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 patients because of its reputation as a deadly and often painful disease. Given these realities, it is not surprising that depression and cancer of the pancreas often occur co-morbidly. Depression and anxiety occur more frequently in patients with cancer of the pancreas than they do in patients with other forms of cancer. The etiology of depression in patients with cancer of the pancreas may be traced to more than the disease's poor prognosis, the pain it causes, or existential issues related to death and dying.
METHODS: Clinical and research data on the connection between depression and cancer of the pancreas were reviewed.
RESULTS: In many instances, symptoms of depression and anxiety may even precede knowledge of the diagnosis; one of several observations that 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 bicarbonate).
CONCLUSIONS: Whatever its etiology, the identification and treatment of depression associated with cancer of the pancreas is an important way in which oncologists and mental health professional can collaborate to enhance quality of life in this unfortunate population of patients. Diagnosis and treatment of depressive disorders as they applied to patients with cancer of the pancreas were reviewed, and psychologic and pharmacologic treatment strategies to deal with these issues were outlined.