Managing cancer-related depression: Insights from patient and environmental perspectives in psycho-oncology

Cancer-related depression (CRD) is a psychological and psychiatric disorder commonly observed among cancer patients. Its onset and progression are closely associated with changes in tumor burden and disease status, and are further influenced by anti-cancer treatments, cancer-related comorbidities, medical ambience and environment, and various social factors. CRD exerts multiple direct and indirect adverse effects on cancer management, substantially impairing patients’ quality of life and long-term survival. With the development of psycho-oncology, CRD has become a prominent focus of academic research. However, comprehensive, forward-looking, integrative reviews on advances in the management of CRD remain scarce. In this review, we systematically searched and synthesized the latest evidence on CRD from the PubMed and Web of Science databases. We delineated a mechanistic axis of CRD that links tumor, immune, neural, and endocrine pathways, and propose an innovative clinical management framework conceptualized along a “tumor–psychology–ambience–society” axis. Overall, CRD is a common, clinically significant, and treatable condition that requires optimal management through close collaboration among oncologists, psychiatrists, psychologists, nursing teams, family members, and broader social support networks. Looking ahead, more in-depth basic research is needed to elucidate the mechanisms underlying CRD, identify more specific biomarkers, and define representative potential therapeutic targets. From a clinical perspective, large-scale real-world studies are warranted to validate whether CRD management strategies guided by the “tumor–psychology–ambience–society” framework can provide integrated benefits for both oncologic and psychological outcomes.