Study looks at breast cancer patients with mental health issues

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CHARLOTTESVILLE, Va. (CBS19 NEWS) -- Researchers hope a new study will spur doctors to better manage mental health in their patients who are dealing with breast cancer and pain management.

The study, led by the University of Virginia School of Medicine, found elderly women battling breast cancer, who also have anxiety, depression or another mental health condition, are more likely to use opioids and more likely to die.

The researchers hope this finding will encourage doctors to consider alternative pain management techniques, including physical therapy, massage and acupuncture.

"The complex relationship among breast cancer, mental health problems, and the use of opioids is not well understood, and the results of this study provide clinicians the evidence they need to make optimal patient treatment-related decisions," said Rajesh Balkrishnan, PhD, of the UVA School of Medicine's Department of Public Health Sciences. "Our findings suggest that patients with breast cancer with mental health conditions have higher opioid use and reduced survival. These results highlight the need for health care providers to evaluate treatment goals and assess whether better concurrent management of breast cancer and mental health conditions is required."

According to a release, breast cancer kills more than 40,000 people in the United States each year, and many patients tend to suffer from anxiety and depression.

Research has suggested about 40 percent of breast cancer patients also have some type of mental health diagnosis.

The researchers reviewed more than 10,000 breast cancer cases that were recorded in the national SEER cancer database, specifically collecting information on care provided to Medicare beneficiaries with cancer.

The cases examined involved women aged 65 years or more who had been diagnosed with stage I, II or III breast cancer between Jan. 1, 2006 and Dec. 31, 2012. All of these patients had received adjuvant endocrine therapy as a treatment for their cancer.

The cases were sorted into two groups, one of women with mental health issues and another of those without.

The researchers say they found the patients with mental health diagnoses had higher opioid use and lower survival rates.

"A need exists for collaborative care in the management of mental health comorbidities in women with breast cancer, which could improve symptoms, adherence to treatment, and recovery from these mental health conditions," wrote the researchers in a paper published in the Journal of Oncology Practice. "Mental health treatments also are recommended to be offered in primary care, which not only would be convenient for patients but also would reduce the stigma associated with treatments for mental health comorbidities and improve the patient-provider relationship."

The researchers recommend doctors and other care providers consider other options of complementary pain treatment.

They also noted some potential limitations to their study, including a lack of information on opioids used and a lack of details on the patients' pain assessments.

The researchers also say mental health conditions, including depression, may be underdiagnosed, which may underestimate the actual percentage of patients with such conditions.

Balkrishnan and another researcher on the study, Xi Tan at West Virginia University, disclosed potential conflicts of interest connected to this study as they both have ties to the pharmaceutical company Merck.

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