Study looks at curbing depression in head and neck cancer patients

Bill Burke, M.D.

A multidisciplinary team of UNMC researchers has secured a $1.6 million grant from the National Institutes of Health (NIH) to study the prevention of depression in head and neck cancer patients.

The rate of depression for head and neck cancer patients is significantly higher than for patients suffering from other forms of cancer, said UNMC psychiatry professor Bill Burke, M.D., the grant’s principal investigator (PI). About 50 percent of head and neck cancer patients suffer from depression while about 15 percent of patients with other forms of cancer become depressed, he said.

This leads to many problems for patients, including a tendency not to complete their treatments, said Dr. Burke, who secured the R01 grant along with co-PI, William Lydiatt, M.D., division director of head and neck surgical oncology in the department of otolaryngology-head and neck surgery.

“Depression is the number one predictor of whether cancer patients will complete their treatment,” Dr. Burke said. “The goal of our study is to see if we can prevent the occurrence of depression in head and neck cancer patients and help ensure they complete their treatment.”

The team will study whether prescribing the antidepressant, Escitalopram, to head and neck cancer patients while they undergo treatment prevents depression.

William Lydiatt, M.D.

The study — which the team hopes to start within the month — will resemble a pilot study the team conducted in 2005. In that study, head and neck cancer patients who were given antidepressants experienced depression at a rate of 15 percent while others who were given a placebo experienced depression at rate of 50 percent.

“The results of that study were incredibly hopeful and powerful,” Dr. Lydiatt said, noting that along with higher depression rates comes a higher rate of self-destructive behavior, including suicide.

Patients with tongue and larynx cancer compose only 2 percent of all cancer cases but they account for about 20 percent of suicides committed by cancer patients, Dr. Burke said.

“That is a powerful illustration why it is important to prevent depression in such patients,” Dr. Burke said.

A variety of reasons exist for the increased rates of depression in head and neck cancer patients, Dr. Burke said, including arduous treatment regimens; surgery and complications that interfere with eating and talking; and the psychological affects of having visible wounds left by the cancer.

Getting out ahead of depression could drastically limit the effect of these complications and greatly improve recovery chances for head and neck cancer patients, Dr. Lydiatt said.

“Prevention of depression may not just be important for quality of life but may also be important to life itself for these patients,” Dr. Lydiatt said.

Ken Cowan, M.D., Ph.D., director of the UNMC Eppley Cancer Center, praised Drs. Burke and Lydiatt for working across disciplines to come up with a potential solution to a problem with tragic ramifications.

“These scientists should be lauded for their foresight and cooperation, which has resulted in work that may bring hope to many who suffer from head and neck cancer,” Dr. Cowan said.

Steven Wengel, M.D., professor and chairman of the UNMC Department of Psychiatry, echoed Dr. Cowan’s comments.

“By combining the strengths of their respective disciplines, this team is conducting work that could save and improve the lives of many head and neck cancer patients,” Dr. Wengel said.