Treatments for breast cancer that disrupt estrogen levels may increase patients’ risk of developing depression, preliminary research suggests.
Both chemotherapy and the commonly used drug treatment, tamoxifen, can disrupt the activity of the hormone estrogen in breast cancer patients. Falling estrogen levels can cause physical symptoms such as hot flashes or cessation of menstrual periods — symptoms commonly associated with menopause.
The new study suggests that breast cancer patients who experience these symptoms “should be targeted for diagnosis of depression and treated if diagnosed.”
“What happens is so much is going on and it seems so obvious that patients would be unhappy. Since the main goal is to get done what has to be done to treat the tumor, the time when a patient might slip into a persistent depression is not so clear unless people are asking the questions, and unless the patient is saying how bad she feels,” study co-author Dr. Donna Greenberg told Reuters Health.
Eight out of 21 of the patients participating in the study, led by Dr. Laura Sheingold Duffy of The Massachusetts General Hospital Cancer Center in Boston and colleagues, developed a major depressive disorder, in most cases in the first 6 months of treatment for breast cancer.
In addition, insomnia, hot flashes, and dysphoria, or a general feeling of malaise, were “almost universal” among the women whose estrogen activity was disrupted by cancer treatments.
Breast cancer patients should not hesitate to mention symptoms of depression to their doctors, according to Greenberg.
“If they have feelings of hopelessness, persistent thoughts of death, trouble with repeated episodes of anxiety, they should bring this to the physicians that are caring for them, so the question of whether they have clinical depression that can be alleviated by treatment can be addressed,” she said.
“I think that we have the ability to treat depression just as we have the ability to treat pain, and it can be easily integrated into care,” she added.
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