Dealing with depression: communicating with cancer patients and grieving relatives

Cancer is an extremely stressful event for both the patients and their families, potentially leading to the development of depression, that has been shown to have a general prevalence of 15-25%. When left unaddressed, depression has a great negative influence on quality of life, coping strategies and active participation in medical care both of patient and care-givers. The relational components of an effective communication with depressed cancer patients and their family members include clinician’s availability to listening, exploring emotions, identifying affective problems and providing empathic responses, in order to promote reciprocal trust and consolidate therapeutic alliance. A first aspect regards a correct assessment of the symptoms (e.g., cognitive-affective dimensions with/without exclusion of neurovegetative symptoms), for a correct diagnosis (e.g., differentiating major depression from minor depression, adjustment disorder, demoralization). Suicide assessment is extremely important in the context of cancer care. A second aspect regards the intervention, both at counselling level or more specific psychotherapeutic treatment. Several types of psychological therapy has been proven to be effective in treating depression of cancer patients and family members with depression (e.g. cognitive-behavior therapy, supportive-expressive group psychotherapy, interpersonal psychotherapy, complicated grief therapy, family focused grief therapy). A sensitive, collaborative and comprehensive approach to the diagnosis and treatment of depression are the cornerstones of communication. Clinical education and training of cancer care professionals, and integration with psycho-oncologists are mandatory to provide adequate care to cancer patients and their families with depression.