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Tuesday, June 29, 1999 Published at 16:06 GMT 17:06 UK


Cancer treatment sparks depression

Many women fight depression after a breast cancer diagnosis

Changes in women's hormone levels created by modern breast cancer treatment may be partly responsible for the major depression which sometimes accompanies the disease.

Researchers at the Massachusetts General Hospital, Boston found that breast cancer patients faced an increased risk of depression because their natural oestrogen levels were disrupted.

One of most modern treatments, Tamoxifen, which studies have shown to greatly decrease the risk of the disease recurring following treatment, works by greatly reducing oestrogen.

Care advised over chemotherapy decision

It is well known that some women can suffer depression when taking the contraceptive pill, which also disrupts the amounts of hormones in the body.

The research team, interviewed 21 breast cancer patients whose treatment programme meant they were likely to develop oestrogen deficiency.

Over the following 18 month period, eight of them (38%), developed symptoms of major depression, most in the first six months of treatment.

The group included 15 women who had not yet experienced the menopause, and 14 of them showed signs of lowered oestrogen levels, having "hot flushes" and ceasing to menstruate.

[ image: Tamoxifen has been hailed as an advance in breast cancer treatment]
Tamoxifen has been hailed as an advance in breast cancer treatment
Dr Donna Greenberg said : "The rather abrupt change in oestrogen adds to other adverse side effects of adjuvant chemotherapy and presents another difficulty for these patients."

She said that this explanation as to why the women might be suffering depression was found to be an important therapeutic tool.

Dr Pamela Ashurst, a consultant psychotherapist from Southampton, said that tamoxifen had the effect of "plunging women into the menopause", and said that patients should carefully weigh up the potential benefits against the costs this would involve.

'Chemical castration'

She said: "Tamoxifen is intended as a chemical means of castration, and you are going to reduce the circulating amount of female hormone.

"For a lot of women this will lead to feelings of depression."

But while hormone-related depression could in some cases be alleviated by hormone-replacement therapy, in a breast cancer patient this would not generally be possible.

She said: "If you treat everybody as an individual, there might be some people who perhaps choose not to take Tamoxifen.

"It is important for women to realise that there are still choices."

She added that it was only natural for any women facing breast cancer to fight feelings of depression.

She said: "It is an affront to the way you feel about yourself."

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17 May 99 | Health
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16 Feb 99 | Health
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23 Sep 98 | Medical notes
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