# 007 Depression in Advanced Cancer, 2nd ed

Background:  Diagnosing and providing treatment for a major depressive episode in patients with advanced cancer can improve quality of life. However, diagnosing major depression in an advanced cancer can be complicated by the fact that many cancer symptoms overlap with the somatic symptoms of depression. Clinicians often rely more on the psychological or cognitive symptoms of depression (worthlessness, hopelessness, excessive guilt, and suicidal ideation) than the physical/somatic signs (weight loss, sleep disturbance) when making a diagnosis in advanced cancer patients. Endicott has proposed substituting somatic criteria with affective criteria when evaluating depression in advanced cancer patients: