Different foods including antioxidant rich foods; probiotics; magnesium/zinc rich foods including whole grains, legumes, nuts, berries, leafy vegetables and avocados; chamomile tea; EGCG present in tea; omega-3 fatty acids; curcumin; mushroom mycelium extracts and dark chocolate may help in dealing with anxiety and depression symptoms in cancer patients. Certain herbs and herbal supplements such as holy basil/tulsi and Ashwagandha extract may also have anti-anxiety properties.
Anxiety and Depression in Cancer Patients
A cancer diagnosis is a life-changing event associated with increased anxiety and clinical depression amongst the patients as well as their family. It changes the patients’ personal life, work and relationships, daily routines, and family roles, eventually leading to anxiety and depression. A systematic review and meta-analysis suggested that depression may affect up to 20% and anxiety up to 10% of patients with cancer, as compared to 5% and 7% in the general population. (Alexandra Pitman et al, BMJ., 2018)
Cancer diagnosis and treatments can be extremely stressful and can have a substantial impact on the quality of life and mental health of the patient. The anxiety and stress in cancer patients may be mostly associated with the fear of death, fear of cancer treatments and related side-effects, fear of changes in physical appearance, fear of metastasis or spread of the cancer and the fear of losing independence.
The most popular approaches for dealing with anxiety include relaxation techniques such as yoga, meditation and deep breathing, counselling and medication. Scientific evidence suggests that anxiety and depression can hinder cancer treatment and recovery, as well as increase the chances of dying from cancer. Hence, dealing with anxiety and depression appropriately and improving the mental health of cancer patients becomes crucial.
When it comes to dealing with anxiety and stress, we often reach out to the healthcare professionals for medications and counselling. However, the most important factor that we all overlook is the role of nutrition (foods and supplements) in the patient’s mental health. Different studies indicate that when compared to cancer patients with a normal nutritional status, patients at risk of malnutrition experienced increased pain, anxiety and depression. (Mariusz Chabowski et al, J Thorac Dis., 2018)
Foods and Supplements that may reduce Anxiety and Depression in Cancer Patients
Right foods and supplements when included as part of the cancer diet, may help in reducing or dealing with anxiety and depression in cancer patients.
Probiotics for Anxiety and Stress in Laryngeal Cancer Patients
In a study done by the researchers of Shanxi Medical University in China on 30 patients with laryngeal cancer and 20 healthy volunteers, they found that the use of probiotics can ameliorate the anxiety and stress in patients scheduled for laryngectomy. (Hui Yang et al, Asia Pac J Clin Oncol., 2016)
Foods containing Probiotics
Taking these probiotic foods may help in dealing with anxiety and stress symptoms in cancer patients.
- Yogurt and Cheese – Fermented dairy foods
- Pickles – A fermented food
- Kefir – Fermented probiotic milk
- Traditional buttermilk – Another fermented dairy drink
- Sauerkraut – Finely shredded cabbage fermented by lactic acid bacteria.
- Tempeh, Miso, Natto – Fermented soybean product.
- Kombucha – Fermented Green Tea
Vitamin D deficiency and Depression in Metastatic Lung Cancer Patients
In a very recent study done by the researchers of the Memorial Sloan Kettering Cancer Center Department of Psychiatry and Behavioral Science in New York on 98 metastatic lung cancer patients, they found that Vitamin D deficiency may be associated with depression in patients with metastatic lung cancer. Hence, Vitamin D supplementation may help in reducing depression and anxiety in these cancer patients. (Daniel C McFarland et al, BMJ Support Palliat Care., 2020)
Vitamin D Rich Foods
Taking these Vitamin D rich foods may help in dealing with anxiety and depression symptoms in cancer patients.
- Fishes such as Salmon, Sardines, Tuna
- Egg yolks
Vitamin D and Probiotic co-supplementation
Another study done by the researchers of Arak University of Medical Sciences and Kashan University of Medical Sciences in Iran also found that the co-administration of Vitamin D and probiotics may help in improving the mental health of women with polycystic ovary syndrome (PCOS). (Vahidreza Ostadmohammadi et al, J Ovarian Res., 2019)
Curcumin for Depression and Anxiety symptoms in Patients
Curcumin is the key active ingredient present in Turmeric, a curry spice frequently used in Asian countries.
- In a recent meta-analysis done by the researchers of the University of Catania in Italy, they evaluated data from 9 articles, 7 of which included results from those who were affected by major depressive disorder, while the other two included results from those who suffered from depression secondary to a medical condition. The study found that curcumin use significantly reduced the depression and anxiety symptoms in patients. (Laura Fusar-Poli et al, Crit Rev Food Sci Nutr., 2020)
- Different other studies also supported the findings on the potential benefits of the use of curcumin supplements in reducing depression and anxiety symptoms in patients with different medical conditions including diabetes with peripheral neuropathy. (Sara Asadi et al, Phytother Res., 2020)
- Another study done in 2015 also found that Curcumin has the potential to reduce anxiety in individuals with obesity. Obesity is one of the key risk factors of cancer. (Habibollah Esmaily et al, Chin J Integr Med., 2015)
- A previous study done in 2016 by the researchers of Kerala found that a formulation of curcumin and fenugreek may be beneficial in significantly reducing occupational stress. (Subash Pandaran Sudheera et al, J Clin Psychopharmacol., 2016)
Vitamin C deficiency increases Anxiety and Depression
Vitamin C deficiency is widely associated with stress-related disorders such as anxiety and depression. Hence, supplementation of Vitamin C, also known as ascorbic acid, a strong antioxidant, emerges as a possible therapy strategy for anxiety and depression in cancer patients. (Bettina Moritz et al, The Journal of Nutritional Biochemistry, 2020)
This also aligns with the findings of a study done by the researchers of University of Otago in New Zealand in 2018, where they concluded that high Vitamin C status was associated with elevated mood in male students recruited from local tertiary institutes in Christchurch, New Zealand. (Juliet M. Pullar et al, Antioxidants (Basel)., 2018)
A previous study done by the researchers from the same University also found that increased intake of Vitamin C rich food such as kiwifruit by individuals with moderate mood disturbance can improve overall mood and psychological well being. (Anitra C Carr et al, J Nutr Sci. 2013)
Vitamin C Rich Foods
Taking these Vitamin C rich foods may help in dealing with anxiety and depression symptoms in cancer patients.
- Berries such as blueberries and strawberries
- Kiwi fruit
- Citrus fruits such as oranges, lemons, grapefruits, pomelos, and limes.
- Tomato juice
Antioxidants such as Vitamin A, C or E for Anxiety and Depression
A study conducted by the researchers of the Santokba Durlabhji Memorial Hospital in Jaipur, India evaluated the impact of deficiency of Vitamin A, C or E (which are strong antioxidants) on generalised anxiety disorder (GAD) and depression.The study found that patients with GAD and depression had significantly lower levels of vitamins A, C, and E when compared to healthy individuals. The dietary supplementation of these vitamins significantly reduced anxiety and depression in these patients. (Medhavi Gautam et al, Indian J Psychiatry., 2012).
Along with Vitamin C rich foods, fruits such as plums, cherries, berries; nuts; legumes; and vegetables such as broccoli, spinach and kale may reduce anxiety and depression.
Omega-3 Fatty Acid for Depression in Newly diagnosed Lung Cancer Patients
Fatty fishes such as salmon and cod liver oil are rich in omega-3 fatty acids.
Researchers from the National Cancer Center Research Institute East in Kashiwa, Japan carried out a clinical study to evaluate the association between daily omega-3 fatty acid intake and depression in 771 Japanese Lung Cancer patients. The study found that total omega-3 fatty acid intake and alpha-linolenic acid may be associated with reduced depression in lung cancer patients. (S Suzuki et al, Br J Cancer., 2004)
Chamomile Tea for Anxiety and Depression in Cancer Patients Treated with Chemotherapy
In a study published by the researchers of Iran in 2019 based on data from 110 cancer patients visiting to the department of chemotherapy at 22 Bahman Hospital in Neishabour, Iran, they evaluated the impact of chamomile tea on anxiety and depression in 55 cancer patients undergoing chemotherapy and found that the intake of chamomile tea reduced the the depression in these patients by 24.5%. (Vahid Moeini Ghamchini et al, Journal of Young Pharmacists, 2019)
Magnesium Supplements for Anxiety and Depression in Cancer Patients treated with Chemotherapy
A study published in the Journal of Clinical Oncology in 2017 evaluated the impact of using magnesium oxide supplements in 19 cancer patients who reported continued anxiety and difficulty with sleep initiation following chemotherapy and/or radiation for different cancer types. 11 patients reported a reduced anxiety post using magnesium oxide supplements. The study concluded that magnesium use may be beneficial in reducing sleep disturbance and anxiety in cancer patients. (Cindy Alberts Carson et al, Journal of Clinical Oncology, 2017)
Magnesium Rich Foods
Taking these magnesium rich foods may help in dealing with anxiety symptoms in cancer patients.
- Whole Grains
- Leafy Vegetables
- Dark Chocolate
Dark Chocolate for Symptoms of Depression
Dark chocolate is rich in magnesium, iron, copper and manganese and different antioxidants. Dark chocolate containing more than 70% cocoa has a very low amount of carbohydrates and sugar.
In a multi-national study, researchers examined the association between dark chocolate consumption and depressive symptoms in US adults. The data was obtained from 13,626 adults who were aged more than 20 years and participated in the National Health and Nutrition Examination Survey between 2007-08 and 2013-14. The study found that dark chocolate intake may be associated with a reduced risk of clinically relevant symptoms of depression. (Sarah E Jackson et al, Depress Anxiety., 2019)
Zinc Supplements for Depression
Scientific evidence supports a positive association between zinc deficiency and the risk of depression. Zinc supplementation may help in reducing depressive symptoms. (Jessica Wang et al, Nutrients., 2018)
Zinc Rich Foods
Taking these zinc rich foods may help in dealing with depression symptoms in cancer patients.
- Whole Grains
- Egg yolks
Tea Catechins for Depression in Breast Cancer Survivors
Tea catechins such as epigallocatechin-3-gallate (EGCG), predominantly present in green tea and black tea may help in reducing the depression in breast cancer patients/survivors.
Based on the data from a population-based cohort study conducted between April 2002 and December 2006 in Shanghai, China involving 1,399 breast cancer women, the researchers of the Vanderbilt Epidemiology Center in the United States evaluated the association of tea consumption with depression in breast cancer survivors. The study found that regular tea consumption may help in reducing depression in breast cancer survivors. (Xiaoli Chen et al, J Clin Oncol., 2010)
Mushroom Mycelium Extracts may reduce Anxiety in Patients with Prostate Cancers
In a study done by the researchers of Shikoku Cancer Center in Japan involving 74 prostate cancer patients, they found that, in patients who had strong anxiety before supplement ingestion, dietary administration of mushroom mycelium extracts significantly alleviated these feelings. (Yoshiteru Sumiyoshi et al, Jpn J Clin Oncol., 2010)
Herbs or /Herbal supplements that may reduce Anxiety and Depression
Tulsi / HolyBasil, Green Tea, Gotu Kola
In a systematic review published in the Phytotherapy Research journal in 2018, it was highlighted that the administration of the extracts from gotu kola, green tea, holy basil or tulsi, may be effective in reducing anxiety and/or depression. (K. Simon Yeung et al, Phytother Res., 2018)
In a clinical study done by the researchers of the Department of Neuropsychiatry and Geriatric Psychiatry in Hyderabad, India, they found that the use of ashwagandha may help in reducing stress and anxiety in adults.(K Chandrasekhar et al, Indian J Psychol Med., 2012)
Ashwagandha extract has the potential to reduce the levels of the stress hormone called cortisol which is found to be elevated in those under chronic stress.
There are some studies which also indicated that herbs such as black cohosh, chasteberry, lavender, passionflower and saffron may have the potential to mitigate anxiety or depression. However, well-designed large clinical trials are essential before these herbs can be recommended and used for managing anxiety or depression in cancer patients. (K Simon Yeung et al, Phytother Res., 2018)
Foods that may increase Anxiety and Depression
Following foods/drinks should be avoided or taken in moderation by cancer patients with anxiety and depression symptoms.
- Sugar sweetened drinks
- Refined and processed grains
- Caffeinated Coffee
- Processed meat and fried foods.
Taking antioxidant rich foods; probiotics; magnesium/zinc rich foods including whole grains, legumes, nuts, berries, leafy vegetables and avocados; chamomile tea; EGCG; omega-3 fatty acids; curcumin; mushroom mycelium extracts and dark chocolate may help in reducing anxiety and depression symptoms in cancer patients. Many herbs and herbal supplements such as holy basil/tulsi and Ashwagandha extract may also have anti-anxiety properties. However, before taking any supplements, discuss with your oncologist to avoid any adverse interactions with the ongoing cancer treatments.
Cancer patients often have to deal with different chemotherapy side effects which affect their quality of life and look out for alternative therapies for cancer.Taking the right nutrition and supplements based on scientific considerations (avoiding guesswork and random selection) is the best natural remedy for cancer and treatment related side-effects.