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G. Rodin. Lancet 2014; 384: 1076–1078. Published online August 28, 2014 http://dx.doi.org/10.1016/S0140-6736(14)61342-8

This Comment considers three linked papers published from The Lancet group of publications (Lancet, Lancet Oncol and Lancet Psychiatry); it describes 'a rigorous approach to the implementation and assessment of a complex intervention to alleviate depression in people with cancer.' In a multicentre phase 3 trial, 62% of those with cancer and depression responded positively (Symptom Checklist Depression Scale – SCL-20 among other measurements) compared with only 17% in those who received standard care. Intervention included, both antidepressant medication and psychological treatment delivered by a number of different carers, including with up to ten sessions with a nurse, all in liaison with the oncologist. The cost for this additional treatment was an additional £613 for each patient. In a parallel study carried out with those with lung cancer (only 13% 5-year survival), the above intervention also reported an improvement in depression although the result was not so dramatic.