Worldwide, there were around 18.1 million cancer cases in 2020. That is 18.1 million people dealing with the life-altering diagnosis of having cancer. While the physical effects of cancer and cancer treatment are often the primary concern of the medical team in charge of treating the disease, there are significant mental health implications as well.
This psychological impact of cancer is often under-recognized by both patients and doctors, but it’s importance cannot be understated. Cancer and cancer treatment can impact mental health directly – in the case of brain tumors or other neurological problems – and indirectly, as the emotional and psychological stress associated with cancer diagnosis takes its toll.
This article will explore the different ways cancer can impact mental health; the five stages patients go through when coming to terms with their diagnosis, and how to cope with the mental challenges of having cancer.
CANCER AND MENTAL ILLNESS
Mental illness affects 1 in 5 adults in the United States, according to the National Institute of Mental Health. The term ‘mental illness’ is typically used to refer to a wide range of mental health problems, including anxiety disorders, depression, schizophrenia, bipolar disorder, and many others. These mental disorders have varying degrees of severity, but all can significantly impact a person’s ability to function in their day-to-day life.
Cancer, on the other hand, is a disease that affects the cells of the body. Cancer can develop in almost any type of cell, and it has the potential to spread (metastasize) to other parts of the body. Cancer is the second leading cause of death worldwide, and the National Cancer Institute estimates that 39.5% of men and women will be diagnosed with cancer at some point in their lifetime.
While cancer and mental illness are two very different conditions, they can sometimes occur together. What does that mean? What is the connection between cancer and mental illness, and what impact can it have on a person’s health?
Mental illness increases cancer risk
People with mental disorders are at an increased risk of developing certain types of cancer. For example, one Johns Hopkins study found that people with severe mental illnesses, such as bipolar disorder, schizophrenia, and severe clinical depression, were 2.6 times more likely to develop cancer than those without these illnesses.
Reasons for this are most likely linked to the overall health of people with mental illnesses, which can be poor. People with these disorders are less likely to exercise or eat a healthy diet, for example, and may engage in more risky behaviors like smoking, excessive drinking, and drug use.
As of yet, there is no evidence to suggest that mental illness somehow directly causes cancer. However, the lifestyle choices and behaviors associated with mental illness can certainly increase a person’s risk of developing the disease.
Cancer can lead to mental illness
Cancer can also lead to mental illness, either directly or indirectly.
Certain cancers, such as brain tumors, are known to cause mental illness. In fact, 1 in 3 adults diagnosed with a brain tumor experience personality changes as a result of the cancer or its treatment.
Brain tumors can cause a wide range of neurological problems, including seizures, memory loss, confusion, and changes in mood and behavior. These symptoms can be very debilitating, and they can significantly impact a person’s quality of life.
Cancer can also lead to mental illness indirectly through the emotional and psychological distress of having the disease. Cancer is a life-altering diagnosis, and it can be very difficult to come to terms with the new reality of being a cancer patient.
20% of cancer survivors are affected by depression, while 10% suffer from anxiety. These mental health conditions can be difficult to manage for patients, and many require treatment to cope with the emotional challenges of their diagnosis.
Mental illness increases cancer mortality risk
Just as the presence of mental disorders leads to an increased risk of developing cancer, research has also shown that mental illness can make cancer more deadly.
An extensive analysis of over 200,000 breast cancer patients found that mental illness can lead to a dramatic 30% increase in cancer mortality risk. Another study of US veterans diagnosed with lung cancer found that treating preexisting mental health disorders can improve cancer survival rates.
One of the main reasons why mental illness contributes to lower cancer survival rates is because people with a mental disorder are less likely to follow the treatment regimens prescribed to them. They may miss appointments or fail to take their medications as directed, for example, and these behaviors can have a significant impact on cancer outcomes.
Addressing mental health issues is an important part of cancer care. After all, it’s impossible to fully recover from cancer if your mental and emotional well-being isn’t taken into consideration.
Let’s take a closer look at what it means to cope with a cancer diagnosis and the various emotional stages you may experience.
THE FIVE STAGES OF CANCER COPING
Upon receiving a cancer diagnosis, most people go through a similar process of grief and mourning. This process is often referred to as the “five stages of grief,” which was first described by Swiss-American psychiatrist Elisabeth Kübler-Ross in her 1969 book On Death and Dying.
The five stages of grief are:
While the five emotional stages of dealing with a cancer diagnosis are not experienced by everyone exactly the same way, they can provide a useful framework for understanding the emotional journey that many cancer patients go through.
Denial and shock
Even though many patients respond to a cancer diagnosis by confronting the reality of their situation head-on, it’s common to experience periods of denial.
At first, you may refuse to believe that you have cancer or that the diagnosis could be inaccurate. You may downplay your symptoms and avoid taking any action related to the disease.
Denial is actually a form of self-protection. It can be difficult to accept that you have a potentially life-threatening illness, and denial can help you to cope with the initial shock of a cancer diagnosis. “Denial is nature’s way of letting in only as much as we can handle,” wrote Kübler-Ross.
In time, denial will give way to a more realistic understanding of your situation that will help you cope with cancer more effectively.
Anger and frustration
It’s also common to feel angry and frustrated after receiving a cancer diagnosis. You may be mad at yourself for not being healthier or at the medical providers who didn’t catch your symptoms sooner.
Anger can also stem from a sense of helplessness and a feeling that life has dealt you an injustice. After all, anger is a normal reaction to feeling pain over a loss (in this case, the loss of a healthy body).
While understandable, anger can also be counterproductive. It may lead you to make impulsive decisions or take unnecessary risks. The key is to find healthy ways to express your feelings rather than letting them get the best of you.
You may find it helpful to express these emotions of anger through writing, talking with loved ones, or participating in some form of stress-relieving activity like exercise or meditation.
The third stage of grief is bargaining. This is when patients start to make deals with themselves or with a higher power in an attempt to change the reality of their cancer diagnosis.
For example, you may find yourself promising to eat better and live a healthier lifestyle if only your cancer would go away. Or, you may bargain for more time by promising to do things that you haven’t had the chance to do yet if your life is spared.
Bargaining can be a way of regaining a sense of control over a situation that feels completely out of your hands. It can also provide temporary relief from the pain of cancer by giving you something to focus on other than your diagnosis.
Depression and sadness
Depression is when the reality of your cancer diagnosis starts to sink in, and you may feel overwhelmed by sadness and despair.
You may lose interest in activities that you used to enjoy, have trouble sleeping, or struggle with changes in your appetite. You may also start to feel hopeless and powerless as you come to terms with the fact that your life is going to change in significant ways.
It’s completely normal to feel sad or depressed after receiving a cancer diagnosis. However, it’s important to realize that these feelings are only temporary and should start to subside as you begin to accept your diagnosis and find effective coping strategies.
If depression persists, it’s important to seek professional help. Depression can have a significant impact on your physical health and can even make it more difficult for your body to fight cancer.
Acceptance and hope
The final stage of grief is acceptance and hope. At this point, you’ve embraced the reality of your cancer diagnosis and are taking steps to cope with the challenges that lie ahead.
You may start to experiment with different treatment options or focus on adopting healthier habits for living with cancer. You may also begin to develop a stronger support system with friends and loved ones who can provide ongoing emotional and practical support.
In other words, you’ve shifted your perspective from focusing on the past to looking toward the future. While accepting that your life will never be quite the same again is difficult, it’s also an important step in making peace with your cancer diagnosis.
Remember that acceptance does not mean that all the previous stages of grief disappear entirely. Rather, acceptance is when you begin to accept your diagnosis as a fact of life. Feelings of anger, sadness, and depression may still arise from time to time, but you know how to cope with them and move forward.
EFFECTIVE COPING STRATEGIES
Overall, the key to coping with a cancer diagnosis is finding ways to make peace with your situation and focusing on what’s ahead rather than what’s behind you. With proper support and effective coping strategies, you can learn to live well with cancer.
Here is some practical advice on how to mentally cope with a cancer diagnosis.
It’s easy to get overwhelmed with anxiety and uncertainty if you don’t have a solid understanding of what to expect when you have cancer.
One of the most important things you can do is learn everything you can about your specific diagnosis and treatment options so that you feel more confident in making decisions about your care.
Make sure to ask your health care team plenty of questions and keep a notebook handy to jot down important information. Find out exactly what type of cancer you have, where it is, whether it has spread, the chances of a cure, what kind of treatment you will need, how long the treatment will last, and similar.
The more you know, the more in control you will feel.
Maintain open and honest communication
Communicating openly and honestly with your health care team, friends, and family is essential for maintaining good mental health during cancer treatment.
Your cancer care team should know about any changes in your body, mood, or behavior so that they can adjust your treatment accordingly. You should also feel comfortable telling them about your fears and concerns so that they can help you find ways to cope.
In addition, keep friends and family updated on what’s going on with you. It can be helpful to have a close support system to lean on during tough times. If you’re feeling overwhelmed, sad, or anxious, tell them how you’re feeling.
You may not want anything more than to shut yourself off and focus on your treatment, but it’s important to stay social and connected with a support group that cares about you.
Plan for changes
There are bound to be certain aspects of your life that change once you have cancer.
For example, you may need to alter your work schedule or stop driving if your treatment requires it.
Your body might also change in ways that you’re not prepared for, such as hair loss, weight changes, and fatigue.
It’s important to anticipate these changes so that you can plan accordingly.
For instance, if you know you’ll be dealing with fatigue, make sure to schedule plenty of rest into your day and cut back on any extra-curricular activities.
If you’re worried about how cancer will impact your work life, talk to your employer about what accommodations can be made.
The more prepared you are for the changes cancer will bring, the easier it will be to cope with them.
Prioritize a healthy lifestyle
Never underestimate the importance of maintaining a healthy lifestyle during cancer treatment.
Exercise, eat well and get enough sleep to boost your overall physical and mental well-being.
Stress can wreak havoc on your body and mind, so be sure to take time to relax and de-stress as needed. Find time for your favorite hobbies, take a yoga class, or read a good book.
Do whatever you can to take care of yourself both physically and emotionally.
Accept help from your support system
Surrounding yourself with a strong support system is crucial for maintaining good mental health during cancer treatment.
Family, friends, co-workers, religious leaders, and cancer survivors can all offer helpful advice, emotional support, and practical assistance.
Don’t be afraid to ask for help when you need it. Whether you need someone to drive you to your appointments or just to listen while you vent, your support system is there for you.
While cancer can be a frightening diagnosis, remember that there are always people who care about you and want to help. Treat yourself with compassion through this difficult time by seeking out the support and love you need from those around you.
Try to live as normally as possible
People thrive in a routine, and cancer doesn’t change that. While your life may be turned upside down by your diagnosis, it’s important to continue living as normally as possible.
Do the things you enjoy, see friends and family, take time for self-care, and stick to a regular schedule if you can.
It will help keep you focused on the positive and make it easier to cope with the challenges that come with cancer.
Mental illness and cancer are closely linked – mental illness can increase cancer incidence and mortality risk, while cancer can cause mental illness in more ways than one.
The fact of the matter is that mental health problems are an often overlooked issue for people living with cancer. But it’s crucial to be aware of the mental and emotional effects that can accompany this disease so that you can take steps to proactively manage them.
By staying connected with loved ones, prioritizing a healthy lifestyle, and seeking out support from those around you, you can maintain good mental wellbeing during cancer treatment and beyond.
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