It is believed that up to one-third of cancer patients treated in hospitals suffer from mental health problems.¹ The risk of mental health issues in cancer patients is up to 3x higher compared to others.² The most common mental health problem is depression.³ Whilst depression in cancer affects patients of all age groups, it is more likely to affect young adults.⁴

Whilst going through one of the most difficult health journeys, it’s difficult for a patient to focus on mental health along the term. However, if neglected, mental health problems can lead to physical health problems leading to poor cancer treatment outcomes. This may be due to lack of adherence to treatment plans, indulging in substance abuse such as drugs and alcohol and lack of exercise, good diet, and hygiene.

Throughout cancer treatment, it’s important to watch for signs of mental health deterioration and illness:

• Frequent feelings of despair, sadness, hollowness, for long periods of time
• Losing interest in hobbies and activities earlier enjoyed
• Significant weight loss or weight gain
• Sleep disorders including lack of sleep, oversleeping, or other difficulties
• Frequent feelings of fatigue
• Feelings of guilt, helplessness, and lack of self-esteem
• Indecisiveness and memory issues
• Mood swings
• Contemplating death or suicide regularly or even attempting suicide

Many of these symptoms can also result from cancer treatment, however it shouldn’t be assumed that any feeling of illness, fatigue or emotion are due to treatment only. A person with cancer should talk with their doctor about any of these symptoms and get help with identifying the cause.

The causes of mental health issues among cancer patients

Cancer is a life-threatening disease, which understandably means there is a lot of emotional stress related to it. Furthermore, there are serious physical discomforts, pains and physiological changes caused by cancer treatments. Other factors causing mental burden amongst patients can include:

Social rejection and stigma: According to statistics, depression is the most common psychiatric disorder in cancer patients.3 The condition can vary with the type of cancer, treatment being undertaken and intensity, etc. They may suffer mental health issues due to fear of stigma and social rejection – both perceived and apparent.

Family and career – If the cancer patient is young then there could be the fear of academic or career setbacks due to the prolonged illness, rehabilitation period or even the fear of death. Acceptance is a major challenge, across age groups and irrespective of the relationship or status of people. They need to manage the response from their friends and family members as being diagnosed with cancer instantly makes everyone fear the risks to life. Being diagnosed with cancer often makes people make major changes to their plans such as postponement of having children, building a home, getting married or pursuing higher studies. It’s important to ensure that morbidity fears to not overtake a patient’s life, and that they continue to make plans which motivate them.

Financial stress – An illness like cancer might not be predictable, and it does cause financial stress for most people. Cancer treatments  are lengthy and the financial impact caused by years of work lost due to disability are significant.⁵ These financial hardships caused by an inability to continue with a job, cost of treatment or travel if paying out of pocket, financial implications on the family in the eventuality of the patient’s death, disability or extension of the treatment period can cause depression and other mental health problems.⁵

Supporting mental wellness among cancer patients

Cancer patients and survivors must endure a lot of physical and mental challenges, and the right advice, support and attention from caregivers, family and friends can expedite and enhance the chances of recovery.

Here are some of the things that can be done to provide the desired mental health support and comfort to the patients:

Help them express: While it is important to give the person their space and time to process the situation, it is also equally important to make things conducive for them and encourage them to talk about any of their fears and concerns.

Don’t be judgmental: You’re not the one living with this disease, so to judge what cancer patients can or can’t do, or how they are feeling isn’t helpful. Therefore, it must be remembered that there is no need to judge their feelings and to point out where the person could be wrong or to disagree and try to force one’s own point of view on them.

Try not to underplay the situation: As family and friends, it is a common tendency to try and make others believe that they have nothing to fear or worry about. However, trying to cheer up a cancer patient or to advise ‘positive thinking’ might make the person shut down and not share their feelings. What is needed is empathy when listening and calm discussion about what can be done to make things better. However, it’s always a good idea to just indulge in some fun activities that the patient can enjoy with ease.

Approach your loved ones with empathy and patience 

Suffering from a life-threatening disease is not easy by any stretch of imagination. Therefore, trying to take things lightly or to make the patient feel that it is nothing to worry about might not do anyone any good. The ideal approach would be to show empathy, care, and attention to the patient. Remember that remaining calm and truthful will help generate the much-needed trust between the caregiver and the patient. Further, this will prepare the patient for any eventuality with greater ease.

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. Linden W et. al. (2012). Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. J Affect Disord.;141:343–351. doi: 10.1016/j.jad.2012.03.025.
3. Gregurek, R., & E.T.A.L. (2010, June 22). Psychological problems of patients with cancer. PubMed. https://pubmed.ncbi.nlm.nih.gov/20562751/
4. Gagliese, L., Gauthier, L. R., & Rodin, G. (2007). Cancer pain and depression: a systematic review of age-related patterns. Pain research & management, 12(3), 205–211. https://doi.org/10.1155/2007/150126
5. Macmillan Cancer Support. (2012). No Small Change. Time to act on the financial impact of cancer. https://www.macmillan.org.uk/documents/policy/money-and-cancer-policy-report.pdf