Evidence currently available demonstrates that psychosocial interventions benefit cancer patients experiencing depressive symptoms, but the overall quantum of its effectiveness ranges from mild to moderate. Since there are several hundreds of studies that focus on psychosocial interventions meant for cancer patients, we have pruned the analysis to cover the published meta-analysis, as derived through these studies. Here, we have excluded the role played by preventative studies and depression treatment studies. The effects that these interventions have may differ in these two different types of studies.
While not all pharmacologic studies demonstrated the benefits for depression experienced by cancer patients, all studies that used antidepressants and followed standard procedures for antidepressant trials did. Because it takes around 4 to 6 weeks for antidepressants to achieve full effect, studies of antidepressants less than 6 weeks demonstrated lesser benefits. Currently, there is data to substantiate the effectiveness of selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants. While trazodone, which is an atypical antidepressant, demonstrated some benefits in the treatment of depressive symptoms, it is generally not used as an antidepressant due to severe sedation experienced at therapeutic doses.
While there are reports that explain alternative or complimentary therapy programs, there haven’t been any controlled trials to measure their effectiveness for depression experienced by cancer patients.
Treatment of Cancer-related Fatigue
Relatively lesser number of controlled clinical trials involving treatment for cancer-related fatigue was published. The use of epoetin alfa for patients experiencing anemic symptoms due to chemotherapy treatment is the only treatment that can be substantiated by clinical evidence currently available. There were a few controlled trials that assessed exercise programs, and in some of these, results were promising but of a preliminary nature. Certain encouraging outcomes have also been achieved with psychosocial interventions.
Treatment trials involving cancer-related fatigue generally have small sample sizes, and it is likely that majority of these studies were underpowered in order to detect the desired outcome.
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