Cancer patients who are able to maintain social interactions with family and friends during the course of their treatment are less likely to suffer from severe depression -- an extremely common problem among patients newly diagnosed with cancer.

In a paper published in the journal Psycho-Oncology, Michigan State University researchers Margot Kurtz and Charles Given suggest that depression in cancer patients can be reduced if clinicians better manage symptoms so that patients are able to continue their social activities during treatment.

"I believe that the most significant finding is the important role that disruptions in social function -- that is contact with family, friends and daily interactions -- along with symptom management, have upon levels of depression," said Given, a professor of family practice in MSU's College of Human Medicine. "This is particularly important because management of symptoms will allow patients to continue their customary social roles, which will, in most cases, reduce their feelings of depression during treatment."

"Physical symptoms of the disease and declining physical abilities may cause depression and anxiety, which can begin with diagnosis and continue through treatment," said Kurtz, a professor of family and community medicine in the MSU's College of Osteopathic Medicine.

Over the course of one year, the researchers conducted four interviews with 228 elderly lung cancer patients. Lung cancer is an especially virulent disease and is becoming the leading cause of cancer-related deaths in men and women in the United States. Currently, the five-year survival rate is 15 percent.

In the study, each patient's symptoms of depression, physical functioning, social functioning, physical symptoms and related conditions were assessed at each interview.

At each interview, it was found that the best predictors for serious depression were severity of patients' cancer symptoms and the patients' reported losses in social functioning.

The number of patients who were depressed declined over the course of the study from 39 percent in the six to eight weeks following diagnosis to 31 percent after one year for men and from 42 percent to 33 percent for women.

"This decline," said Given, "appeared to be due to the declining numbers of symptoms, as well as recovery of social function over time."

Kurtz and Given said the study suggests that health care providers should pay closer attention to symptom management when treating cancer, especially in older patients.

"Since the mental health of elderly patients appears to be inextricably tied to their symptom experience, which is related to their abilities to continue to function socially, symptom management must be a foremost concern of oncologists and other health care providers," the authors wrote in their paper.

They also suggested that clinicians try to identify any psychosocial difficulties soon after diagnosis of lung cancer and take other steps such as giving information, reassuring patients and referring patients to other resources.

The study was funded by grants from the National Institute for Nursing Research and the National Cancer Institute.

---Michigan State University

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