Clinical trial tests psilocybin-assisted therapy for depression in advanced lung cancer patients
It’s the first trial specific to lung cancer using hallucinogenic mushroom-assisted therapy
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At The Ohio State University in Columbus, Ohio, Alan Davis, PhD (left) and Theodore Wagener, PhD (right) developed the first-ever clinical trial treating lung cancer patients with psilocybin-based therapy.
view moreCredit: The Ohio State University Comprehensive Cancer Center
Nearly 40% of people with lung cancer experience depression, and many also face anxiety, hopelessness and questions about mortality after diagnosis. Researchers at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) and the Center for Psychedelic Drug Research and Education (CPDRE) in the College of Social Work (CSW) are leading a clinical trial to test whether psilocybin-assisted therapy can help reduce depression and emotional distress among patients with lung cancer.
An unmet mental health need
This new research addresses a pressing gap in cancer care: Many people with advanced lung cancer are living longer because of treatment advances, but depression, anxiety and distress can still affect daily life, relationships and the ability to cope with treatment.
This is the first study to test psilocybin-assisted therapy for depression specifically in people with lung cancer. The emotional strain can be especially intense for people with lung cancer, yet treatment options for cancer-related depression have changed little as cancer care has improved.
Psilocybin is a naturally occurring psychedelic compound found in certain mushrooms. In this study, it is given in a carefully controlled medical setting with counseling and support from trained therapists.
"There is growing evidence that psilocybin-assisted therapy may help relieve depression in people with cancer, but no study has focused specifically on patients with lung cancer," said Alan Davis, PhD, co-principal investigator of the study and directs Ohio State's Center for Psychedelic Drug Research and Education. "This is the first clinical trial designed to determine whether this approach can address the unique psychological challenges faced by this patient population."
"Many patients are diagnosed with advanced disease and are forced to confront questions about their future very quickly," said Theodore Wagener, PhD, co-principal investigator of the study and director of Ohio State's Center for Tobacco Research. Both Wagener and Davis are scientists with the OSUCCC – James Cancer Control Research Program. "Patients may experience anxiety, existential distress, loss of meaning and concerns about their families. Some also carry guilt tied to the stigma that can be associated with lung cancer."
Researchers say these emotional burdens can affect quality of life, daily routines, relationships and how patients experience cancer treatment.
Testing a guided treatment model
During this clinical trial, researchers will measure changes in depression and emotional well-being to learn whether the approach could offer another option for patients facing advanced cancer.
The trial combines psychotherapy with one supervised dose of psilocybin. Participants first complete about eight hours of preparation with two trained therapists. They then receive psilocybin during a daylong treatment session in a comfortable clinical setting, followed by counseling to help them process the experience.
"From the moment patients enter the study, they are paired with two therapists who support them throughout the entire process," Davis said. "The goal is to help participants feel safe, build trust and make sense of their experiences in ways that may improve their well-being."
Researchers also are studying whether psilocybin may affect inflammation, though more research is needed.
Looking beyond the cancer
For study participant Betty Paschall, the therapy was part of a turning point after a devastating diagnosis. Paschall was diagnosed with stage 4 lung cancer and initially felt overwhelmed by depression despite receiving treatment for her cancer.
"I didn't want to live," she said. "It was like I was the walking dead."
After participating in the study, Paschall said she noticed meaningful changes in her outlook and daily life. She began engaging in activities she had stopped doing and found herself reconnecting with the people and experiences that brought her joy.
"My sister and daughter both saw a difference in me," Paschall said. "I started to get back to myself a little more."
Researchers caution that psilocybin-assisted therapy remains experimental and is not appropriate for every patient. Participants undergo careful screening, and treatment is provided only under close medical supervision.
A successful study, investigators say, could help identify which patients are most likely to benefit and lay the groundwork for larger studies aimed at expanding treatment options for cancer-related depression.
"Cancer care has made major advances, but treatment for the depression, anxiety and distress that can come with advanced cancer has not moved as quickly," Wagener said. "We hope this research helps us better support the whole person, not just the cancer."
More Information
Patients interested in being screened to participate in the study should contact Angela Douglas at douglas.496@osu.edu. To learn more about lung cancer treatment at the OSUCCC - James, visit cancer.osu.edu or call 1-800-293-5066.
Method of Research
Randomized controlled/clinical trial
Subject of Research
People
Betty Paschall, a stage 4 lung cancer survivor, plays with her dog Mocha at their home in Delaware, Ohio.
A clinical trial at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute is exploring a novel approach to treat mental health struggles in lung cancer patients: psilocybin-assisted therapy.
A clinical trial at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute is exploring a novel approach to treat mental health struggles in lung cancer patients: psilocybin-assisted therapy.
Credit
The Ohio State University Comprehensive Cancer Center
The Ohio State University Comprehensive Cancer Center
Early interventions for depression tied to better cancer survival
Large Medicare analysis finds depression was linked to higher cancer mortality, while psychotherapy soon after diagnosis was associated with lower risk
BOSTON, September 28, 2026 — Depression may be an overlooked factor in cancer outcomes, according to a large SEER-Medicare analysis of more than 265,000 adults with six common cancers.
Researchers found that patients with major depressive disorder had a higher risk of dying from their cancer, while those who received psychotherapy within four weeks of their cancer diagnosis had a 21% lower risk of cancer-specific mortality. Only 3% of patients with depression received psychotherapy in that early window, however. Results will be presented today at the American Society for Radiation Oncology (ASTRO) Annual Meeting.
“Depression can be easy to miss in cancer care because symptoms such as fatigue, difficulty concentrating and loss of interest often overlap with the effects of cancer or its treatment,” said Edmund M. Qiao, MD, lead study author and a radiation oncology resident at the University of California San Diego. “But when depression goes unrecognized or untreated, it can add another layer of difficulty at a time when patients need support the most. Our findings suggest that earlier screening and referral for psychotherapy could help address an important gap in comprehensive cancer care.”
Depression is common among people with cancer, but mental health services are not always integrated into oncology care. For the current study, researchers sought to understand whether depression itself was associated with cancer mortality and whether outcomes differed according to the type and timing of mental health treatment. The retrospective analysis examined two common approaches to treating depression: psychotherapy and antidepressant medication.
Researchers analyzed records from 265,639 Medicare beneficiaries age 66 or older who were diagnosed from 2010 to 2017 with breast, colorectal, prostate, bladder, kidney or non-small cell lung cancer (NSCLC). More than one in five patients (22%) also had a diagnosis of major depressive disorder.
Psychotherapy was identified through Medicare procedure codes, while pharmacotherapy was identified through Medicare Part D claims for antidepressant medications. Researchers evaluated treatment within four weeks of cancer diagnosis, with additional analyses at eight and 12 weeks.
Patients with both cancer and depression had an 11% higher risk of cancer-specific mortality than those without depression. One year after diagnosis, 29% of patients with depression had died from their cancer, compared with 21% of patients without depression. At five years, cancer-specific mortality was 43% for patients with depression, compared to 35% for those without it.
Psychotherapy soon after cancer diagnosis showed the strongest association with lower cancer mortality among patients with depression. Patients who received psychotherapy within four weeks had a 21% lower risk of cancer-specific mortality in adjusted analyses using propensity score weighting. There were smaller reductions associated with psychotherapy at eight weeks (13% lower risk) and 12 weeks (12% lower risk).
“Patients who connected with psychotherapy earlier tended to have better outcomes than those who did not receive it during that period,” Dr. Qiao said. “For oncology providers, these findings support identifying patients who may need mental health care and connecting them with appropriate services as early as possible.”
Five-year cancer-specific mortality was 31% among patients who received psychotherapy and 44% among those who did not. In this large patient cohort, however, only 3% of patients with depression had a psychotherapy session within four weeks of their cancer diagnosis, growing to just 4.6% by 12 weeks.
Medication was used much more often than psychotherapy, by 32.5% of patients within four weeks of their cancer diagnosis. It was not associated with lower cancer-specific mortality at any of the measured timepoints when analyzing the cohort without accounting for specific cancer type, however.
Researchers also examined associations between mental health, treatment and cancer-specific mortality for each of the six cancer types. Depression was most common among patients with NSCLC (27%) and least common among those with prostate cancer (13%). It was significantly associated with higher cancer-specific mortality in every cancer group, with the strongest association seen in prostate cancer.
The association between psychotherapy and cancer-specific mortality varied by cancer type, reaching statistical significance for prostate, breast and kidney cancer. Pharmacotherapy was significantly associated with lower cancer-specific mortality among patients with prostate cancer.
The differences across cancer types suggest that the relationship between mental health and cancer outcomes may be more nuanced than a single approach to depression management can capture, Dr. Qiao said.
“In the general population, psychotherapy and medication can both be effective ways to manage depression,” he said. “But cancer care adds context. A patient’s cancer type, prognosis and treatment course may influence both their mental health needs and which interventions are most helpful.”
Because the study was retrospective, it cannot establish that psychotherapy caused the reduction in cancer mortality. Although the researchers used statistical methods to account for measured differences between patients who did and did not receive mental health treatment, unmeasured factors could have influenced both access to psychotherapy and cancer outcomes. The analysis also was limited to Medicare beneficiaries, and future research is needed to examine whether similar patterns are seen in younger patients.
“Cancer care has become increasingly personalized, but mental health care in oncology often remains generalized,” Dr. Qiao said. “These findings suggest we need to think more carefully about how depression may affect different types of cancer and how we can work with patients to create individualized support plans early in their care.”
ASTRO Expert Perspective
“Depression is common among people facing cancer, but it is often under recognized and undertreated. This study shows that timely treatment for depression is associated with better cancer survival. Patients who received treatment within 1 month of diagnosis had a lower risk of cancer death; it also shows that psychotherapy may potentially be underutilized given larger benefits over medication. Tailored and appropriate screening and referral for mental health care is an essential part of life-saving oncology care,” said ASTRO expert Fumiko Chino, MD, a radiation oncologist at The University of Texas MD Anderson Cancer Center in Houston.
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This release contains updated study data provided by the authors. Where figures differ from the abstract, please use those reported in this release.
Attribution to the American Society for Radiation Oncology (ASTRO) Annual Meeting is requested in all coverage.
Study & Presentation Details
- Dr. Qiao will discuss this study in a news briefing on Tuesday, Sept. 29; register here.
- Abstract details (available after 5:00pm ET on Sept. 25; embargoed abstract available on request)
- Session details & virtual meeting link
- Dr. Qiao’s bio & disclosures
- Find more information about the meeting in our press kit.
ABOUT ASTRO
The American Society for Radiation Oncology (ASTRO) is the world’s largest professional society dedicated to advancing radiation medicine, with 11,000 members including physicians, nurses, physicists, radiation therapists, dosimetrists and other professionals who work to improve patient outcomes through clinical care, research, education and advocacy. Radiation therapy is integral to 40% of cancer cures worldwide, and more than one million Americans receive radiation treatments for their cancer each year. For information on radiation therapy, visit Speed of Light – The ASTRO Foundation. To learn more about ASTRO, visit our website and press room and connect with us on social media.
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