Psychological Issues in Geriatric Oncology

Authors:
Archna SarwalFrom the Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York.

Search for other papers by Archna Sarwal in
Current site
Google Scholar
PubMed
Close
 MD
and
Andrew J. RothFrom the Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York.

Search for other papers by Andrew J. Roth in
Current site
Google Scholar
PubMed
Close
 MD
View More View Less
Full access

Optimism about improved survival from cancer has increased. However, even with tremendous improvements in screening techniques and treatment, a cancer diagnosis may shatter the dream of a dignified old age for elderly patients. Cancer diagnosis and treatment often produce psychological stresses resulting from the actual symptoms of the disease, as well as the patient and family's perceptions of the disease and its stigma. Concerns related to cancer have particular meaning for aging individuals who undergo these situations in the context of retirement, widowhood, other medical disabilities, and other losses. Today, patients and families are more interested in treatment issues and quality of life, both during and after treatment. In this article we discuss late life depression, anxiety, and delirium and treatments related to elderly patients coping with cancer.

Correspondence: Andrew Roth, MD, Department of Psychiatry and Behavioral Sciences, Box 421, Memorial Sloan-Kettering Cancer Center, 1242 2nd Avenue, New York, NY 10021. E-mail: Rotha@mskcc.org
  • Collapse
  • Expand
  • 1

    Holland JC, Rowland J, Lebovits A et al.. Reactions to cancer treatment: assessment of emotional response to adjunct radiotherapy. Psychiatr Clin North Am 1979;2:347358.

    • Search Google Scholar
    • Export Citation
  • 2

    Holland JC. Psychological aspects of cancer. In: Holland JF, Frei E, eds. Cancer Medicine (2nd ed). Philadelphia: Lea & Febiger, 1982:11751203.

    • Search Google Scholar
    • Export Citation
  • 3

    Wells KB, Rogers W, Burnham MA et al.. Course of depression in patients with hypertension, myocardial infarction, or insulin-dependent diabetes. Am J Psychiatry 1993;150:632638.

    • Search Google Scholar
    • Export Citation
  • 4

    Passik SD, Donaghy KB, Theobald DE et al.. Oncology staff recognition of depressive symptoms on videotaped interviews of depressed cancer patients: implications for designing a training program. J Pain Symptom Manage 2000;19:329338.

    • Search Google Scholar
    • Export Citation
  • 5

    Blazer DG. Epidemiology of late life depression. In: Schneider LS, Reynolds CF, Lebowitz BD, Friedhoff AJ, eds. Diagnosis and Treatment of Depression in Late Life. Washington DC: American Psychiatric Press, 1994:919.

    • Search Google Scholar
    • Export Citation
  • 6

    Kurtz ME, Kurtz JC, Stommel M et al.. Physical functioning and depression among older persons with cancer. Cancer Pract 2001;9:1118.

  • 7

    Dewey M, de la Camara C, Copeland JRM et al.. Cross-cultural comparison of depression and depressive symptoms in older people. Acta Psychiatr Scand 1993;87:369373.

    • Search Google Scholar
    • Export Citation
  • 8

    Holland JC, Andersen B, Breitbart WS et al.. NCCN distress management clinical practice guidelines in oncology. Oncology 1999;13(Suppl):113147. (Most recent version available at www.nccn.org).

    • Search Google Scholar
    • Export Citation
  • 9

    Roth AJ, Kornblith AB, Batel-Copel L et al.. Rapid screening for psychologic distress in men with prostate cancer: A pilot study. Cancer 1998;82:19041908.

    • Search Google Scholar
    • Export Citation
  • 10

    Bukberg J, Penman D, Holland JC. Depression in hospitalized cancer patients. Psychosom Med 1984;46:199212.

  • 11

    Moffic HS, Paykel ES. Depression in medical in-patients. Br J Psychiatry 1975;126:346353.

  • 12

    Schwab JJ, Bialow M, Brown JM, Holzer CE. Diagnosing depression in medical inpatients. Ann Intern Med 1967;67:695707.

  • 13

    Holland JC, Morrow GR, Schmale A et al.. A randomized clinical trial of alprazolam versus progressive muscle relaxation in cancer patients with anxiety and depressive symptoms.J Clin Oncol 1991;9:10041011.

    • Search Google Scholar
    • Export Citation
  • 14

    Massie MJ, Holland JC: Depression and the cancer patient. J Clin Psychiatry 1990;51(Suppl):1217.

  • 15

    Green AI, Austin CP. Psychopathology of pancreatic cancer. A psychobiologic probe. Psychosomatics 1993:34: 208221.

  • 16

    Kissane DW, Clark DM, Street AF. Demoralization syndrome—a relevant psychiatric diagnosis for palliative care.J Palliat Care 2001;17:1221.

    • Search Google Scholar
    • Export Citation
  • 17

    Olin J, Masand P. Psychostimulants for depression in hospitalized cancer patients. Psychosomatics 1996;37:5762.

  • 18

    Masand PS, Tesar GE. Use of stimulants in the medically ill. Psychiatr Clin North Am 1996;19:515547.

  • 19

    Burns MM, Eisendrath SJ. Dextroamphetamine treatment for depression in terminally ill patients. Psychosomatics 1994;35:8083.

  • 20

    Fernandez F, Adams F, Levy J et al.. Cognitive impairment due to AIDS related complex and its response to psychostimulants. Psychosomatics 1988;29:3846.

    • Search Google Scholar
    • Export Citation
  • 21

    Bruera E, Chadwick S, Brennels C et al.. Methylphenidate associated with narcotics for the management of depressive disorders in cancer patients. Psychosomatics 1992,33: 352356.

    • Search Google Scholar
    • Export Citation
  • 22

    Bruera E, MacMillan K, Hanson J et al.. The cognitive effects of the administration of narcotic analgesics in patients with cancer pain. Pain 1989;39:1316.

    • Search Google Scholar
    • Export Citation
  • 23

    Kalso E, Tasmuth T, Neuvonen PJ. Amitriptyline effectively relieves neuropathic pain following treatment of breast cancer. Pain 1996;64:293302.

    • Search Google Scholar
    • Export Citation
  • 24

    Kast RE. Mirtazapine may be helpful in treating nausea and insomnia of cancer chemotherapy. Support Care Cancer 2001;9:469470.

  • 25

    Musselman DL, Lawson DH, Gumnick JF: Paroxetine for the prevention of depression induced by high-dose interferon alfa. N Engl J Med 2001;344:961966.

    • Search Google Scholar
    • Export Citation
  • 26

    Roth AJ, Scher HI: Sertraline relieves hot flashes secondary to medical castration as treatment of advanced prostate cancer. Psychooncology 1998;7:129132.

    • Search Google Scholar
    • Export Citation
  • 27

    Loprinzi CL, Sloan JA, Perez EA et al.. Phase III evaluation of fluoxetine for treatment of hot flashes. J Clin Oncol 2002;20:15781583.

  • 28

    Weitzner MA, Moncello J, Jacobsen PB, Minton S. A pilot trial of paroxetine for the treatment of hot flashes and associated symptoms in women with breast cancer. J Pain Symptom Manage 2002;23:337345.

    • Search Google Scholar
    • Export Citation
  • 29

    Loprinzi CL, Kugler JW, Sloan JA et al.. Venlafaxine in management of hot flashes in survivors of breast cancer: a randomised controlled trial. Lancet 2000;356:20592063.

    • Search Google Scholar
    • Export Citation
  • 30

    Passik SD, Roth AJ. Anxiety symptoms and panic attacks preceding pancreatic cancer diagnosis. Psychooncology 1999;8:268272.

  • 31

    Massie MJ, Holland JC, Glass E. Delirium in terminally ill cancer patients. Am J Psychiatry 1983;140:10481050.

  • 32

    Breitbart W. Diagnosis and management of delirium in the terminally ill. In: Topics in Palliative Care (vol 5). Oxford: Oxford University Press, 2001:303321.

    • Search Google Scholar
    • Export Citation
  • 33

    Hammerlid E, Ahlner-Elmqvist M, Bjordal K et al.. A prospective multicentre study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients. Br J Cancer 1999;80:766774.

    • Search Google Scholar
    • Export Citation
  • 34

    Stiefel FC, Breitbart WS, Holland JC. Corticosteroids in cancer: neuropsychiatric complications. Cancer Invest 1989;7:479491.

  • 35

    Denicoff KD, Rubinow DR, Papa MZ et al.. The neuropsychiatric effects of treatment with interleukin-2 and lymphokine-activated killer cells. Ann Intern Med 1987;107:293300.

    • Search Google Scholar
    • Export Citation
  • 36

    Patten SB, Love EJ. Drug-induced depression. Psychother Psychosom 1997;66:6373.

  • 37

    Lerner DM, Stoudemire A, Rosenstein DL. Neuropsychiatric toxicity associated with cytokine therapies. Psychosomatics 1999;40:428435.

  • 38

    Walker LG, Walker MB, Heys SD et al.. The psychological and psychiatric effects of rIL-2 therapy: a controlled clinical trial. Psychooncology 1997;6:290301.

    • Search Google Scholar
    • Export Citation
  • 39

    Breitbart W, Wein SE. Metabolic disorders and neuropsychiatric symptoms. In: Holland JC (ed.). Psychooncology. New York: Oxford University Press, 1998:634649.

    • Search Google Scholar
    • Export Citation
  • 40

    Folstein MF, Folstein SE, McHugh PR: “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;189198.

    • Search Google Scholar
    • Export Citation
  • 41

    Stiefel F, Razavi D. Common psychiatric disorders in cancer patients. II. Anxiety and acute confusional states. Support Care Cancer 1994;2:223237.

    • Search Google Scholar
    • Export Citation
  • 42

    Murray GB. Confusion, delirium and dementia. In: Hackett TP, Cassem NH (eds). Massachusetts General Hospital Handbook of General Hospital Psychiatry (2nd ed). Littleton, MA: PSG Publishing, 1987:84.

    • Search Google Scholar
    • Export Citation
  • 43

    Stiefel F, Holland J. Delirium in cancer patients. Int Psychogeriatr 1991;3:333336.

  • 44

    Akechi T, Uchitomi Y, Okamura H et al.. Usage of haloperidol for delirium in cancer patients. Support Care Cancer 1996;4:390392.

  • 45

    Breitbart W, Marotta R, Platt MM et al.. A double-blind trial of haloperidol, chlorpromazine, and lorazepam in the treatment of delirium in hospitalized AIDS patients. Am J Psychiatry 1996;153:231237.

    • Search Google Scholar
    • Export Citation
  • 46

    Sipahimalani A, Masand PS. Olanzapine in the treatment of delirium. Psychosomatics 1998;39:422430.

  • 47

    Breitbart W, Tremblay A, Gibson C. An open trial of olanzapine for the treatment of delirium in hospitalized cancer patients. Psychosomatics 2002;43:175182.

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 18 18 3
PDF Downloads 9 9 5
EPUB Downloads 0 0 0