The Unspoken Mental Toll of Cancer Treatment
The cost of cancer treatment on your body and on your finances can be immense. The cost of cancer to your mental health can be immeasurable.
A cancer diagnosis can be scary experience, but knowing what to expect can help you feel prepared.
That moment when you receive a cancer diagnosis from your doctor, your whole world can stop. You might feel numb to the experience or feel like it’s not “real”. You find you just can’t stop thinking about the events of the diagnosis, how your body feels, or the uncertainty of your future. No matter who you reach out to, no matter how good your prognosis, you find that you can no longer feel like yourself again.
You’re not alone. According to the American Cancer Society, 1 in 3 of all cancer patients experience some type of mental health issue during the course of diagnosis and treatment. This can include depression, anxiety, or even trauma. In turn, poor mental health can have devastating effects on your physical health. While you might find yourself focusing on the physical symptoms of cancer and the physical side effects of treatment, it’s important for you to also address your mental health needs throughout this process so that you can increase your quality of life and even improve the actual outcomes after cancer treatment.
Why you need to pay attention to your mental health even when going through treatment for cancer
Whether you’re undergoing chemotherapy, radiation, surgery or additional treatments, the last thing on your mind might be prioritizing your mental health. You might be thinking that you have to focus all of your energy on your physical health, on your body, at this time. But taking care of your mental health can also have huge impacts on your treatment and wellbeing.
Can help you make better decisions
When you receive the distressing news of a cancer diagnosis, you might feel yourself go into “fight or flight” mode where your sense of safety feels so threatened, you find it difficult to focus on any other information. You might also feel yourself go into “fawn” mode. This can be a trauma response where you find yourself trying to please others by being an “easy patient” or by “not complaining” about your diagnosis to others. By taking care of your mental health, you’re able to better process information from your medical providers and you no longer make decisions about your health from a place of fear.
Can help you to prioritize your needs
Prioritizing your mental health can also help you figure out exactly what you need when processing a cancer diagnosis. For example, you might gain insight into the tasks and activities that drain your energy versus the ones that give you energy. You can also learn to set boundaries with others (and even yourself) around treatment expectations. Paying attention to your mental health can also help you build support systems to help with the other parts of life when going through treatment including cleaning, shopping, and cooking.
Can improve cancer treatment outcomes
Most meaningfully if you have just received a cancer diagnosis or are currently undergoing treatment, taking care of your mental health can improve treatment outcomes and increase your chances of surviving cancer. One study compared outcomes for breast cancer patients who participated in emotional support groups to those patients who did not participate in such groups. This study found that the patients who participated in mental health groups had a 45% lower risk of their cancer returning and a 56% lower risk of dying from cancer. Another study found that veterans who sought mental health services while undergoing cancer treatment reduced their likelohood of dying by 25-30%. Research like this continues to point to the benefits of mental health treatment for cancer patients.
Signs of Mental Health Issues While Going Through Cancer Treatment:
Frequent crying spells
Isolating or pulling away from family and friends
Exhausted physically and mentally
Feeling out of control over your health
Inability to sleep or oversleeping
Angry outbursts at loved ones or providers
Muscle tension, back pain, neck pain, jaw pain
Uncontrollable trembling or shaking
Trouble concentrating on anything else besides treatment
Flashbacks or nightmares related to diagnosis or treatment
Feeling intense fear when going in for treatment or before other medical appointments
Overwhelmed by previously easy tasks
Common Emotions You Might Have During Treatment
Numbness - When you first receive the diagnosis from your doctor, you might feel yourself become emotionally or physically numb. You might even be in denial about your diagnosis or find yourself feeling “empty” when thinking about your body.
Anger - You might find yourself feeling angry at your medical providers for not taking your concerns seriously or for the choice of treatment. You might also feel angry at your loved ones for their inability to support you at times in the way that you need. You might also feel angry at your body for “failing” or angry at yourself for previous decisions.
Fear - As with any major illness, fear can be an overwhelming part of receiving a cancer diagnosis. You might find yourself unable to stop thoughts of dying or death. You might also find yourself fearing pain from the cancer, treatment, or recovery.
Grief - You might feel yourself grieving your “old body” after a surgery like a masectomy or electrosurgery. You can also grieve your physical functioning as previously simple tasks, like laundry or driving, become harder or even impossible.
Guilt - You may experience guilt related to not “catching it soon enough”, replaying scenarios over and over. You might also feel guilt related to not being able to assist chores or providing financially for yourself or your family while in treatment.
Embarrassment - You might feel embarrassed to tell others about your illness or cringe at the thought of being the center of attention during treatment. You might also be scared of judgment from others (i.e. “You smoked for years, what did you expect to happen?” or “You can’t just sleep all the time even if you are in treatment”).
Specific Mental Health Challenges of Cancer
Relationships
Cancer can have a significant impact on your relationship. Couples could potentially face a variety of challenges such as traveling for cancer treatment, the loss of one or both partner’s income due to disruptions in work schedules, making decisions about treatment, and processing the emotional impact of a diagnosis. The stress of treatment can put a major strain on even the strongest of relationships. In some cases, the cancer may even lead to the breakdown of the relationship. It’s important for couples to communicate openly about their experiences and expectations through a cancer diagnosis. Couples counseling can help you and your partner navigate receiving a diagnosis, treatment, and recovery.
Friendships
The physical and emotional challenges of cancer can be overwhelming, and they can affect the way a person relates to their friends. Some people may find that they need to distance themselves from their friends during cancer treatment, either because they need to focus on their health or because they are struggling with the emotional effects of the disease. You also might find yourself angry with your friends either because they just “don’t get it” or they seem to disappear entirely as soon as you tell them about the diagnosis.
Financial Stress
Cancer treatment can be expensive, and many people struggle to pay for the medical bills, especially if they have to take time off work. Additionally, you may need to make changes to your home or vehicle to accommodate your treatment, which can add to your financial stress. It is important for people with cancer to talk to their healthcare provider about the financial implications of their treatment, and to explore options for financial assistance, such as Caring Bridge and Cancer Support Community.
Body Image
The physical changes that can occur as a result of cancer and treatment can be difficult to accept. For example, you may experience weight changes, hair loss, or changes to their skin or other physical features. These changes can affect the way you see yourself and can lead to feelings of insecurity and low self-esteem. It can also result in derealization - a phenomenon where you physically see your body in a reflection but might not really recognize it as you or your own body due to physical differences after treatment.
Grief and Anticipatory Grief
Grief is a natural response to loss, and cancer can cause a person to grieve in many ways. For example, you with cancer may grieve the loss of your health, your ability to do the things you used to enjoy, your body, or your relationships with friends and family. You might even experience anticipatory grief. This refers to the feelings of grief you might feel about a loss that has not happened yet. For example, even upon first hearing the diagnosis, you might begin to grieve the loss of your hair when thinking about treatment outcomes even though you might not experience hair loss and/or that outcome is far into the future. A cancer diagnosis can also bring up past trauma related to loss and grief, whether you lost someone to cancer or a different cause.
Therapy as Part of Your Treatment Plan
Therapy can be an important part of cancer treatment, especially if you are dealing with the emotional challenges of cancer. Therapy can provide a safe and supportive space for you to talk about your feelings in a judgement-free space. A therapist specializing in medical issues or cancer treatment can help you:
Cope with the emotions associated with receiving a diagnosis
Develop healthy coping mechanisms for the emotional impacts of cancer
Build boundaries around your time and your energy so that you can focus on your needs during treatment
Find moments of joy and meaning in your life - yes, even while going through treatment.
Online Therapy
Online therapy, or teletherapy, is an effective way for you to access mental health services from a licensed mental health professional right from the comfort of your own home. Through teletherapy, you can meet your therapist in a video call through a secure, private link on your phone, tablet or laptop. Many cancer patients find it convenient to meet with their therapist online in cases where:
You have to travel across the state for treatment
You’re not feeling well enough to leave your home to see a therapist
You have to be in the same home to watch children or elderly family members
Teletherapy can be an effective way for people with cancer to receive the support and guidance they need to cope with the emotional challenges of the disease. To learn more about what counseling for cancer might look like for you and to get started in scheduling an appointment, click here.
