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Professor Michael Sharpe and colleagues identify that treating depression doesn’t make cancer patients live longer, but it does make lives immeasurably better.

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A follow up study led by Professor Michael Sharpe at the University of Oxford’s Department of Psychiatry – ‘Does depression treatment improve the survival of depressed patients with cancer? A long-term follow-up of participants in the SMaRT Oncology-2 and 3 trials’ – has been published in The Lancet Psychiatry.

It reveals that contrary to the findings of previous small studies, treating depression in cancer patients does not increase the length of life of people with cancer. However the previous publications from these trials found that the benefits to patients’ quality of life are clear and significant.

Our previous clinical trials (SMaRT oncology 2 and 3) have found that the systematic identification and treatment of depression in people with cancer is both effective and cost effective in reducing depression and also in improving quality of life. This study followed up the participants in these trials to find out whether treating depression also increases their survival. We found no evidence that it does. We conclude that whilst treating depression may not increase the length of life of people with cancer its effect on the quality of that life still makes it a priority for cancer services. - Professor Michael Sharpe

Comorbid major depression has been repeatedly found to be associated with worse survival in patients with cancer. However, it was not known if treating depression improved survival. In the SMaRT Oncology-2 (good prognosis cancers) and SMaRT Oncology-3 (lung cancer, a poor prognosis cancer) trials, the study found that a depression treatment programme, Depression Care for People with Cancer (DCPC), was effective in reducing comorbid major depression. In this follow-up study, the team of researchers aimed to identify whether DCPC also had an effect on survival. 

Researchers followed up SMaRT Oncology-2 and SMaRT Oncology-3 participants for a median of 5 years and 1 year, respectively. They found no significant effect of DCPC on survival in the total follow-up period for either SMaRT Oncology 2 or SMaRT Oncology-3. 

However, the evidence for a beneficial effect on quality of life strongly recommends the treatment of depression in people with cancer.

This work was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Oxford at Oxford NHS Foundation Trust, and the Chief Scientist Office of the Scottish Government. The trials were funded by Cancer Research UK.

 

Read the full paper published in The Lancet Psychiatry.