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No. 3 (2026)

GENERAL THERAPY QUESTIONS AND REVIEWS

Anxiety disorders in patients with pancreatic cancer: from epidemiology to clinical outcomes and treatment strategies

https://doi.org/10.48612/psyph/8m17-m792-hrku

Published 2026-10-02

  • V.I. Egorov
    • ,
  • K.K. Yakhin

V.I. Egorov
Kazan State Medical University; Republican Clinical Oncology Dispensary named after prof. M.Z. Sigal

K.K. Yakhin
Kazan State Medical University

Abstract

Background. Pancreatic cancer (PC) is characterized by aggressive progression and a high prevalence of anxiety disorders (20–44 %), which impair quality of life,
reduce treatment adherence, increase postoperative complications, and negatively affect survival.

The Aim — to analyze the prevalence of anxiety disorders in PC patients, their influence on short- and long-term treatment outcomes, and the comparative effectiveness of screening tools and therapeutic approaches.

Materials and methods. A literature review was conducted using PubMed, Cochrane Library, eLibrary and NCCN/ASCO/RUSSCO guidelines from 2004 to 2026.
Prospective and retrospective cohort studies, population-based studies, randomized controlled trials, and meta-analyses were included; case reports and conference
abstracts were excluded. 71 publications were selected.

Results. The prevalence of anxiety disorders in PC ranges from 14.5 to 44 % depending on the assessment method used and the study design. Anxiety is associated with reduced adherence to chemotherapy and surgery, increased postoperative complications (including gastroparesis), and, according to most studies, worse
survival. Biological mechanisms involve activation of the hypothalamic-pituitary-adrenal axis, catecholamine and glucocorticoid release, which promote proliferation,
angiogenesis, and immunosuppression. The optimal screening strategy is two-step: Distress Thermometer (cutoff ≥ 4) followed by GAD-7 (cutoff 7–8) or HADS-A
(cutoff 7–8). Management includes cognitive-behavioral therapy, relaxation techniques, and, when needed, antidepressants (SSRIs/SNRIs). However, only about 25%
of patients receive timely psychological support.

Conclusions. Anxiety in PC is a modifiable risk factor for adverse clinical outcomes. Integrating systematic screening and multimodal anxiety management into routine
patient care pathways is a priority to improve prognosis and oncological treatment results.

Keywords

anxiety, depression, pancreatic cancer, quality of life, anxiety screening, survival

PDF (Русский)

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