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JAMA publication features UNMC study on depression and head and neck cancer

May 20, 2008

A University of Nebraska Medical Center-led pilot study that showed antidepressants can significantly reduce the risk of depression for head and neck cancer patients is the focus of an article published today in the Archives of Otolaryngolgy -- one of the publications produced by the Journal of American Medical Association (JAMA).

The study, which was led by UNMC's William Lydiatt, M.D., and Bill Burke, M.D., showed that only 15 percent of head and neck cancer patients who took antidepressants as part of their treatment experienced depression. That's a hopeful sign considering that 50 percent of the patients in the study group who didn't take antidepressants experienced depression.

These statistics offer hope for head and neck cancer patients, said Dr. Lydiatt, division director of head and neck surgical oncology in the department of otolaryngology-head and neck surgery, because depression is the number one reason head and neck cancer patients don't complete treatment.

"This is a potentially important study and result because it shows for the first time that depression can be prevented for those with head and neck cancer," Dr. Lydiatt said.
The National Institutes of Health seem to agree with Dr. Lydiatt's take on the study's importance. After seeing the results of the pilot study, the NIH granted the UNMC team $1.6 million to expand the study.

While head and neck cancer patients represent a fairly small percentage of those with cancer, they do account for an extraordinarily high percentage of cancer-patient suicides, said Dr. Burke, professor of psychiatry.

For example, he said, 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.

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.

"Our study shows that we may be able to get out in front of depression in head and neck cancer patients and improve their chances of completing the needed treatment," Dr. Burke said.
The findings from the study also may have implications in terms of helping those with other forms of cancer avoid depression, Dr. Lydiatt said.

Ken Cowan, M.D., Ph.D., director of the UNMC Eppley Cancer Center, said the publication in the JAMA journal and the NIH grant are indicators that the work being done by Drs. Burke and Lydiatt has major implications in the treatment of head and neck cancer.

"This study brings an immense amount of promise in terms of improving treatment for those with head and neck cancer," Dr. Cowan said. "Countless lives could be positively affected by the work being done by these scientists."

Steven Wengel, M.D., professor and chairman of the UNMC Department of Psychiatry, said he was excited to see the UNMC team's work recognized.

"Drs. Lydiatt and Burke and their team are doing very important and exciting work," Dr. Wengel said. "They have shown that effective collaboration across disciplines has the potential to save and improve many lives."

UNMC is the only public health science center in the state. Its educational programs are responsible for training more health professionals practicing in Nebraska than any other institution. Through their commitment to education, research, patient care and outreach, UNMC and its hospital partner, The Nebraska Medical Center, have established themselves as one of the country's leading centers in cancer, transplantation biology, bioterrorism preparedness, neurodegenerative diseases, cardiovascular diseases, genetics, biomedical technology and ophthalmology. UNMC's research funding from external sources now exceeds $80 million annually and has resulted in the creation of more than 2,400 highly skilled jobs in the state. UNMC's physician practice group, UNMC Physicians, includes 513 physicians in 50 specialties and subspecialties who practice primarily in The Nebraska Medical Center. For more information, go to UNMC's Web site at www.unmc.edu.

University of Nebraska Medical Center



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