Psychological Effects: Cancer Can Have a Significant Impact on Patients
Jana Bolduan Lomax, PsyD
Clinical Health Psychologist
Owner, Shift Healing
Many individuals experience both wanted and unwanted changes in emotions and relationships as a result of a cancer diagnosis and treatment. Some people find resilience and optimism to face challenges; while others might experience intense fear, anxiety, sadness, and/or anger. Some people discover strengthening and deepening of relationships; while others may experience disappointment and isolation from friends and loved ones. When an individual, couple, or family deal with cancer they also deal with many types of stress. The way one handles stress can have a significant impact on the way an individual and their healthcare team manage cancer.
A recent literature review conducted by Tesaro Inc. regarding the psychosocial aspects of ovarian cancer care highlights the significant impact of emotional distress and the limited time spent addressing it in standard cancer care settings. “According to the findings from the literature review, ovarian cancer is frequently diagnosed late, leading to urgency in treatment and leaving little time for healthcare professionals (HCPs) to consider, assess or address the psychological aspects of care. The psychological impact of cancer can have a significant impact on treatment outcomes as 80% of women experienced poor mental health and patients with depression and anxiety are at a significantly greater risk of mortality, hospitalization and poorer treatment outcomes.
“Despite this, women reported that they receive information about the tangible and practical aspects of treatment, but much less so for the psychosocial aspects of the disease and how to cope. Women are also less likely to discuss the topic with their HCPs because most women feel uncomfortable raising psychological and emotional concerns during their appointment. They are often worried about taking up too much time from their provider. As a result, women with ovarian cancer feel isolated, with little support, and feel the need for more information.
“The review also revealed that the ovarian cancer patient journey includes considerable fear for disease recurrence. The review also revealed women with recurrent ovarian cancer are not receiving the same level of support as those who are newly diagnosed, with one study showing that for 53% of patients, no one had discussed symptoms of recurrence, and 63% of nurses claim they don’t have the time do so.
“Recurrence of ovarian cancer also takes a psychological toll with 60% of women with recurrence reporting they can do less than they wanted to do because of their emotional status (versus 16% of women without recurrence) and 66% of women with recurrence reporting having trouble concentrating (versus 26% of women without recurrence).”
How Are You Coping?
There are innumerable physical, practical, emotional and social stressors involved in a cancer experience. The importance of the psychosocial concerns and strategies for coping cannot be underappreciated. Feelings of loss, grief and fear are all normal and expected throughout the cancer diagnosis and treatment process. What may not be healthy is if such feelings continue in a manner that interferes with daily functioning. These feelings and their impact on life might be difficult to assess, especially since cancer treatments can interfere with hormones, appetite, sleep, energy levels and memory. Additionally, you may not be able to participate in normal daily activities due to cancer treatments; so some of the areas normally used to determine how well a person is coping are affected by treatment. Nonetheless, emotional and social well-being are important aspects of effective cancer treatment and adaptive coping.
In order to understand how you are coping, here are some important questions to ask yourself or to discuss with a qualified medical provider:
- How is your mood and outlook for the future?
- Can you discuss your cancer and fears you have, or are you keeping everything inside, afraid you will scare your family or children?
- Do you feel like a burden, worthless or hopeless?
- Do you have interest in your daily activities, but you find it difficult to participate in them due to a lack of energy associated with treatments? Or, would you say you have generally lost interest in most all activities aside from energy levels or limited physical abilities?
- Are you open to new ways to spend your time productively and to nurture your mind?
- Do you still enjoy seeing your family/friends and spending time with them when you feel up to it?
- Are you turning people away? Could you benefit from speaking to others who have experienced similar cancer diagnosis/treatment? Physical and functional changes can logically lead to feelings of anger, frustration, and loss; which might be improved by connecting with others in similar situations.
- You may want to consider the quality of your self-talk and thoughts about the future. Are you optimistic and do you look forward to the future, or could you benefit from speaking to a professional about distressing feelings of sadness or worry?
- Consider if there have been any changes in your alcohol or substance use. Have you increased drinking or using medications to the point where it is concerning to yourself or your family? If you see an increase or change in drinking or other substance use to tune out emotionally, consider speaking to a medical or mental health professional.
- Are you struggling to achieve restful sleep? Extended sleep deprivation or disrupted sleep can lead to increased risk for depression, anxiety, and impaired problem solving.
Strategies for Adaptive, Active Coping
Like other areas of life, it is important to have a number of tools in your kit for coping with all this stress. Stress management strategies can help deal with the stress that comes from having cancer, as well as the stress that can come from treatments such as chemotherapy and radiation and other areas of life in general. Social support through groups, social media, and/or family can help you to feel connected and less isolation in order to effectively deal with stress. For example, it can help you develop more active coping skills. A strong support network can reduce the effects of stress in several ways:
- It can help you see an event as less stressful. That will lessen your body’s response to it.
- It can improve how you cope by providing problem solving techniques and resources for help when you need it.
- It can help enhance positive health behaviors such as exercise and proper nutrition.
- It can provide support that makes it easier to adhere to your medical treatment plan.
Studies have shown that, in addition to a strong support network, there are many emotional and physical benefits from activities to manage stress and become more intentional in self-care and relaxation. Evidence-based stress management activities include:
- Counseling with a skilled professional
- Cognitive Behavioral Therapy
- Mindfulness and Meditation activities (Mindfulness Based Stress Reduction)
- Deep breathing exercises
- Yoga, Tai Chi
- Complementary therapies such as Healing Touch, Massage, Acupuncture
- A Gratitude Practice
- Artistic expression, journaling
Cancer and its treatments brings unexpected stress into the lives of individuals and their loved ones. Managing stress in active and adaptive ways is a vital way of healing from cancer – for your body, mind, soul, and spirit. It is important to discuss such emotional and social concerns with trained professionals and your healthcare team, as well as your loved ones. You may just find that what you are experiencing is an absolutely normal response to an abnormal life circumstance!
Jana Bolduan Lomax, PsyD
Clinical Health Psychologist and Founder
Shift Healing, LLC, 2150 W 29th Ave, Suite #125, Denver, CO 80211
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