Patients with head and neck cancer who show symptoms of depression are at a greater risk of mortality, according to research published in Cancer.1

Among patients with cancer, those with head and neck cancer have among the highest rates of depression. Depression is, furthermore, linked to an up to 39% greater risk of mortality among all patients with cancer. Behavioral and biological pathways (eg, treatment interruption and treatment response rates, respectively) may be causal factors for these outcomes.

For this study, researchers evaluated whether depressed patients with head and neck cancer are more likely to have treatment interruptions and poorer treatment responses, and whether these factors affect prognosis.

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Of 134 included patients, 73.9% were male, 84.3% were Caucasian, and 48.5% had stage IV disease. Symptoms of depression were determined at study entry.

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Showing more symptoms of depression was associated with higher rates of chemoradiation interruption (odds ratio, 0.865; P = .010), poorer response to treatment (odds ratio, 0.879; P = .005), and shorter survival (hazard ratio, 0.868; P < .001). Treatment disruption was not, however, associated with survival, though survival was linked to treatment response.

Only 4 patients with a treatment interruption had a poor treatment response, suggesting these variables may be independent.

The authors concluded that these results highlight “the need for a careful assessment of depressive symptoms among patients with head and neck cancer preparing to undergo treatment, which may help to identify patients who may be at risk for an incomplete therapeutic response and poorer long-term outcomes.”


  1. Zimmaro LA, Sephton SE, Siwik CJ, et al. Depressive symptoms predict head and neck cancer survival: examining plausible behavioral and biological pathways. Cancer. 2018 Jan 22. doi: 10.1002/cncr.31109 [Epub ahead of print]