Topic: Chemo and Depression??

My husband is 56 and was diagnosed with unresectable CC in November 06.  He was on 5 FU and radiation at Mayo, and since returning home, the local oncologist has him on weekly IV 5 FU.  I don't know why he hasn't used some sort of "cocktail" as most are on, but so far, CA-19 9 has returned to normal along with liver enzymes.  Pain continues to be a problem, but we seemed to have leveled off with the fentanyl patches for now.

I really feel that he gets more depressed and weepy on the chemo.  Granted, cancer can do this to a person, but I feel it is worse after weeks of chemo.  Perhaps it's the overwhelming fatigue, but it seems to be more than just that, and I saw a glimmer of my husbands previous optimistic personality after a week off of chemo.

I suppose if this is really just the cancer and fatigue, I can accept it.  The thought that it could be reversed by stopping or changing meds is one I wrestle with.  I'm sure we've all wrestled with the is chemo worth it question,  I've just never seen anyone make a direct connection between chemo and depression.  I suppose antidepressants are an option.  It hasn't been suggested to us yet.  It seems with the liver, Drs are hesitant to keep adding more meds to an already full medicine cabinet, and a stressed liver.

Thoughts and experiences would be appreciated.  It's hard to enjoy the time left to us if one is constantly feeling sad and useless.

Pam

Re: Chemo and Depression??

Hi Pam,

I can appreciate all your concerns and all you're going through. I was going to suggest anti-depressants when I read your post, then got to the part about the docs not wanting to stress the liver, and that makes sense. I had anti-depressants prescribed for my mother but she was in hospice care by then, so there was no hope and they weren't worried about further liver damage. And she died a few days later, anyway. But your situation is vastly different - there's still a chance of a cure or at least a remission in your husband's case, so I guess it's better to be cautious about medication.

So I guess I'm not very helpful so far, but I understand what you're feeling because my mother was very depressed at the end of her life. Totally understandable to be depressed when you've been handed a death sentence, and I resented people that gave me examples of optimistic souls who were cheerful to the end. Everyone deals with things differently and it's great to have a wonderful attitude, but not everyone can be that way. And though your husband wasn't told there was NO HOPE, like my mother was, he may be thinking that there is no hope. I'm sure, as you said, the fatigue and weakened immune system and constant battling from the chemo greatly contribute to his low spirits. Any medication can disrupt your mental balance and make you more prone to depression or anger - as I've learned from taking Tylenol Sinus medicine, which used to make me and my husband so angry that we called it "the Mean Pill."

Being made to feel like you're just a case number and not a human being anymore contributed to my mother's depression, too, which is why I broke her out of the hospital and got her home so she could be surrounded by loving family and friends. It sounds like your husband is at home, but if he's spent a lot of time in hospitals, it can be torture for the soul, I believe.  Also, if he's had a previous history of depression - or anxiety attacks, as my mother had - he's probably predisposed to feeling blue or anxious when circumstances are so terrible and frightening. Maybe there are herbal supplements like St. John's Wort that wouldn't be so hard on his liver? I know there must be others out there, too, that you could ask doctors about. Also, you may want to look into acupuncture - it worked wonders for my mother's nausea during chemo, and my sister swears it cured her of all of her ills.

My last suggestion, for what it's worth, is that maybe meditation, yoga, or some kind of inspirational reading - on book or to listen to on CD - would help. My mother was briefly energized by listening to Deepak Chopra.

Sorry I can't be of more help - hopefully the chemo is the culprit and there will be an end in sight to the chemo so he will return to his chipper self.

Great luck and love going your way,
Joyce

3 (edited by JeffG Sat, 02 Jun 2007 09:40:27)

Re: Chemo and Depression??

Hi Pam,   Just wanted to echo what Joyce posted.  Once diagnosed with this disease a major major life change takes place.  Practically everything you once were has to be adjusted or changed.  I personally not only feel but know I,m not able to do many many things I use to do.  If I get a stubborn streak going and do something I should not, pain is now my reward.  I have slowly become domesticated and accept for now that it isn't that bad.  In fact it makes me feel good to see my sweetie of 30 plus years come home from work and smile , seeing I have made her a favorite meal or the house is clean and smells fresh or I tell her a hot bubble bath is already for her.  Heck ya I'm still useful!  Doing the pots and pans still erks me.  I have my moments of depression and can't get motivated all.  I tried anti-depressants years ago for about 3 weeks and said that was it and stopped them.  The wear and tear of having chemo contributes without a doubt. My self esteem is crushed, although I'm still me I can't do what me wants a lot of times.  I think my biggest contributor is loneliness and ISOLATION.  I feel like I'm a prisoner of war at times.  So I combat that with keeping my mind extremely active with reading and researching and doing smaller projects.  Instead of erecting 6 foot fencing, I started making little ole bird houses with extra details like doors ,windows , chimneys, and balconies.  I would be lying if I said I wasn't a little angry, but for the most part I have let it go and chocked it up to reality which we all know can be down right cruel and devastating at times. I just felt that I had to let go of my anger or it would eat me up and steal the energy I need for fighting this wicked disease.  To stop my rambling; Yes some of us have been dealt a bad hand, but like in poker you keep on going til you get a winning hand.  If that don't happen then foldem and await until the next game and just maybe your luck will change and win a few hands.  So, now you have heard my reasons why I am sometimes depress and weep.  You can't take a breath without hearing, seeing, and in my case touching cancer.  You know today I said the heck with it and booked a vacation to a serene but also playfull place in Branson, MO 3 months from now.  I will go whether laying in the back seat or driving.  Positive frame of mind and hopefullnest can be a powerful tool for those who can muster it up.  Pam I'm 51 and just not ready to give in even though in reality the odds are against me.  Maybe that ACE in the hole may come in time.  Prayers and support coming your way for your husband and you.  It can be a rough ride at times.
Jeff G.

Take it to the Limit,One More Time! (Eagles)

Re: Chemo and Depression??

Hi Pam,

I could relate to your email because of the situation with my brother who passed a few months ago.  Many people have asked me what I would do differently if I could do it over again.

His pain was pretty bad from the beginning and he relied heavily on the Fentanyl patchs, this caused all kinds of problems as medications always do.

He also suffered from depression although he was not very verbal about this part.

I think if I could have done it again, I would have taken him to do some intense radiation treatments, we originally decided against this because he would have to be away from his family for an extended period of time.  But, I think if we could have addressed his pain in a way that didn't mean more and more medication he would have had more "quality" time with his family.

He also had good results with accupuncture and liked going.  Exercise is very helpful for depression as well.  I know it's probably hard to think about considering he doesn't feel well, but the natural high after helps.

You might consider seeing a naturopath who can address some of these issues in a natural way that doesn't affect the liver - ours was always very concerned about that.   

Another thing I thought was interesting was that Mark's testosterone level was unbelievably low during his chemotherapy.  The naturopath was working to increase that, which was one of the causes of his depression.

I hope you can help your husband find some relief.  Let us know if anything works.

Much love to you,
Stacie

Re: Chemo and Depression??

Pam - I think if Sam and I had it to do over again, he would choose not to take any chemo treatments.  The treatments may have extended his life but his quality of life for the last 6 months that he lived was certainly not good and it was his decision, not the oncologist, to quit treatments.

I don't think Sam suffered from depressesion; his biggest problem was pain which was in the chest area and not the area of the liver.  He was also on the fentanyl patches and oxicodone.

There were numerous mets to the lung area.  He did have 28 days of radiation to the liver when he was first diagnosed and then radio frequency ablation after an unsuccessful attempt to do a liver resection.    They also performed radiation to the chest area late in his treatment to relieve some of the pain.  Also a big problem for Sam was his loss of appetite.  I could not get him to eat hardly anything during those last few months.  Nutrition is so important. 

I know I'm not being much help.  My thoughts are with you; the only advice I can offer is to stay close to home if you can.  The road can get weary for both of you
if you have to travel for a long distance.

Re: Chemo and Depression??

Pam,

My husband was 39 yrs. old and a year away from retirement in the navy when dx in 2005 with Stage IV CC.  I would find him lying down on the couch or in the computer room with tears in his eyes.  He was in so much  depression that his oncologist sent him to see a therapist instead of giving  him chemo treatment during one of his appointments.  He has been seeing a therapist once a month, taking 3 kinds of anti-depressant since then. He's happier to say the least but has the energy to keep on and not being consumed with sadness. 

Take care.
Edith