Influence of Treatment Caused Impairments on Anxiety and Depression in Patients with Cancer of the Esophagus or the Esophagogastric Junction

  • Thomas KieferEmail author
  • Dorothea Krahl
  • Carsten Hirt
  • Heinz Völler
  • Lorenz Völkel
  • Georg Daeschlein
Original Research



After therapy of cancer of the esophagus or the esophagogastric junction, patients often suffer from anxiety and depression. Some risk factors for elevated anxiety and depression are reported, but the influence of steatorrhea, the frequency of which has only recently been reported, has not yet been investigated.


Using the Hospital Anxiety and Depression Scale (HADS), we analyzed the correlation of anxiety and depression with steatorrhea, appetite, and weight loss in 72 patients with cancer of the esophagus or of the esophagogastric junction, who were treated at our rehabilitation clinic between January 2011 and December 2014. In addition, effectiveness of psychological interviews was analyzed.


We have evaluable anxiety questionnaires from 51 patients showing a median anxiety value of 5 (range 0–13). As for the depression, results from evaluable questionnaires of 54 patients also showed a median value of 5 (range 0–15). Increased anxiety and depression values (> 7) were observed in 25.4% and 37.0% of the patients respectively. Patients who were admitted with steatorrhea for rehabilitation showed a statistically higher anxiety value (median 6.3 vs. 4.7, p < 0.05), reduced appetite, and a weight loss above 15 kg depicting a correlation to anxiety and depression. Psychological conversations helped lowering the depression but had no influence on anxiety.


Impairments after cancer treatment, such as steatorrhea, appetite loss, and weight loss, should be interpreted as an alarm signal and should necessitate screening for increased anxiety and depression. Psychological therapy can help improving the extent of the depression.


Anxiety Depression Esophagus carcinoma Exocrine pancreas insufficiency Rehabilitation Steatorrhea 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that there is no conflict of interest.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent of the patients for being included in the study is not necessary since we present data of retrospectively analyzed data. No informed written consent was obtained.

This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Klinik am SeeRüdersdorf beiGermany
  2. 2.Department of Internal Medicine C, Hematology/OncologyUniversity of GreifswaldGreifswaldGermany
  3. 3.Center of Rehabilitation ResearchUniversity of PotsdamPotsdamGermany
  4. 4.Department of DermatologyUniversity Medicine GreifswaldGreifswaldGermany

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