Cancer is hard – physically and emotionally. The diagnosis alone can trigger fear, uncertainty, and stress, all of which can be exacerbated throughout prognosis discussions, treatment decisions, procedures and just managing the normal activities of daily living with this dark shadow lurking in the background.
Anxiety is also part of the mix, even when a patient moves out of treatment and into survivorship. Undergoing scans to monitor for possible recurrence. A health change even years after getting the “all clear.” Annual physicals with their primary care physician. All these situations can trigger the same overwhelming emotions the patient felt throughout their initial battle with cancer.
For some, cancer feels like a life sentence that carries an enormous emotional penalty. Which is why supporting a patient’s mental health needs is an important component of a comprehensive care plan.
Mental Health Challenges
A cancer diagnosis and subsequent treatment can bring forward several mental health issues, the most common being anxiety, depression, and adjustment disorder. While patients who have struggled with these and other mental health disorders in the past are more susceptible, the cancer diagnosis and all that comes with it can trigger symptoms in any patient. It can also exacerbate disorders that had previously been controlled.
While most symptoms will fall on the mild end of the spectrum, they can evolve over time into something more severe and long-lasting. For example, though uncommon, some cancer patients find themselves with symptoms much like post-traumatic stress disorder (PTSD), usually resulting from a traumatic experience during treatment such as an adverse or unexpected surgical outcome.
Many patients also struggle with feelings of guilt related to their illness. Guilt could stem from thoughts about not being able to manage chores or tasks as well as before. They may also experience worry that they are a “burden” to someone else. Guilt is not always rational, but if left unaddressed it can cascade into anxiety, depression, and even anger.
Finally, it’s important to recognize that cancer-driven mental health issues can impact the very relationships patients rely on for emotional support. Feelings of guilt, despondence, detachment and even shame can take control of a patient’s internal dialogue and create distance between them and their loved ones. Again, the emotions aren’t always rational. But when someone is sick, or treatment has taken a toll on their appearance and/or stamina, it is easy to fall into an emotional hole that can overwhelm personal relationships.
Early Attention is Key
It is vital that mental health issues be assessed and addressed as early as possible in a patient’s care plan. Symptoms are not always obvious. The patient who is upbeat and positive at the clinic may be falling apart as soon as they are alone. Or the patient who starts treatment determined to beat their cancer can, over time, become hopeless or overwhelmed.
If patients in need are not given the resources to manage the internal dialogues pecking away at their emotional fortitude, it can have a domino effect that impacts treatment outcomes, long-term health and wellness, and the interpersonal relationships they need in the battle for their lives.
To make that happen, the patient’s clinical team can look for signs that they may be struggling. They can also integrate mental health assessments into their standard practice, approaching it in the same manner they do other health issues – straight forward and empathetic and without judgement. It can be as simple as inquiring if the patient is okay or letting them know it is normal and okay to not be okay – and that resources are available to help them manage their mental health in the same way resources are available to help them manage pain or nutritional needs.
At American Oncology Network (AON), those resources now include credentialled behavioral health therapists to whom patients can be referred for additional assessment and, if needed, a therapy program tailored to their unique needs. Therapists are currently available to practices in Arkansas and will soon be available in Iowa, Missouri, Louisiana, and Indiana. The Behavioral Health Team is growing, with the goal of having credentialled, licensed therapists available to patients in every state where AON has partner practices.
The Mind-Body Connection
Helping a patient with their mental health struggles can be as simple as having someone that is not on their medical care team or in their family or circle of friends who will listen to and reassure them that their thoughts and feelings are normal and understandable; someone who can give them the tools to cope with what they’re experiencing. In some cases, a patient may only require a few sessions for them to feel emotionally stronger. In other cases, more intense or longer-term therapy may be necessary, such as when a pre-existing disorder has been triggered by their diagnosis. What is important is getting the patient the support they need before it spirals out of control.
There is a strong connection between the mind and body. What impacts one will almost always impact the other. For cancer patients struggling with mental health issues, helping them get to an emotionally healthy place can change their entire outlook and empower them to withstand the many challenges they will face whatever their outcome might be.