Assess the feasibility, acceptability and preliminary effectiveness of implementing a telephone-supported
self-care intervention during an eight-week period for patients with cancer who have completed primary treatment and have moderate depressive symptoms.

Toolkit with antidepressant skills workbook, DVD on depression, and life after cancer treatment book. Eight weekly 10-15 minute telephone coaching contacts.

• N = 25   
• AGE: Mean = 52 years
• MALES: 22%  
• FEMALES: 78%
• CURRENT TREATMENT: Not applicable
• KEY DISEASE CHARACTERISTICS: Majority 1-2 years after diagnosis; variety of cancer diagnoses including breast, gynecologic, blood, prostate, colon, and brain

• SITE: Multi-site   
• SETTING TYPE: Outpatient    
• LOCATION: Montreal, Canada

PHASE OF CARE: Late effects and survivorship

Phase II Intervention-only study

PHQ-9 depression scale at baseline and at two-month follow-up.

The mean severity of PHQ-9 depression decreased significantly from screening to two months.

Promising intervention consisting of weekly coaching and self-intervention including antidepressant skills workbook and DVD training that significantly decreased depression in cancer survivors.

• Small sample (< 30)
• Risk of bias (no control group)
• Unintended interventions or applicable interventions not described that would influence results

The PHQ-9 depression scale is a simple tool that oncology nurses can use in the clinical setting to assess for depressive symptoms in patients with cancer. Identification of patients with high depression scores can benefit from additional interventions, such as skills training and coaching by nurses, to facilitate self-care in reducing symptoms and improving quality of life as a cancer survivor.

To assess the safety and efficacy of celecoxib single therapy on depressive symptoms of patients with colorectal cancer who underwent chemotherapy.

Parallel-group, randomized, double-blind, placebo-controlled trial, randomized to either 400 mg per day celecoxib or placebo for 6 weeks.

• N = 40
• AGE: 18-65 years
• MALES: 65% in celecoxib arm; 55% in placebo arm  
• FEMALES: Not listed
• CURRENT TREATMENT: Chemotherapy
• KEY DISEASE CHARACTERISTICS: Stage I–IV colorectal cancer diagnosed more than 100 days 
• OTHER KEY SAMPLE CHARACTERISTICS: 15% in celecoxib group and 20% in placebo group reported past psychiatry history

• SITE: Single site   
• SETTING TYPE: Outpatient    
• LOCATION: Tehran University of Medical Sciences, Tehran, Iran

PHASE OF CARE: Active anti-tumor treatment

Parallel-group, randomized, double-blind, placebo-controlled trial

Hamilton Depression Rating Scale, Visual Analog Scale to measure pain intensity, at week 2, 4, and 6 post-treatment. Adverse events were evaluated at each point using a checklist. Medication adherence was measured with weekly capsule counts with participant reports of medication intake.

HRDS scores were significantly greater in the celecoxib treatment group at week 2 and remained higher until week 6 (p = 0.028). There was not a significant difference between mean VAS scores between the groups at week 2, 4, and 6 (p = 0.459). Gastrointestinal side effects that have been attributed to celecoxib, such as abdominal pain and diarrhea, were not significantly different between the intervention groups. No symptoms of cardiovascular adverse event or serious adverse event occurred.

Celecoxib monotherapy is potentially safe and effective treatment for mild to moderate depression in patients with colorectal cancer undergoing chemotherapy.

Small sample (< 100)

Oncology nurses are in a key position to screen for psychological distress in patients undergoing chemotherapy. Celecoxib has been shown in this study to be effective for mild to moderate depression in patients with colorectal cancer. Celecoxib may also be effective in patients with other malignancies although further research is needed. Oncology nurses should discuss with physicians the use of celecoxib for any patients with colorectal cancer exhibiting mild to moderated depression as evidenced on psychological distress screening.