Treatment Options for Mesothelioma Patients With Depression

Health & Wellness

Studies indicate that about 30-60% of cancer patients experience clinical symptoms of depression at some point during their cancer experience. For several reasons, cancer patients are not as likely to report mental health symptoms to their physicians as they are their physical symptoms, which leads to underdiagnosing and undertreating mental health issues in mesothelioma patients. 

Luckily, many cancer treatment centers are beginning to regularly screen for emotional distress (which includes looking for relationship strain, anxiety and depressive symptoms). The American College of Surgeons’ Commission on Cancer in 2015 mandated routine emotional distress screening in cancer centers. The goal of this mandate was to increase awareness of the importance of addressing mental health and emotional wellbeing  and to diagnose and appropriately treat cancer patients with mental health symptoms like depression.

Who Should Mesothelioma Patients Talk to About Depression?

Oncology health care providers are typically the ones who mesothelioma patients are used to talking to about their health and are a great place to start the conversation about mesothelioma and depression. Ideally, the distress screening tools that cancer treatment centers use open the door to discussion about mental health symptoms that mesothelioma patients are experiencing. 

Many times, oncologists may offer to prescribe an antidepressant to their patients once a diagnosis of depression is confirmed. Primary care physicians and psychiatrists are also very well qualified to diagnose depression and offer treatment options. 

Other mental health professionals such as mental health counselors, clinical social workers and marriage and family therapists specialize in diagnosing and treating depression with psychotherapy. 

Many comprehensive cancer treatment centers have mental health professionals on staff that specialize in helping mesothelioma patients and their loved ones with all the mental health and relationship challenges that are common within the cancer experience. Some cancer treatment centers have psychiatrists to provide more specialized medical care to cancer patients.

What Are Options for Treating Depression?

When diagnosed with mesothelioma and other incurable illnesses, the treatment goal is to extend life as long as possible while maximizing quality of life. Depression has a negative impact on quality of life and thankfully there are many efficacious mental health treatment options that have been developed in the last several decades. 

Oncology care providers have recognized the importance of incorporating screening and treating mental health issues to improve prognosis and quality of life. If you or a loved one are experiencing symptoms of depression while battling mesothelioma, please let your health care team know so that you can receive treatment and feel better!

Medication

Antidepressants have been around since the 1950s and there have been many improvements in the treatment of depression with medications since that time. Each new antidepressant that is developed aims to treat the symptoms of depression better with less unwanted side effects. 

Commonly prescribed antidepressants with cancer patients include SSRIs (selective serotonin reuptake inhibitors), SNRIs (serotonin norepinephrine reuptake inhibitors) and atypical antidepressants. Your physician will discuss your depressive symptoms and your personal or family history of depression treatment to recommend the best medication for you. 

A frustrating aspect of taking antidepressants can be that it may take four to six weeks to begin to see an improvement in your mood. So, patience is necessary.

Psychotherapy

Mental health professionals (aka psychotherapists) provide psychotherapy, which is also called “talk therapy.” Research has shown that two types of psychotherapy are most effective in treating depression: Cognitive behavior therapy (CBT) and interpersonal therapy. 

CBT involves working with the psychotherapist to identify the thoughts, feelings and behaviors that are contributing to the depressive symptoms and to develop ways to change our thinking and behaviors to reduce the symptoms of depression. 

Interpersonal therapy helps patients evaluate their relationships with others and provides strategies to improve those relationships, which can help reduce symptoms of depression.

If your cancer treatment center does not have a mental health professional on staff to work with you, then you can ask your oncologist or oncology nurse for a referral to a local therapist with expertise in oncology. Additionally, you can reach out to your insurance provider to find mental health providers in your area.

Options for Treatment-Resistant Depression

Most mesothelioma patients with depression respond well to either antidepressant therapy, psychotherapy or a combination of both. However, there are a few other options for people with treatment resistant depression.These therapies can involve stimulating the brain with electroconvulsive therapy (ECT), repetitive transcranial stimulation (rTMS) or vagus nerve stimulation (VNS.)  The National Institute of Mental Health provides more in-depth information about how these therapies work. 

Editor’s Note: This is Part 2 of a two-part blog series. Part 1 looks at rates of depression among cancer patients and why depression remains underreported for mesothelioma patients.

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