Mental Health Matters: Depression and Anxiety Linked to Recovery After Gastric Cancer Surgery
Jensen K, Sood D, Horns J ... Disparities in outcomes and costs of gastrectomy for gastric cancer among patients with depression and anxiety. Surgical Oncology Insight, 2026; 3
Mental Health Support May Play an Important Role in Recovery After Gastric Cancer Surgery
For people facing gastric cancer surgery, preparing for treatment often focuses on physical health, nutrition, and the operation itself. New research suggests that mental health may also be an important part of preparing for—and recovering from—major cancer surgery.
A 2026 study published in Surgical Oncology Insight examined whether depression and anxiety were associated with surgical outcomes and healthcare costs among patients undergoing partial or total gastrectomy for gastric cancer. The researchers analyzed 1,502 patients treated between 2011 and 2021 using a large U.S. insurance claims database. About 15% had a documented diagnosis of depression, anxiety, or both before surgery.
What Did the Researchers Find?
Patients with a diagnosis of depression and/or anxiety experienced several differences in their recovery after surgery.
They had a median hospital stay of 11 days compared with 9 days for patients without these diagnoses. They were also more likely to experience a postoperative complication: 13% experienced a complication within 30 days compared with 8% of patients without depression or anxiety. These differences remained significant even after researchers accounted for factors including age, sex, whether patients lived in rural areas, and whether they underwent a total or subtotal gastrectomy.
The study also found higher healthcare costs. The median cost of the initial hospitalization was approximately $50,262 for patients with depression or anxiety compared with $42,380 for those without these diagnoses. By 90 days after surgery, median total costs were approximately $56,983 compared with $43,707.
Interestingly, the researchers did not find a significant difference in hospital readmissions or emergency department visits between the two groups.
Why Does This Matter?
Gastrectomy is a major operation, and recovery can affect a patient's ability to continue other parts of cancer treatment. For some patients with gastric cancer, chemotherapy is given before and/or after surgery. Complications or a prolonged recovery could potentially delay the next phase of treatment.
Importantly, the researchers stress that depression or anxiety should never be viewed as a reason to deny or delay potentially curative surgery. Instead, these conditions may represent factors that healthcare teams can identify and support as part of comprehensive cancer care.
The authors suggest that strategies such as mental health screening, behavioral health referrals, psychosocial support, and psychological preparation before surgery may be worth incorporating into perioperative care. However, this study did not directly test whether these interventions improve surgical outcomes, so additional research is needed.
What Patients and Caregivers Should Know
Mental and emotional health are part of cancer care—not something separate from it. Patients preparing for gastric cancer surgery may want to talk with their healthcare team about anxiety, depression, sleep problems, stress, or difficulty coping before treatment.
Support could include counseling, oncology social work, behavioral health services, support groups, or other psychosocial resources. Addressing these concerns may help patients feel better supported throughout a demanding treatment and recovery process.
Important Limitations
This was a retrospective study using insurance claims, so it can identify associations but cannot prove that depression or anxiety caused poorer surgical outcomes. The database also did not include important clinical information such as cancer stage, severity of depression or anxiety, complexity of the operation, or whether patients completed chemotherapy. In addition, the study primarily included commercially insured patients and did not include information on race or ethnicity.
The Bottom Line
This research reinforces the importance of treating the whole person when preparing for major cancer surgery. Patients with documented depression or anxiety experienced longer hospital stays, more postoperative complications, and higher healthcare costs following gastrectomy for gastric cancer. Rather than affecting eligibility for surgery, these findings point toward an opportunity to better integrate mental health screening and supportive care into cancer treatment planning.
