Mental health in patients with advanced cancer at the end of life: evaluation of evidence and future directions

ABSTRACT Introduction: The mental health of patients with advanced cancer at the end of life is a strong contributor to suffering on the part of both the patient and family. A closer look is needed to address the complexity of psychological adaptation to provide a comfortable transition between life and death. Areas covered: This review describes patient related factors, interventions, and outcomes targeting maintaining and improving mental health for individuals with advanced cancer at the end of life. The Preferred Reporting Items for Systematic reviews and Meta-analyses was used to review the state of the science and the evidence-based hierarchy provided a structure for ranking research quality. Expert commentary: Psychological adaptation for patients with advanced cancer is often comingled with physical symptoms to the extent that neither is distinct. Quality of life is essential in comfort care at end of life. All contributing factors must be considered including the often-missed spiritual needs, cultural factors, developmental issues, and communication relative to end of life. Discussed are both gaps in the science and interventions useful to enhancement of mental health comfort for patients with advanced cancer and their families at the end of life.