Oregon's 2020 legalization of psilocybin therapy for depression in terminal illnesses like advanced cancer has faced significant implementation challenges. This review synthesizes empirical data on psilocybin therapy for cancer-related depression, evaluating benefits and adverse effects. It examines therapeutic strategies, dosing regimens, and barriers to responsible, equitable access, including ethical protocols, healthcare integration, statewide availability, legal ambiguities, and clinical standards. Using Oregon as a case study, the review underscores the need to address regulatory, logistical, and ethical obstacles to establish rigorous and equitable psilocybin care models.
Ketamine may offer rapid relief for depression and suicidality in cancer patients, especially those with advanced disease or near the end of life, where conventional antidepressants often work slowly or poorly. This review of clinical trials and case studies examines ketamine's efficacy and safety as a standalone or combined treatment in this population. The evidence is promising but limited; larger, well-controlled studies with long-term follow-up are needed to confirm effectiveness, safety, and optimal dosing for palliative care.