Persistent depression during adjuvant cancer therapy heightens treatment toxicity and significantly worsens overall quality of life for patients with early-stage cancer.
Depression During Adjuvant Cancer Therapy
Depression affects a substantial proportion of individuals undergoing cancer treatment. This prospective multicenter study evaluated 927 patients receiving adjuvant therapy following resection of non-metastatic cancer. Depressive symptoms were assessed at treatment initiation and again six months later. Four clinical trajectories were identified: never depressed, new onset, remission, and persistent.
At six months, nearly one quarter of patients experienced persistent depression and more than one in ten developed new depressive symptoms during treatment. Persistent depression occurred more frequently in women, younger adults, patients without partners, and those with breast cancer.
Persistent Depression Predicts Greater Toxicity
Persistent depression was strongly associated with increased hematologic, digestive, and neuropathic toxicities as well as higher levels of asthenia. These patients reported poorer functioning and a greater symptom burden, which together resulted in a marked reduction in overall quality of life. The relationship between depression and toxicity appeared independent of most demographic and clinical variables.
Baseline depression and impaired functional status emerged as the leading predictors of depressive symptoms during treatment. Age influenced how symptoms evolved over time, with younger individuals more likely to experience persistent issues.
Clinical Implications for Quality of Life
The findings indicate that untreated depression during adjuvant therapy is a significant contributor to adverse clinical and quality-of-life outcomes. Integrating early psychological assessment and targeted support into standard cancer care may reduce toxicity and improve treatment tolerance.
Routine screening at the start of adjuvant therapy and continued monitoring across the treatment course may help identify patients at greatest risk and facilitate timely intervention.
Reference: Obispo B et al. The role of baseline and persistent depression in adjuvant cancer therapy: impact on toxicity and quality of life. Int J Clin Health Psychol. 2025;25(4):100640.
