ABSTRACT
Patients with advancing cancer may be understandably sad. Certain cancers, including pancreatic cancer, appear to be more strongly associated with depression. It is understandable that every patient with any illness may feel sad, angry or bitter and may seem quite 'depressed'. However, it is important to decide which it is and whether the patient is clinically depressed and requires treatment. Sadness should respond to the opportunity to express one's feelings and the offer of appropriate support. Clinical depression may require specific drug therapy in addition to psychological support. The diagnosis of depression is made by assessing a number of physical and mental symptoms. Patients with sadness rather than depression are normally able to express and discuss their feelings in a rational and philosophical way. As a general rule, if the patient is ill as a result of their sadness, they are probably clinically depressed.
