SLU study: Integrative palliative care critical to improve mental health among pancreatic cancer patients

ST. LOUIS – For patients facing a pancreatic cancer diagnosis, a compassionate approach to care can be transformative. Yet, a new study published in Healthcare reveals that palliative care, a service focused on enhancing the quality of life for those with serious illnesses, remains significantly underutilized among pancreatic cancer patients in the United States. 

The study found that only 25% of patients newly diagnosed with pancreatic cancer received a palliative care consultation within their first year. Additionally, despite one in three patients experiencing depression or anxiety, just half received any form of mental health support, either through therapy or medication.

Divya Subramaniam, Ph.D., associate professor of health and clinical outcomes research at SLU’s School of Medicine and the paper’s lead author, said patients typically endure significant suffering — not just from physical pain but also from the fear and loss of functionality and dignity, all of which contribute depression and anxiety. Subramaniam adds that this study addresses a major gap by examining the initiation of palliative care and its impact on treating new-onset mental health issues in patients with pancreatic cancer.

"Our findings highlight a disproportionately low uptake of palliative care, especially given the high prevalence of advanced cancer at the time of diagnosis. These findings underscore a critical unmet need in improving their quality of life while these patients live with cancer," Subramaniam said.

This retrospective study examined a random sample of an all-payer medical record database in the United States, focusing on 4,029 adults diagnosed with primary pancreatic cancer for the first time. Nearly half of the patients were over the age of 70, and more than 70% had multiple severe medical conditions in addition to pancreatic cancer.

However, the study’s findings point to more than just the low uptake of palliative care. The researchers also observed that older patients and those diagnosed with either depression or anxiety alone, but not both, were less likely to receive treatment for mental health issues. Notably, palliative care consultation did not appear to influence the likelihood of receiving mental health treatments.

"Mental health and palliative care are essential components of quality cancer care, especially for aggressive diseases like pancreatic cancer," Subramaniam said. "Our findings call for a more integrated approach to patient-centered care, one that places equal emphasis on mental health as a critical part of cancer treatment and intervention."

Other authors include Zidong Zhang, Ph.D., of the AHEAD Institute, Saint Louis University School of Medicine; Zachary Timmer, Elisabeth C. DeMarco, and Michael P. Poirier, of Department of Health and Clinical Outcomes Research, Saint Louis University School of Medicine; and Leslie Hinyard, Ph.D., of the AHEAD Institute and Department of Health and Clinical Outcomes Research, Saint Louis University School of Medicine.

About AHEAD Institute

The Advanced HEAlth Data (AHEAD) Research Institute at Saint Louis University is a comprehensive center for data-driven innovation and research to improve the health of individuals and populations. The institute brings together researchers from various fields and disciplines to help improve patient and population health, advance the quality of health care and decrease health care costs. The new institute will utilize and develop data resources, novel analytic methods, predictive modeling, machine learning, and integrated wearable health devices and collaborate with national research networks.

About Saint Louis University School of Medicine

Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious diseases.