If any words universally strike fear in the hearts of people, they are, “You have cancer.” Upon receiving a cancer diagnosis, people’s first question is often, “Am I going to die?” The answer to that depends on the type of cancer a person has, how early it was detected, how aggressive the cancer is, and whether it has spread to other parts of the body. A cancer diagnosis can bring up a wide range of difficult emotions and significantly impact many areas of a person's life. The support of a mental health clinician to help cope with the psychological impact of cancer may be an invaluable aspect of the treatment process for people with cancer and their loved ones.
Our bodies are made up of millions of tiny cells, which are dying and replacing themselves every day. Normally, when there is an error in this process, our bodies have mechanisms to “snip out” the error, so replication continues in a normal manner. When this process goes awry and is not corrected, abnormal (cancer) cells can grow. Cancer cells lack normal cells’ ability to control their growth and die, so they continue to reproduce, forming tumors. The exception to this is leukemia, which is a cancer of the cells that form blood cells. In this case, the cancer cells circulate throughout the body in the bloodstream, rather than forming a tumor.
Some people inherit the likelihood that they will develop cancer from their families. Other people may develop cancer because of an exposure to a known carcinogen (cancer causing agent), such as cigarette smoke. Still others develop cancer for no apparent reason. The good news is that the risk of developing a number of types of cancer can be reduced by living a healthy lifestyle, which includes not smoking or using smokeless tobacco products, getting regular exercise, eating a healthy diet, maintaining a healthy weight, and avoiding heavy alcohol use.
There are over 100 types of cancer, and different types have a variety of effects on the body, which is why they require different treatments. Broadly, there are two categories of cancers:
Before the mid 1970’s, when the specialty of psycho-oncology (oncology = cancer) was initially conceptualized, very little, if any, concern was given to a patient’s psychological state or needs when they had cancer. This happened for several reasons:
1. It was not known that a person's mental health, or lack thereof, had any bearing on their physical illnesses.
2. At the time, physicians were not trained to deal with patients’ emotional needs.
3. The word “cancer” carried such a stigma that often patients were not even told their diagnosis.
4. Having a mental illness or needing psychological help also carried a tremendous stigma.
Over time, while there still remains somewhat of a stigma, awareness of people's emotional and mental health needs has increased, and now these principles are being more fully incorporated into physician training programs. The formation of the specialty of psycho-oncology has been a huge step forward in treating the whole patient and not just the cancer. Also, the realization that cancer impacts the entire family, not just the patient has helped to create a more supportive environment in oncology treatment settings. Unless the client refuses it, this therapist will always include the family in some way when working with a cancer patient.
Ideally, every person who develops cancer would undergo a mental health screening after being diagnosed. This would help to identify potential areas of concern, and also familiarize the patient and their family with the mental health providers who specialize in working with cancer patients. It would also help to de-stigmatize seeking help for mental health issues if every cancer clinic had counseling services available on-site.
Jane, 52, came in to therapy to discuss her concerns regarding her husband’s (Russell, 65) lung cancer. They had been told that after some initial surgery and chemotherapy, Russell’s cancer was incurable. Jane felt completely overwhelmed and needed a safe place to explore her feelings, which ranged from confusion to anger to sadness to concern for her two teenagers to deep love for Russell. After two individual sessions with the therapist, she and Russell began to come in together to share their grief and profound sadness that Russell had limited time left with his family. As happens in many families dealing with cancer, both Jane and Russell had avoided talking about Russell’s prognosis openly with their children, due to their fear that it would only make the children feel badly. The therapist decided that psychoeducation was very important in this realm; the reality is that everyone is already feeling bad, and it would be very beneficial for them to have each other’s support. The entire family came in for the next session. Many tears were shed as each member shared their fears and concerns for Russell and for each other. Jane said she felt that she must function as both herself and Russell after his death, but feared that she would not do a very good job of it. In a loving way, both Russell and the children let Jane know that Russell was irreplaceable, and that she did not need to try to be anyone but herself after his death. Jane’s relief was palpable. Following the therapist’s suggestion, the family set up a time at least weekly to check in with each other.
Know Cancer - An online social network dedicated to connecting, educating, and empowering all people affected by the many forms of cancer. The overall purpose of the site is to create an environment where people can learn, interact, and ultimately find what they need. Being diagnosed with cancer can be quite overwhelming, and our goal is to make it easier for people to find information, resources, and support. The site features three main areas:
1) Know Cancer Community – Customizable profiles, journal, photo galleries, and more. Take part in the Know Cancer Blog & Forum, and ask questions to our resident Oncologist in the “Ask the Expert” section. You can also watch Healthy Living Videos from a wide range of health care professionals.
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Last updated: 08-13-2014