Depressive disorder in patients with cancer - pathophysiology and treatment strategies

Guidelines for diagnostic and therapy of depressive disorder in oncology and palliative medicine are pivotal for an optimal care of cancer patients. This psychiatric comorbidity influences quality of life, treatment compliance, health-care costs and perhaps even, mortality. Recent developments in neuro-imaging and molecular biology allow a new framework of understanding of the pathophysiology of depression in cancer patients. Beside their well-known efficacy against depression and anxiety new antidepressants are also beneficial in the treatment of fatigue, anorexia, cachexia, hot flashes and neuropathic pain. Psychosocial interventions improve, well-being, quality of live and depressive symptoms, however survival rates remain unaffected. This manuscript reviews the pharmacological treatment of depression in; cancer patients and provides an overview of new neuroimmunological research pertinent to the increased incidence of depression in oncological patients.