Management of anxiety and depressive symptoms

Supportive care in cancer has evolved rapidly in recent years to improve the control of patients’ symptoms even in the face of treatment that is not curative. Laudatory as this is, the attention has focused largely on physical symptoms, and particularly pain. The focus on the “psychic suffering” has been considerably less. Yet, Shakespeare’s observation relates well to the patients with cancer, when “the mind is commanded to suffer with the body.” It is this “suffering of the mind” that psycho-oncology addresses to reduce distress and improve the quality of life (1). It is reassuring that supportive care is increasingly giving attention to the psychological or “human” side of care (2). This chapter outlines the recognition, diagnosis, and management of the most common forms of distress that the oncologist confronts-anxiety and depressive symptoms.