Laura Pole, RN, MSN, OCNS, BCCT Senior Researcher
Nancy Hepp, MS, BCCT Project Manager
Last updated May 5, 2021.
Common in people with cancer,1 depression is a treatable mood disorder that may be accompanied by physical, behavioral and cognitive symptoms. If depression is prolonged or severe, functioning can be impaired. “Depression may make it harder to cope with cancer treatment. It may also interfere with your ability to make choices about your care. As a result, identifying and managing depression are important parts of cancer treatment.”2
From The Ecology of Breast Cancer:3
Depression is not only important psychologically but also can increase inflammation and alter some immune system functions.4 This can promote conditions for tumor growth, invasion and metastasis.
Depression may make it harder to cope with cancer treatment. It may also interfere with your ability to make choices about your care.
Risk Factors for Depression
Individuals with these factors are at a higher risk of developing depression:8
- Stressful life events and circumstances
- Parental depression
- Interpersonal dysfunction
- Being female
- Shift work
Reducing or removing these risk factors where possible may promote a more effective response to treatment.
Author, clinical professor and BCCT advisor Rachel Naomi Remen, MD, explains the healing power of journaling.
Even when people are getting the best of cancer treatment, they often feel like they need more help with organizing their care and managing symptoms and side effects. Helpsy empowers members to take control of their health through a real-time virtual nurse support service. This service is available via mobile devices, a Helpsy website and automated phone calls.
Many complementary approaches can be helpful for depression. The Society for Integrative Oncology clinical practice guidelines list the following evidence-based integrative therapies for depression:10
- Exercise or physical activity
- Massage from a therapist trained in oncology massage
- Nature immersion, such as forest bathing
- Mind-body approaches such as these:
Supportive-Expressive Therapy (SET) has also been effective in research studies. SET is a type of group therapy that promotes social support among the group members and encourages them to express emotions and fears related to their disease, focusing on facing and grieving losses.
At least one nutritional supplement—omega-3 fatty acids—is effective in major depressive disorder. Pure eicosapentaenoic acid (EPA) or an EPA/docosahexaenoic acid (DHA) combination of a ratio higher than 2 (EPA/DHA >2) are considered effective, according to the International Society for Nutritional Psychiatry's consensus-based practice guideline for clinical use of omega-3s in major depressive disorder (although not specific to people with cancer).11
Women with mild to moderate depressive symptoms reported significantly better scores in all five measures of depression in a small randomized trial. An intervention combining a brisk 20-minute outdoor walk, increased light exposure throughout the day and a vitamin regimen had high adherence for eight weeks. The goal of the walk was to increase target heart rate of 60% of maximum, and the supplements included vitamins B1, B6, B2, B9, D, and selenium.12
In addition to complementary therapies, consider seeing a professional such as a therapist, oncology social worker or oncology navigator to help you explore your situation and identify an approach that is right for you.
Integrative Programs, Protocols and Medical Systems
|For more information about programs and protocols, see our Integrative Programs and Protocols page.|
- Cancer.Net. Depression
- SIO: clinical practice guidelines
- Deng GE, Frenkel M et al. Evidence-based clinical practice guidelines for integrative oncology: complementary therapies and botanicals. Journal of the Society for Integrative Oncology. 2009 Summer;7(3):85-120.
- Deng GE, Rausch SM et al. Complementary therapies and integrative medicine in lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013 May;143(5 Suppl):e420S-e436S.
- Greenlee H, DuPont-Reyes MJ et al. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA: A Cancer Journal for Clinicians. 2017 May 6;67(3):194-232.
- Dr. Cynthia Li: Brave New Medicine
- Gurdev Parmar and Tina Kaczor: Textbook of Naturopathic Oncology
- Helpsy Inc.: Helpsy Health
- Andrew Weil Center for Integrative Medicine: Breast Cancer: An Integrative Approach (2019-2021)
- Dr. Ralph Moss: Dealing with the Trauma of Cancer: Dr. Moss interviews Dr. James S. Gordon
- UK Royal College of Anaesthetists, Macmillan Cancer Support, and the National Institute for Health Research Cancer and Nutrition Collaboration: Prehabilitation for People with Cancer
- Block KI, Block PB, Gyllenhaal C: Integrative Treatment for Colorectal Cancer
- Integrative Cancer Review
- Martin L. Rossman, MD: Fighting Cancer from Within
- September 2018 Issue of the Journal of Alternative and Complementary Medicine
- Wayne Jonas, MD: Your Healing Journey: A Patient’s Guide to Integrative Breast Cancer Care
- Donald I. Abrams, MD, and Andrew T. Weil, MD: Integrative Oncology, 2nd Edition
- Ted Schettler, MD, MPH: The Ecology of Breast Cancer: The Promise of Prevention and the Hope for Healing
- Keith I. Block, MD: Life over Cancer: The Block Center Program for Integrative Cancer Treatment
- Lorenzo Cohen and Alison Jefferies: Anticancer Living: Transform Your Life and Health with the Mix of Six
- Michael Lerner: Choices In Healing: Integrating the Best of Conventional and Complementary Approaches to Cancer
- Fang Fu, Huaijuan Zhao, Feng Tong, and Iris Chi: A Systematic Review of Psychosocial Interventions to Cancer Caregivers
- Martin L. Rossman, MD: Fighting Cancer