The American Society of Clinical Oncology (ASCO) released updated guidelines for treating anxiety and depression in adult cancer survivors late last month.
, screening and assessment for depression and anxiety have improved, and a large new evidence base has emerged. To ensure the most up-to-date recommendations, a group of experts spanning psychology, psychiatry, medical and surgical oncology, internal medicine, and nursing convened to review the current literature on managing depression and anxiety. The review included 61 studies — 16 meta-analyses, 44 randomized controlled trials, and one systematic review — published between 2013 and 2021.
The expert panel's recommendations fell into three broad categories — general management principles, treatment and care options for depressive symptoms, and treatment and care options for anxiety symptoms — with the guidelines for managing depression and anxiety largely mirroring each other. For patients experiencing both depression and anxiety symptoms, treatment of depressive symptoms should be prioritized.
Among patients with moderate symptoms, clinicians can offer patients a range of individual or group therapy options, including cognitive-behavioral therapy , behavioral activation, mindfulness-based stress reduction, or structured physical activity and exercise. For patients with severe symptoms of depression, clinicians should offer individual therapy with one of these four treatment options: CBT, behavioral activation, mindfulness-based stress reduction, or interpersonal therapy.
"These guidelines make no recommendations about any specific pharmacologic regimen being better than another," the experts wrote. And"patients should be warned of potential harm or adverse effects."
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