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Depression In The Elderly Cancer Patient
Ernest H. Rosenbaum, MD, William Goodson, IV, BA

Depression is common in probably 20-30% of cancer patients. It is principally related to several factors:

1. Concerns about the future after a cancer diagnosis, future treatments and survival after a cancer diagnosis.
2. Loss of a spouse, lack of psychosocial emotional support, stress of everyday life, stress from loss of physical function, and debility.
3. Distress and depression from personal and family problems.
4. Depression secondary to certain medications.
5. Depression secondary to physical symptoms from fatigue, pain, sleep problems, loss of appetite, inadequate food and eating intake, cognitive problems, feelings of hopelessness, feelings of guilt, and side effects from therapy.
6. Depression from lack of psychosocial support and confronting mortality and religious and spiritual issues.
7. Depression from lack of quality of life.
8. Isolation due to physical factors and emotional reasons.
9. Depression from lack of financial resources and/or financial support. This is especially true in the current economic conditions.

The treatment of depression requires psychological supportive therapy, drug therapy, and supportive care from family, friends, and caregivers. These issues are magnified when the patient is facing end-of-life considerations, or when the patient has no family and/or limited financial resources. Additionally, the specific side effects of cancer and its treatments also frequently lead to depression.

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