Psychosocial aspects of lung cancer

doi:10.1016/j.lungcan.2004.08.002

Lung Cancer

Volume 47, Issue 3, March 2005, Pages 293-300

https://doi.org/10.1016/j.lungcan.2004.08.002 Get rights and content

Summary

Background:

Lung cancer is one of the commonest cancers in the industrialised world, and persons with this grave disease must deal not only with the physical effects but also with the psychosocial aspects.

Methods:

This review is based on an examination of intervention, prospective and case-control studies with more than 50 participants published between 1966 and 2003.

Results:

The studies show that on average one out of four persons with lung cancer experience periods of depression or other psychosocial problems during their illness. Persons who are not offered treatment for their cancer and persons with small-cell lung cancer have a higher risk compared to other groups of lung cancer patients. The degree of depression can be reduced by psychosocial interventions.

Conclusions:

We suggest that psychosocial screening of persons with lung cancer could prevent depression and might result in improved quality of care.

Introduction

Lung cancer is one of the commonest cancers in the industrialised world. In Europe, lung cancer accounts for about 25% of deaths from cancer among men and 9% among women [1]. Among women, mortality rates from lung cancer are increasing faster than for any other cancer type [2]. The grave prognosis is due partly to the fact that the disease is usually diagnosed in advanced stages [3], with an overall 5-year survival rate in Europe of 6–16% [4] and a less favourable rate for persons with small-cell lung cancer than for those with non-small-cell lung cancer [5].

Clinical psychosocial interventions are more often applied to cancer patients with longer expected survival times than those of lung cancer patients. A number of studies have indicated the need to focus on the quality of life of lung cancer patients [6], [7], [8], owing to improvements in palliative treatment [9], [10], [11]. Few studies have, however, investigated the psychosocial effects or the effects of psychosocial interventions on persons with lung cancer.

We conducted a review of studies of the psychosocial effects of a diagnosis of and treatment for lung cancer as well as randomised studies of psychosocial interventions, in order to evaluate the evidence for more extensive psychosocial intervention programmes for these persons.

Section snippets

Materials and methods

The MedLine (1966–August 2003) database was searched with the keywords lung and cancer combined with psychosocial or social and anxiety or depression or quality of life. Citations were also sought manually in the identified papers and reviews. Through this search, we identified 212 studies—194 through MedLine and 18 found manually. The exclusion criteria are listed in Fig. 1. A full list of the studies can be obtained by contacting the corresponding author.

Prospective studies

Of the 10 prospective studies identified (Table 1), only one included measurement of the baseline prevalence of depression before diagnosis. In this study from the United Kingdom [12], [13], the overall prevalence of depression among 50 persons with inoperable lung cancer was reduced from 26% before diagnosis to 16% at follow-up. This reduction was found only among patients receiving radiotherapy or chemotherapy. Among persons who did not receive any specific anticancer treatment, the number of

Discussion

In our review of studies on the psychosocial aspects of lung cancer, only 14 fulfilled our inclusion criteria. The review nevertheless revealed that persons with lung cancer have a high risk for psychosocial problems after diagnosis and treatment.

Most of the identified studies used depression as an outcome measure, but wide variations in the prevalence of this significant psychiatric disorder were reported, ranging from 5% [18] to 52% [25]. Not surprisingly, the potential for cure was an

Acknowledgement

The study was financed by the Danish Cancer Society, Psychosocial Research Foundation.

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REVIEWPsychosocial aspects of lung cancer

Summary

Background:

Methods:

Results:

Conclusions:

Introduction

Section snippets

Materials and methods

Prospective studies

Discussion

Acknowledgement

Chest

Lung Cancer

Lung Cancer

Ann Oncol

Eur J Cancer

Eur J Cancer

Cancer burden in the year. The global picture

Eur J Cancer

Screening for lung cancer: a systematic review and meta-analysis of controlled trials

Thorax

Do morphology and stage explain the inferior lung cancer survival in Denmark?

Eur Respir J

Depression in patients with lung cancer: prevalence and risk factors derived from quality-of-life data

J Clin Oncol

The relationship of psychological distress, extent of disease, and performance status in patients with lung cancer

Cancer

Quality of life of long-term survivors of non-small-cell lung cancer

J Clin Oncol

Patterns of symptom distress in adults receiving treatment for lung cancer

J Palliat Care

Depressive illness and lung cancer. II. Follow-up of inoperable patients

Eur J Surg Oncol

REVIEW
Psychosocial aspects of lung cancer