Experts urge to explore psilocybin and other psychedelics for cancer distress among women with gynecologic cancers

USA: In a recent commentary published in the International Journal of Gynecological Cancer, a panel of experts have urged to explore psilocybin and other psychedelics for women’s cancer distress. 

The doctors stated, "Oncologists should stop prevaricating and explore the use of psilocybin and other psychedelics to ease the often overwhelming distress faced by women with late-stage gynaecological cancers." Psilocybin is the active ingredient in ‘magic mushrooms.' 

Dan Yaniv, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA, and colleagues suggest that conventional ‘gold standard’ psychotherapeutic approaches, such as cognitive behavioural therapy (CBT), take too long to change old habits and require too much stamina. 

Women with gynecologic cancers face several psychological and physical challenges throughout their treatment journey. Late stages associated with poor prognosis and chronic side effects of treatment, often leave women with existential uncertainty stemming from unpredictable disease trajectory and continuous fear of death.

They described the case of a patient in her 30s with end-stage ovarian cancer. Her fear for her future was real and overwhelming. She had neither the time nor the stamina for the options available to ease her distress.

The researchers point out that there are a quarter of ovarian cancer patients like her who report anxiety, depression, and death anxiety. This is not limited to ovarian cancers, as many gynecologic cancers are unfortunately diagnosed in young women where there is an even greater burden of fear and anxiety is even greater. 

Psychedelics, specifically psilocybin, have been promising for the treatment of several psychological symptoms including depression, anxiety, end-of-life distress, and traumatic stress disorder. The researchers suggest the encouraging results of studies of people with other cancer types. 

To date, evidence indicates that psilocybin exerts action in a similar way and is as effective as antidepressants, with few or no side effects. When combined with psychotherapy, it exerts its beneficial effects in just one or two sessions. 

The team mentioned a pooled data analysis of 10 clinical trials which revealed that one or two doses of psilocybin had sustained and rapid antidepressant effects that lasted for up to 6 months. 

They add, "Concerns regarding the potential of psilocybin for recreational abuse or mental illness have not materialized, and data suggest psilocybin use may actually be protective against psychological distress and suicidality."

"Considering the prevalence of existential distress among patients with ovarian and other gynecologic cancer and the potential safety and benefits of psychedelics, there is a clear requirement for more well-designed protocols prioritizing safety and exploring psilocybin, and other psychedelics, in this vulnerable population," they concluded. 

The authors plan to begin a trial in 2024 to look at the impact of psilocybin on patients with advanced cancer who are experiencing depression and anxiety associated with their illness. 

Reference:

Yaniv D, Ramondetta LM, Cohen L, et alPsilocybin-assisted psychotherapy for cancer-related anxiety and depressionInternational Journal of Gynecologic Cancer Published Online First: 18 July 2023. doi: 10.1136/ijgc-2023-004659