Psilocybin, the active compound in certain mushrooms, shows promise as a treatment for depression and anxiety in cancer patients, particularly those nearing end of life. Oregon legalized supervised psilocybin therapy in 2020, making it the first U.S. state to do so. While clinical research shows the treatment can rapidly reduce depression and improve quality of life, the actual rollout has faced challenges including regulatory hurdles, lack of professional standards, and unequal geographic access.