What are the guideline sources, guidelines and references for Anxiety and depression in patients with cancer ?
Guideline sources The following summarized guidelines for the evaluation and management of anxiety and depression in patients with cancer are prepared by our editorial team based on guidelines from the American Society of Clinical Oncology (ASCO 2023) and the European Society of Medical Oncology (ESMO 2023). 1 2 Calculator Calculator Calculator Generalized anxiety disorder-7 s Hamilton anxiety scale HAM A Hamilton d Guidelines 1. Diagnostic investigations Assessment tools: obtain regular screening and assessment for anxiety in all patients with cancer in all phases of illness. B Show 5 more https://web.pathway.md/diseases/recGxzcZtGxH6C2b0 1/3 6/23/23, 2:39 AM Anxiety and depression in patients with cancer Pathway 2. Medical management Pharmacotherapy: As per ASCO 2023 guidelines: Consider offering pharmacotherapy for depression or anxiety in patients without access to first-line treatment, expressing a preference for pharmacotherapy, or not improving following first-line psychological or behavioral management. C Consider offering pharmacotherapy for depression in patients with a history of treatment response to medications, severe symptoms, or accompanying psychotic features. C As per ESMO 2023 guidelines: Offer antidepressants for symptomatic relief in patients with cancer. B Recognize that SSRIs have few significant drug-drug interactions, with the notable exception of tamoxifen metabolism, which is least affected by escitalopram, sertraline, and venlafaxine. Avoid offering paroxetine in patients taking tamoxifen because of negative clinical outcomes. B 3. Nonpharmacologic interventions General principles: As per ASCO 2023 guidelines, use a stepped-care model (selecting the most effective and least resource-intensive intervention based on symptom severity) when deciding on treatment for anxiety and/or depression, as well as taking into account the following variables to inform the choice of treatment approach: psychiatric history (prior diagnoses with or without treatment) history of substance use prior mental health treatment response functional abilities and/or limitations related to self-care, usual activities, and/or mobility recurrent or advanced cancer presence of other chronic diseases (such as cardiac disease) member of socially and/or economically marginalized group (such as Black race, low socioeconomic status). B Show 2 more As per ESMO 2023 guidelines, offer a combination of psychotherapeutic and psychopharmacological modalities for the treatment of anxiety and depression in patients with cancer. A Psychosocial interventions: As per ASCO 2023 guidelines, derive psychological and psychosocial interventions provided by mental health practitioners from manualized, empirically supported treatments. Recognize that manuals for evidence-based treatments specify content, structure, delivery mode, session https://web.pathway.md/diseases/recGxzcZtGxH6C2b0 2/3 6/23/23, 2:39 AM Anxiety and depression in patients with cancer Pathway number, treatment duration, and related topics. Tailor treatment according to linguistic, cultural, and socioecological contexts. B Show 4 more As per ESMO 2023 guidelines: Consider offering the following therapies in patients with anxiety and depressive symptoms: CBT mindfulness-based therapy psychoeducation supportive-expressive therapies. B Offer meaning-centered therapy and dignity therapy in specific cancer settings (such as end- of-life). A 4. Patient education General counseling: offer information regarding depression and anxiety in all patients with cancer and any patient-identified caregiver, family member, or trusted confidant. Offer resources, such as the providers' contact information for further evaluation and treatment within or external to the facility whenever available. B Show 2 more 5. Follow-up and surveillance Assessment of treatment response: assess treatment response regularly (including pre- treatment, 4 weeks, 8 weeks, and end of treatment) by a mental health professional in patients referred to and receiving psychological treatment. B Show 2 more References 1. Barbara L Andersen, Christina Lacchetti, Kimlin Ashing et al. Management of Anxiety and Depression in Adult Survivors of Cancer: ASCO Guideline Update. J Clin Oncol. 2023 Apr 19;JCO2300293. Open 2. L Grassi, R Caruso, M B Riba et al. Anxiety and depression in adult cancer patients: ESMO Clinical Practice Guideline. ESMO Open. 2023 Apr;8 2 101155. Epub 2023 Mar 14. Open https://web.pathway.md/diseases/recGxzcZtGxH6C2b0 3/3