Depression as a Predictor of Disease Progression and Mortality in Cancer Patients

However, it is important
to acknowledge that the overall effect sizes are relatively
small and that causality has not been absolutely
established. We would like to highlight that this meta-analysis
does not support a need for patients and their families
to feel responsible for their disease outcome if they experience
depression. It has become accepted in popular culture
that cancer patients need to maintain a positive attitude to
heroically defeat cancer, a recommendation that Spiegel and
Giese-Davis have termed an ‘‘emotional straightjacket.’’

Even if one did ascribe to this belief, the magnitude of the
effect of depression on mortality does not seem to warrant
the assignment of responsibility and blame to cancer
patients.