Investigators revealed that psilocybin-assisted psychotherapy and other psychedelics may effectively ease symptoms of anxiety and depression in patients with late-stage gynecologic cancers, according to a new commentary published by Yaniv et al in the International Journal of Gynecological Cancer.
Background
Psilocybin is the active ingredient in what is known as “magic mushrooms.”
The investigators argued that conventional, gold standard psychotherapeutic approaches such as cognitive behavioral therapy may take too long to modify old habits and require too much stamina.
“[Patients] with gynecologic cancers face various physical and psychological challenges throughout their treatment journey. Late stages associated with poor prognoses, along with chronic side effects of treatment, often leave [patients] with existential uncertainty stemming from unpredictable disease trajectory and continuous fear of death,” emphasized the study authors.
Citing a recent case of a younger patient with advanced ovarian cancer whose “fear for her future was real and overwhelming,” the study authors demonstrated that these patients often don’t have the time or energy for standard mental health treatments.
“Up to a quarter of [patients with] ovarian cancer report depression, anxiety, and death anxiety. This is not limited to ovarian cancers, as many gynecologic cancers are unfortunately diagnosed in young [patients], where the burden of anxiety and fear is even greater—often related to the fact that young children may lose their mothers,” the study authors underscored.
The Case for Psilocybin
Psilocybin and other psychedelics have shown promise in treating various psychological issues, including anxiety, depression, posttraumatic stress disorder, and end-of-life distress. The results of previous studies involving patients with other types of cancers have been encouraging, suggesting that psilocybin could be as effective as antidepressants, with few or no side effects. Further, psilocybin may provide patients with beneficial effects when combined with psychotherapy after just one or two sessions.
A recent pooled data analysis of 10 clinical trials found that one or two doses of psilocybin had rapid and sustained antidepressant effects that lasted for up to 6 months.
Conclusions
“Concerns regarding psilocybin’s potential for recreational abuse or mental illness have not materialized, and data suggest psilocybin use may ... be protective against psychological distress and suicidal [thoughts or actions],” the study authors highlighted. “Considering the prevalence of existential distress among [patients with] ovarian and other gynecologic cancers and the potential benefits and safety of psychedelics, there is a clear need for more well-designed protocols prioritizing safety and exploring psilocybin and other psychedelics in this vulnerable population,” they concluded.
The investigators plan to examine the impact of psilocybin on patients with advanced cancers and disease-related anxiety and depression in a new trial expected to launch in 2024.
Disclosure: For full disclosures of the study authors, visit ijgc.bmj.com.
