Psychiatric aspects of Cancer: The need for early evaluation

Cancer isn’t just a physical battle; it takes a toll on your mental well-being too. Research in Singapore reveals that nearly 7 out of 10 cancer patients experience some level of anxiety, and at least 7 out of 20 grapple with depression during their journey. Early detection of these mood-related challenges is vital. Once recognized, timely interventions, including psychological therapy and medication, can provide much-needed support.

Anxiety and Depression are not always obvious

Cancer can have a significant impact on a person’s mental well-being, causing feelings of distress, anxiety, and depression. In Singapore, research has shown that 10% of adult cancer patients experience generalized anxiety, while 17% suffer from major depression. But what’s equally important, yet often overlooked, are the milder symptoms of anxiety and depression that can persist and affect a patient’s quality of life during their cancer journey.

Studies have found that between 15% and 16% of cancer patients initially visiting an oncologist experience these milder forms of anxiety and depression, known as sub-syndromal symptoms. Additionally, a striking 80% of these patients reported unmet emotional needs.

In a study at a cancer center, 206 newly diagnosed cancer patients were asked to complete a mental health assessment at three different times over a six-month period. While some patients were lost to follow-up or passed away, the results were still significant. Approximately 60-68% of patients showed signs of sub-syndromal anxiety, and 27-28% exhibited sub-syndromal depression. Although certain factors like cancer stage and age were linked to these symptoms, no clear predictors were identified for baseline symptoms.

Early detection and support

In summary, nearly 7 out of 10 cancer patients experienced milder forms of anxiety, and at least 7 out of 20 had mild depression over a six-month period. These rates are higher than what’s typically seen in the general population and inpatients visiting oncologists for the first time.

Given the prevalence of these mood-related issues, it’s crucial to identify and address them early. Screening tools like the Distress Thermometer, Patient Health Questionnaire (PHQ9), and Distress Anxiety Stress Scale 21 (DASS21) can help with this. Timely interventions, including psychological therapy and medication, can make a significant difference in helping patients manage their emotional well-being during their cancer journey.

When in doubt, ask your doctor

In the battle against cancer, remember that your mental health is a critical part of your overall well-being. If you or a loved one is facing cancer, don’t hesitate to reach out for support. 

If you experience any mood swings, anxiety, or signs of depression, let your treating oncologist know, or contact us to arrange for an appointment. Our doctors and psychologists at Mind Care Clinic are experienced in assessing and treating emotional difficulties relating to cancer.

By opening up about your feelings and seeking the assistance you need, you’re taking an important step towards a stronger, more resilient fight against cancer. 


  1. Tan SM, Beck KR, Li H, Lim ECL, Krishna LKR. Depression and anxiety in cancer patients in a tertiary general hospital in Singapore. Asian J Psychiatr 2014; 8: 33-37.5
  2. Lim HA, Mahendran R, Chua J Peh CX, Lim SE, Kua EH. The distress thermometer as an ultra-short screening tool: a first validation study for mixed-cancer outpatients in Singapore. Compr Psychiatry 2014; 55: 1055-62.
  3. Mahendran R, Lim HA, Chua J, Lim SE, Psychosocial concerns of cancer patients in Singapore. Asia Pac J Clin Oncol 2015; DOI: 10.1111/ajco.12344. 
  4. Mahendran, R, Haikel A Lim, Joyce YS Tan, EH Kua, K Griva. The prevalence and predictors of subsyndromal anxiety and depression in adult Asian cancer patients across the first year of diagnosis. Asia-Pacific J Clin Oncol 2016. DOI: 10.1111/ajco.12562. 

About The Author

Dr. Rathi Mahendran is a highly respected psychiatrist in Singapore with decades of experience in the field of mental health, and psychiatric care in cancer patients. Dr. Rathi practises at Mind Care@SBF, together with a team of psychologists to provide comprehensive and personable care.