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Cancer patients are vulnerable to depression and anxiety for many reasons: metabolic or endocrine alterations, treatment with debilitating chemotherapy regimens, immune response modifiers, and chronic pain associated with their physical illness. Quite apart from the normal emotional impact of the diagnosis of a life-threatening illness, an estimated 20% to 25% of cancer patients meet diagnostic criteria for major depression or anxiety, treatable psychiatric conditions that have serious detrimental effects on their quality of life.1