Depression and cancer treatment outcomes in African American and Caucasian cancer patients: A chart review study

Abstract

Objective: Depression is a significant predictor of cancer death, but its impact on African Americans’ cancer treatment and treatment outcomes has not been well studied. This study examines the relationship between depression treatment, completion of cancer treatment, and treatment outcomes among African American cancer patients in comparison with Caucasian cancer patients in Northeast Ohio. Methods: Medical records for 34 depressed breast and prostate cancer patients (18 African Americans and 16 Caucasians) with duration of 5 to 8 years were reviewed. Data on the variables of baseline distress level, depression treatment status, completion of prescribed cancer treatment, and treatment outcome (i.e., cancer recurrence, metastasis, and death) were abstracted. Simple statistics (frequency) was performed on these variables for the African American and Caucasian patients that received depression treatment and those who did not, respectively. Results: In the study group, 30% of the African Americans with elevated baseline distress (≥4 on a 10-point Distress Thermometer) were treated for depression, as compared to 60% of the Caucasians. Three of five African Americans that reduced or discontinued chemotherapy or hormonal therapy did not receive depression treatment. At 5 to 8 years after an initial cancer diagnosis, two of the African Americans, one treated and the other untreated for depression, both had cancer recurrence. Another untreated African American in the study developed metastasis and then died. By contrast, none of the African Americans treated for depression developed metastasis or died. Conclusions: The findings suggest that under treatment of depression was associated with poor cancer treatment completion and treatment outcomes, especially in the African American group. Improving depression treatment of these patients deserves serious attention in future research.