Psilocybin-assisted Psychotherapy for End-of-Life Anxiety and Depression in Cancer Patients

Ellen Rahel^*
*Correspondence: Ellen Rahel, Department of Psychiatry, University of Lausanne, Prilly, Switzerland, Email:

Introduction

The psychological toll of a terminal cancer diagnosis extends far beyond physical suffering. Many individuals facing the end of life struggle with profound existential distress, characterized by anxiety, depression, hopelessness, and fear of death. These emotional burdens not only diminish quality of life but can also complicate palliative care, impair relationships, and erode the dignity of dying. Conventional psychiatric treatments, including antidepressants and anxiolytics, often fail to provide meaningful or timely relief in this context. Side effects, slow onset of action, and a narrow focus on symptom suppression rather than existential well-being limit their effectiveness. In recent years, there has been growing interest in psychedelic-assisted psychotherapy, particularly with psilocybin, as a novel therapeutic approach to address these deep-rooted psychological and spiritual concerns in terminally ill patients [1].

Description

Psilocybin, a naturally occurring compound found in certain species of mushrooms, has been used for centuries in various cultural and spiritual rituals. Modern clinical research, however, is only recently beginning to rediscover its potential. In controlled therapeutic settings, psilocybin has been shown to induce powerful alterations in consciousness, including experiences of ego dissolution, mystical insight, emotional catharsis, and a sense of unity or interconnectedness. These effects appear to be associated with sustained improvements in mental health outcomes when paired with structured psychological support. For patients confronting mortality, such experiences may help to reframe fear of death, reduce emotional suffering, and facilitate acceptance of the end-of-life process [2,3].

This study examines the effects of psilocybin-assisted psychotherapy on anxiety and depression in cancer patients with terminal or life-limiting diagnoses. Participants were recruited through oncology and palliative care clinics and underwent rigorous screening to ensure medical safety and psychological readiness. Eligible participants were adults diagnosed with advanced-stage cancer, exhibiting clinically significant anxiety and/or depressive symptoms as measured by validated scales such as the Hamilton Anxiety Rating Scale (HAM-A) and the Beck Depression Inventory (BDI). Exclusion criteria included a personal or family history of psychotic disorders, active substance abuse, or unstable cardiovascular conditions. Participants received a single high-dose psilocybin session (approximately 25 mg), embedded within a broader therapeutic framework consisting of preparatory and integration sessions facilitated by trained psychotherapists [4].

The therapeutic protocol emphasized safety, trust, and psychological openness. Prior to the psilocybin session, participants engaged in two to three preparatory meetings to establish rapport with therapists, clarify intentions, and discuss possible experiences and coping strategies. The psilocybin session itself took place in a comfortable, non-clinical setting, with music, eyeshades, and supportive guidance designed to facilitate an inward journey. Two trained therapists remained present throughout the session to provide emotional support and help participants navigate challenging psychological content. Following the experience, participants took part in several integration sessions to reflect on insights, process emotions, and translate the experience into their daily lives [5].

Conclusion

In conclusion, psilocybin-assisted psychotherapy represents a promising new frontier in the treatment of end-of-life psychological distress. For patients facing terminal cancer diagnoses, this intervention offers a rare combination of rapid symptom relief and profound existential insight. By facilitating deeply meaningful experiences that reframe suffering, enhance emotional processing, and cultivate acceptance, psilocybin may provide a unique therapeutic avenue that traditional treatments cannot match. While further research is essential to refine protocols, confirm safety, and expand access, the results of this study underscore the need to reconsider how we approach mental health in palliative care. As society continues to grapple with how to best support those at the end of life, integrating innovative, compassionate, and evidence-based approaches like psychedelic-assisted therapy may ultimately help patients face death with greater peace, dignity, and meaning.

Acknowledgment

None.

Conflict of Interest

None.

References

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