Last year, I had a cancer scare. During a routine colonoscopy, my doctor found a polyp. When I got the phone call from my GI doctor himself, and he said, “we found cancerous cells. We need you to come back for a second colonoscopy,” the world fell silent.

 

The two weeks that followed, waiting for that second colonoscopy, lasted a lifetime, with waves of fear and uncertainty crashing in. The second colonoscopy confirmed that all of the cancerous cells were removed. Now I’m on the list for an annual colonoscopy, so if anything comes back, we catch it early.

 

When a person hears “you have cancer,” the next few weeks move fast. Scans. Staging. Oncology appointments. Treatment decisions.

 

And at the same time, even a short wait, like waiting for scan results, can feel like an eternity.

 

In the middle of all that, depression is easy to miss. Or it gets set aside for “later.”

 

A new study suggests later may be too late.

 

In a large study of older adults on Medicare, ages 66 and older, people with depression who started therapy within 4 weeks of a cancer diagnosis had a 21% lower risk of dying from their cancer than those who didn’t (Qiao et al., 2026). Yet only 3% got therapy in that window. The findings are early and show a link, not proof of cause, but they point to a gap that we as therapists can help close.

 

In this article, I cover:

• What the new research found about depression, early therapy, and cancer death in older adults
• How this fits with what we already knew about depression and cancer
• The limitations of this research, and why it’s still a win for older adults
• How to use these findings in your practice, including a referral letter you can send to oncology and primary care teams

 

 

New Research: Early Therapy, Depression, and Cancer Survival in Older Adults

Researchers at the University of California, San Diego looked at more than 265,000 Medicare beneficiaries age 66 and older who were diagnosed between 2010 and 2017 with one of six common cancers: breast, colorectal, prostate, bladder, kidney, or non-small cell lung cancer. About 1 in 5 (22%) had a diagnosis of major depressive disorder before their cancer diagnosis (Qiao et al., 2026).

The team then looked at who received therapy or an antidepressant in the first 4, 8, and 12 weeks after the cancer diagnosis. Here’s what they found:

• Depression was linked to an 11% higher risk of dying from cancer.
• Therapy in the first 4 weeks was linked to a 21% lower risk of cancer death for people with depression. The link was weaker when therapy started later: 13% lower at 8 weeks and 12% lower at 12 weeks.
• Very few got therapy in that window. Only 3% of people with depression saw a therapist in the first month, and fewer than 5% by 3 months.
• Antidepressants reached far more people, about 1 in 3, but weren’t linked to fewer cancer deaths overall. The one exception was prostate cancer.

The lead researcher, Dr. Edmund Qiao, noted why depression is so easy to miss in cancer care: fatigue, trouble concentrating, and loss of interest can look like the cancer itself or the side effects of treatment.

 

Depression and Cancer Mortality: What Earlier Research Shows

The connection between depression and cancer death isn’t new. A meta-analysis of 76 studies found that both a depression diagnosis and higher depressive symptoms predicted higher mortality in people with cancer, even after accounting for medical factors (Pinquart & Duberstein, 2010). A more recent meta-analysis of cohort studies found that depression and anxiety were linked to higher cancer-specific mortality as well (Wang et al., 2020).

What this new study adds is timing. It suggests the first weeks after diagnosis may be an especially important window for mental health care, and that this window is almost always missed.

 

 

Limitations of This Research on Depression and Cancer Survival

Whenever I read a study like this, the Pollyanna in me gets excited, and the clinician in me slows down and asks what this research can and can’t tell us. So, here are some important things to keep in mind.

• It hasn’t been peer reviewed yet. This research was presented at the American Society for Radiation Oncology (ASTRO) 2026 Annual Meeting and hasn’t been published in a peer-reviewed journal.
• It shows a correlation, not a cause. The study looked back at Medicare records, so it can’t prove that therapy lowered the risk of cancer death.
• Other factors may explain part of the link. People who got therapy quickly may have had more support, easier access to care, or more energy to engage with their health.
• The link wasn’t the same for every cancer. The association between therapy and lower cancer death was statistically significant for prostate, breast, and kidney cancer.
• It only includes people 66 and older on Medicare. We don’t know if the findings apply to younger adults or people with other insurance. That said, this is also a win. Too few studies focus on adults over 65, so research this large on older adults is exactly what our field needs.
• You may see different numbers in the news. Some early coverage reported figures from the original conference abstract. ASTRO has asked that the updated figures in its news release be used, and those are the numbers I share here.

Even so, 97% of older adults with depression didn’t see a therapist in the first month after a cancer diagnosis. That’s a gap we can do something about.

 

How Therapists Can Support Older Adults After a Cancer Diagnosis

Ask About Depression, Anxiety, and Other Mental Health Symptoms Right Away

When an older client gets a cancer diagnosis, ask about depression and other mental health symptoms right away. Don’t wait for the dust to settle. If you notice depression or other mental health concerns, encourage therapy now, not after treatment ends.

This matters most for clients who already have a history of depression. In this study, those were the people at higher risk, and they were also the people least likely to get therapy in the first month.

 

Depression after a cancer diagnosis belongs in the first conversation, not the last.

 

Reach Out to Oncology and Primary Care Teams

This study is also a natural way to connect with the medical teams caring for your clients. Reach out to local oncology practices and primary care providers, share what this research found, and let them know how to refer to you. A short email or letter is all it takes.

A Sample Referral Letter You Can Adapt

Here’s a brief script you can adapt:

Dear Dr. [Name] and team,

My name is [Your Name], and I’m a [license/credential] in [city] who provides psychotherapy to older adults and their families focused on adjusting to a new medical diagnosis, depression, anxiety, family strain, etc. 

I wanted to share a new study presented at the American Society for Radiation Oncology (ASTRO) 2026 Annual Meeting. Among Medicare beneficiaries age 66 and older with depression and one of six common cancers, those who received psychotherapy within 4 weeks of diagnosis had a lower risk of cancer death. Yet only 3% received therapy in that window. The findings are early, but they point to an important access gap.

I’d welcome the chance to support your patients who are struggling with depression or anxiety after a cancer diagnosis or other medical conditions. I can typically see new clients within [timeframe], and I [accept Medicare / other insurance details / offer telehealth].

To refer, please [call/fax/email] [contact information]. I’m also happy to connect by phone if that would be helpful.

Thank you for the care you provide.

Warmly,

[Your Name, credentials]

[Practice name, phone, email, website]

Include a link to the ASTRO news release on the study so they can read it for themselves.

Feel free to copy and paste this example into your own letterhead or email and add your details.

 

When Should Therapy Start After a Cancer Diagnosis?

So when a clinician asks me whether it’s better to let a client get through the first round of appointments before bringing up therapy, here’s what I say.

 

Should I wait until things settle down before recommending therapy after a cancer diagnosis?

My answer is: No. The first weeks are exactly when depression is easiest to miss and, based on this early research, may be when therapy matters most. Ask about depression and other mental health symptoms right away, and if they’re there, provide treatment for them. You can always adjust the pace of therapy around treatment. You can’t get those first weeks back.

Don’t Wait to Address Depression and Other Mental Health Concerns After a Cancer Diagnosis

I still remember how silent the world went after that phone call. And I remember how long those two weeks felt.

For many, that silence comes with a harder diagnosis and a longer road than mine. Many face it while grieving other losses, managing other health conditions, or living with pre-existing mental health concerns.

This is also when people need therapy. Not only after treatment ends. Not only when things settle down. Now.

We may not be able to change a diagnosis or make the waiting any shorter. What we can do is let people know they’re not alone, and help them find a sense of peace and connection while so much feels uncertain.

Depression and anxiety after a cancer diagnosis belong in the first conversation, not the last.

 

Professionals: Want to Deepen Your Skills with Depression in Older Adults?

 

Effective Therapy with Older Adults (3 CE Credits)

 

If you’re building your clinical skills in this area, I recommend starting with Effective Therapy with Older Adults. You’ll learn why depression and anxiety often look different in older adulthood and how to catch what’s easy to miss, plus an aging-informed approach to case conceptualization you can use starting with your next session. It’s on demand, so you can start today.

Learn more here

 

Related Articles

• What Keeps Older Adults From Seeking Mental Health Care?
• How to Build a Therapy Practice Devoted to Therapy with Older Adults
• How to Treat Depression in the Midst of Dementia
• What If Aging Isn’t Decline? New Yale Research Says Older Adults Actually Improve Cognitively and Physically