... Depression in cancer patients is associated with non-disclosure of cancer diagnosis (Degi, 2009), lower quality of life (Grassi et al., 1996;Koller et al., 1996), high suicide rate (Henriksson, Isometsa, Hietanen, Aro, & Lonnqvist, 1995), poorer adjustment to the disease (Watson, Haviland, Greer, Davidson, & Bliss, 1991), poor adherence to medical treatment (Pirl & Roth, 1999), and less optimism about treatment effectiveness (Cohen, de Moor, & Amato, 2001). Further, depression affects many bodily functions such as endocrine and immune functioning, which persistently activate the hypothalamic-pituitary-adrenal (HPA) axis, affects and compromises immune surveillance of tumors and resistance to cancer progression, increases DNA damage and inhibits apoptosis (Gidron, Russ, Tissarchondou, & Warner, 2006;Irie, Miyata, & Kasai, 2005;Levy, Herberman, Lippman, D'Angelo, & Lee, 1991). In general depression is associated with decreased number and cytotoxicity of T and NK (natural killer) cells which influence cancer progression (Levy et al., 1991). ...