depression in cancer patients is common and may affect treatment outcome either directly (by lowering defenses) or indirectly (by lowering compliance). Neoadjuvant chemotherapy for advanced uterine cervix or breast cancer is a strenuous undertaking and may lead to depression and impair patients' willingness to comply with the rest of the treatment (eg, surgery or radiotherapy). We compare Beck Depression Inventory (BDI) scores both before and after neoadjuvant chemotherapy in order to verify if depression influences treatment outcome. We studied 22 advanced uterine cervix and 20 breast cancer patients submitted to three courses of neoadjuvant chemotherapy. We used cisplatin and ifosfamide for cervix, and fluorouracil, adriamycin, and cyclophosphamide for breast cancer. We did not identify significant differences in the number of depressed patients, before and after treatment. Cognitive affective, somatic-performance, and total BDI scores were not significantly different from before to after chemotherapy for both breast and uterine cervix cancer. After treatment, the number of depressive breast cancer patients increased while the number of uterine cervix cancer patients decreased. This trend to depression was found more often in less responsive breast cancer patients than in the more responsive cervix cancer patients. We were not able to link depression to treatment failure or success, but patients who responded to treatment were less depressed at the end of treatment.

Prognostic Factors of Depression in Patients With Cancer Undergoing Chemotherapy and Radiotherapy

“…However, some reports indicated this point (7,9), but So reported that difference in the amount of depression was significant between patients undergoing chemotherapy and radiotherapy (12). Miranda et al stated that before and after one period of chemotherapy, depression was not significantly different, but those with lower depression scores showed a better response to treatment (20). Supporting patients with cancer leads to a better treatment response.…”

Distress, anxiety, and depression in cancer patients undergoing chemotherapy

“…Depression is suspected when symptoms of sadness persist and are accompanied by increasing dysfunction, feeling of worthlessness, lowered self-esteem, suicidal preoccupation or inability to anticipate anything with pleasure [ 15 ]. Miranda et al, (2002) [ 16 ] evaluated depression in breast and cervix cancer patients undergoing neoadjuvant chemotherapy and found no difference in proportion of depressed however, the number of depression patients increased after chemotherapy for breast cancer which is reduced for uterine cervix cancer [ 16 ]. The patients who responded to treatment were less depressed.…”

Distress Among Locally Advanced Breast Cancer Patients from Diagnosis to Follow-Up: A Critical Review of Literature

“…Among those, 14 were QT studies and two were QL studies. One study found that 30% of patients were depressed before NACT, and 45% after NACT with an increased number of depressed patients if the tumor was not responsive [49]. Yet another cross-sectional study assessing 85 patients (stage I-IIIA) on average found very little depression among all women [51].…”