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Cancer and Mental Health

Ms. Deepanwita Roy

5 Min Read

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According to the National Cancer Registry Programme (NCRP), the number of cancer patients is likely to increase from 13.9 lakhs in 2020 to 15.7 lakhs in 2025 – an increase of nearly 20%. One good thing is that at least one-third of common cancers are now preventable, thanks to advanced medical science; however, a cancer diagnosis at any phase of life most often comes as a devastating surprise to the patients as well as their caregivers, and families. From the time of diagnosis to the time of treatment and recovery, each and every patient undergoes mild to severe emotional turmoil which not only affects their health but also indirectly causes a potential threat to their road to recovery.

Did You Know?

– It is estimated that up to one-third of people treated for cancer in hospitals have a common mental health condition*

– Rates of major depressive disorder are thought to be up to three times higher than in the general population.**

– Anywhere from 8-24% of people with cancer are also living with depression.***

– Youth and young adults are at greater risk for depression and other conditions compared to adults with cancer.4 ****

Despite the alarming statistics, India still is far-behind from providing the holistic approach to cancer care. But in hope for a better tomorrow, let us discuss a few common concerns noticed in people with cancer and their possible solutions for care.

Common Concerns Noticed in People With Cancer and Possible Solutions

Stress, Anxiety and Depression

Feeling overwhelmed is a perfectly normal response to any cancer diagnosis. For many people, the news leads to depression, which can make it more difficult for them to adjust, make the most of the treatment, and take advantage of whatever source of social support is available. Some people might reach a state of pessimism where they refuse to undergo surgery or simply stop going to radiation or chemotherapy appointments. The struggles are different for everyone. Some find it difficult to explain their illness to their children or find it difficult to deal with their spouse’s response. For some, the struggle is to choose and decide on the right hospital and medical treatment. For others, it may be on how to control stress, anxiety and uncertainty associated with the entire treatment process. It is no less for the caregiver as well. Sometimes when the news of a cancer diagnosis is shared with the family, they also tend to go through a myriad of doubts, anxiety and fear.

Staying in touch with a mental health professional from the days of early detection to the treatment journey can help a great deal. The primary aim as mental health professionals is to assist and support them in coping with the physical, emotional and lifestyle changes associated with cancer as well as with medical treatment that can be challenging and painful. Cognitive Behavior Therapy (CBT), mindfulness based interventions and supportive therapy are commonly used where their intrusive thoughts, the loop of overthinking is challenged, they are given options to deal with the discomfort, relaxation exercises such as breathing and progressive muscular relaxation exercises to relieve the pain associated with the treatment procedure.

A combination of individual and group therapy works best for cancer patients. Individual sessions typically emphasize the understanding and medication of patterns of thinking and behavior. Group psychological treatment with others who have cancer gives patients a chance to give and receive emotional support and learn from the experiences of others.

Emotional Incongruence and Difficulty Dealing With Negative Emotions

It is important to feel your feelings, you have every right to mourn your losses, you may keep wondering ‘why is it happening only with you?’ It’s okay to feel this way, but remember, you are more than your cancer.

Mental health experts suggest everyone to be gentle with themselves. Look for ways to feel good inside and out. Avoid the “Be positive” trap: it is normal to have bad days. But if your anxieties, worries and fear are interfering with your day to day activities or sleep habits, it is important to acknowledge and address them without crying in silence or by suffering alone.

You can work hands-on in learning problem-solving strategies in a safe-space and work through your grief, fear and other recurring emotions. The life-threatening crisis can even prove to be an opportunity for a life-enhancing personal growth.

Physical Symptoms and Side Effects to Treatment

Nausea and vomiting often accompany chemotherapy. Learning relaxation activities such as deep breathing, and progressive muscular relaxation exercises, meditation, imagery techniques would effectively relieve nausea without the side effects of pharmaceutical approaches.

The rigorous treatment often brings side effects such as, frequent mood swings, sleep disturbances and memory changes. The side effects coupled with hormonal changes can alter emotions. All of these feelings are normal but acknowledging & challenging your emotions whenever it is relevant would help to cope with the situation much better.

Body Image Issues

Studies have shown that people diagnosed with breast cancer and maxillofacial cancers experience body image issues. Two dimensions of body image issues have been described: affective and cognitive.

– The affective dimension is associated with the feelings that people have about their own body.

– The cognitive dimension, on the other hand, includes thoughts and beliefs associated with their body.

These two dimensions can have a certain degree of overlap, and mismatch between the two can lead to stress and behavioral change and depression in people with cancer.

Every patient should be encouraged to be a part of support groups to stay connected. Many times, patients feel that their spouses or caregivers fail to understand their feelings. In such situations, talking to someone who has gone through a similar phase in their lives could help them to overcome their loneliness associated with it. Often they might find it liberating to talk and share their experiences and their cancer can be a great resource to build awareness. The highlight should not just be to speak of coping mechanisms but to address the mistakes they made: not engaging in self-screening, avoiding regular mammograms and so on…

Fear of Recurrence

Fear of recurrence (cancer coming back) is common and expected. Every ache and pain may cause you to think, ‘Is my cancer back?’ There are ways to ease your fears.

– Accept your emotions. Talk about your fears with your healthcare provider, trusted friend or other survivors.

– Practice mindfulness or meditation. Awareness in the moment often helps reduce anxiety, stress and fear of recurrence.

– Take control of your health. Stick to your doctor’s advice including what examinations you need in the future and how often you should do them.

– Maintain a healthy lifestyle. Eat right, sleep well and get enough exercise.

– Join a support group for cancer survivors. Getting to know other cancer survivors will help you feel less alone as you learn how they are coping with the same worries.

Remember, you are not alone. Don’t be shy about seeking out mental health professionals for support. You won’t need it forever, but it can help during this time.

Take care of yourself. You deserve it!

References:

(1) Nakash O, Levav I, Aguilar-Gaxiola S, et al. (2013). Comorbidity of common mental disorders with cancer and their treatment gap: findings from the World Mental Health Surveys. Psycho-oncology, 23(1), 40-51. *

(2) Smith H. R. (2015). Depression in cancer patients: Pathogenesis, implications and treatment (Review). Oncology letters, 9(4), 1509-1514. **

(3) Krebber, A. M., Buffart, L. M., Kleijn, G., Riepma, et al. (2013). Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments. Psycho-oncology, 23(2), 121-30. ***

(4) Park, E. M., & Rosenstein, D. L. (2015). Depression in adolescents and young adults with cancer. Dialogues in clinical neuroscience, 17(2), 171-80.****

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Written by

Ms. Deepanwita Roy

Consultant Clinical Psychologist (RCI Registered ) at MFine with 7+ years of clinical experience. Prefer a holistic approach in therapeutic practices using Cognitive Behaviour Therapy (CBT) and mindfulness-based interventions. My interest areas lie in managing stress, anxiety, depression, sleep problems & providing care & support to the LGBTQIA+ community. Apart from providing regular online consultations, I take interest in writing content related to mental health, engage in conducting webinars for EAP programs and work on research and development.

Cancer and Mental Health

Did You Know?

Common Concerns Noticed in People With Cancer and Possible Solutions

Stress, Anxiety and Depression

Emotional Incongruence and Difficulty Dealing With Negative Emotions

Physical Symptoms and Side Effects to Treatment

Body Image Issues

Fear of Recurrence

References:

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