Cancer is a serious illness. It can be fatal. Even when cancer isn’t life-threatening, it can have lasting health consequences. A diagnosis of cancer can affect not only the person with cancer, but also their loved ones, for months and years past diagnosis.
If you have just been diagnosed with cancer, you may be frightened and overwhelmed with health information that may be confusing or hard to understand. Your primary concern is probably finding a good doctor and beginning treatment right away. You may not be thinking about your mental health. But mental health is important, too. Stress, anxiety, and worry will not improve your physical condition. While a therapist or counselor can’t treat your cancer, working with a qualified mental health professional can help improve your mood, outlook, and state of mind.
It can be hard to find the right counselor even if you’re in good physical health. It may seem like a difficult and unnecessary task, but it’s important to talk to a trained professional about your concerns. If you aren’t sure where to begin, start with our therapist directory.
Cancer is a disease that affects the body, but it can also have a big impact on emotional health. It’s normal to have feelings of anxiety, depression, fear, or worry after diagnosis and during treatment.
Some common concerns people with cancer experience include:
- Depression. According to statistics from the National Cancer Institute, between 15% and 25% of cancer patients have depression.
- Anxiety. A study from the British Medical Journal found that up to 10% of cancer patients have anxiety.
- Posttraumatic stress. A 2017 study found that about a fifth of people diagnosed with cancer had PTSD after diagnosis.
- Worry about loss of independence
- Worry and stress about finances or medical bills
- Difficulty enjoying hobbies and activities
- Uncertainty, negativity, or fear, especially about what the future holds
- Fatigue or lower energy
- Intimacy and relationship difficulties
- Body image issues
- Denial, anger, or grief
Many of these concerns relate. For example, cancer can lead to unhappiness and distress about changes in the body due to illness and treatment, and people with cancer often struggle with body image. It’s common not to want sex or other forms of intimacy due to body image issues, pain, treatment-related nausea, or for other reasons. But a decrease in intimacy can also affect emotional health. Also common is loss of self-esteem or self-confidence. Relationships may also suffer as a result of both partners’ fear, stress, and worry.
Therapy can help. Trained counselors (often someone who specializes in cancer treatment, such as an oncology social worker) can offer help with addressing feelings and learning ways to cope with challenges.
Family therapy may also be a good option. Partners of people with cancer are also likely to be affected. They may take on extra household and family responsibilities, which may lead to stress and frustration, and guilt as a result of these feelings. Family or couples therapy can help partners talk about their fears and worries, address relationship issues, and develop strategies to help things go more smoothly during cancer treatment.
Survivors of cancer often struggle with anxiety, posttraumatic stress, and depression. Research shows adults who have survived cancer are twice as likely to have mental health issues as adults who have never had cancer. Anxiety in particular affects many survivors of cancer. PTSD is also fairly common. It’s normal to fear cancer returning after treatment, to be unsure of how to return to life after cancer, or to feel uncertain about navigating a future that might have been impossible to consider during treatment.
It’s also common for cancer survivors to have mental health concerns after successful treatment. Once there are no more signs of cancer in the body (NED, or “no evidence of disease”) people may be overwhelmed by the emotions they held back during treatment. So, it’s important to work with a professional after treatment, even if mental health symptoms don’t come up right away.
A survivor’s family may also be affected. According to estimates from the National Cancer Institute, about 24% of adults who have cancer are parents to children under 18. Children of a parent with cancer are at risk for anxiety and distress and are likely to have other mood changes. It may be difficult for parents to talk to children about cancer, especially young children who might not understand. Reaching out to a family or child therapist may be beneficial for the entire family.
Though many people experience mental health concerns during and after cancer treatment, or as a result of treatment, cancer itself does not directly cause mental health issues.
It’s common to experience mood changes after diagnosis, whether these concerns arise immediately or during treatment. These mood issues, such as anxiety, stress, depression, irritability, or hopelessness, among others, can be a direct reaction to diagnosis.
Cancer treatments can lead to changes in emotions and mood as well. This is because treatments activate the immune system, which in turn leads to changes in brain chemicals. Chemotherapy treatments also often have side effects such as fatigue, depression or anxiety symptoms, difficulty concentrating, or hallucination—on top of the physical side effects.
In some cases, mental health issues can cause physical symptoms, such as pain and fatigue. Stress is one mental health concern that often leads to physical health issues. Anxiety can cause chest pain, heart palpitations, or digestive issues. Some people might wonder whether mental health concerns might also lead to cancer.
There is no strong evidence to show stress, anxiety, or other mental health issues can cause cancer. Some research suggests mental health factors could lead to a higher risk for cancer, but this link is not fully backed by scientific evidence. One 2013 study examining work stress determined there was no evidence work stress was a risk factor for cancer.
Some people have trouble with thinking processes as a result of chemo. They may feel as if a sort of fog is clouding their thoughts. Known as “chemo brain,” this fog can make it difficult to pay attention, concentrate on school or work, remember new information, or sleep. Feelings of fatigue or depression may come with these mental changes. Even if physical symptoms aren’t severe, chemo brain can affect daily life by making it difficult to complete cognitive tasks.
Though it’s called “chemo brain,” this condition can happen at any time during cancer, even in people who aren’t receiving chemo. Doctors believe it can be caused by a number of factors, including the cancer itself, along with other factors such as fatigue, depression, or poor nutrition.
Often, chemo brain goes away after a short time. But brain problems can persist, so it’s important to talk to a doctor when problems start, instead of waiting until they hamper daily life. Doctors, and supportive family and friends, can help keep track of symptoms and problems and develop coping strategies.
Cancer treatments are often successful, and many people who have cancer live for years past diagnosis. But people who struggle with mental health concerns, during treatment or afterward, may have a lower quality of life. Because the emotional effects of cancer are far-reaching and can become serious, it’s important to seek help before they become worse.
Even survivors of cancer who have no mental health symptoms are urged to reach out to a counselor who specializes in post-cancer care. Research shows that fewer than a third of cancer survivors talk about mental health issues with their doctors, even though they are at high risk for anxiety and depression. Talking to a counselor early on can help keep issues from getting serious.
People may feel relieved and hopeful after cancer treatment. But feelings of anxiety and stress are also normal. It’s often difficult to return to life as it was before diagnosis. Loved ones may not understand what has changed, and feelings of isolation are also common in cancer survivors.
Reaching out to a cancer support group, especially one led by a trained counselor, is one way to address the emotional effects of cancer. Strong support is a key factor in good emotional health, and it can help to talk to other people who have experienced something similar.
One type of mental health provider who helps people with cancer is an oncology social worker. Oncology social workers help people make sense of their diagnosis, locate resources, find ways to talk about cancer with friends and family, and learn how to manage their cancer. They can help people find other counselors for more in-depth mental health treatment.
Talk therapy is often recommended to people coping with the effects of cancer. Cognitive behavioral therapy is a type of therapy that can have good success. CBT helps people challenge negative thoughts and change the patterns of thinking that lead to them. Family or couples therapy may be recommended if you have a partner and/or children. Group therapy can also be helpful for some.
Therapists may recommend relaxation exercises, meditation, or mindfulness practices as part of treatment. Journaling or art therapy can be helpful for some people. These activities often help reduce symptoms of anxiety and stress.
- Coping with feelings of guilt: Isaac, 43, was recently diagnosed with stage 2 lung cancer. He tries to be optimistic at first, but after beginning treatment he begins to feel depressed and hopeless. Thinking about how he smoked for a few years in college, he begins to feel like he brought his cancer on himself, that it was his fault for choosing to smoke. He also feels angry that friends who still smoke do not have lung cancer when he does. His mood becomes irritable, and he snaps at his wife and 10-year-old son when they try to offer support. When his wife suggests they go to a few sessions of family counseling together, Isaac scoffs, saying, “It’s my lungs that are diseased, not my mind.” But eventually he decides it might help to talk about his thoughts. In family counseling, the therapist gives each of them time to talk about what they are feeling. Isaac finds it difficult to share his guilt, but he does, along with his fear of dying and leaving his family alone. Isaac’s wife shares her fear of losing her husband and her desire to be supportive to him as he continues treatment. Isaac’s son says he doesn’t want Dad to die, and he also points out that no one asks to get sick. The therapist tells the family that what they are feeling is common and encourages them to be open with their feelings at home so they can all support each other. She normalizes Isaac’s guilt and helps him learn to practice self-compassion. After a few more sessions of family counseling, Isaac continues in individual therapy to work on his guilt and anxiety and also goes to a support group once a month. Isaac’s wife decides to attend a support group meeting for partners of people with cancer. As he continues to learn to be more emotionally open with his family, Isaac begins to regain his hopefulness.
- Feeling isolated from family and friends: Corina, 51, is recovering from breast cancer. She had a successful mastectomy, and her scans show no further signs of cancer. Her family and friends are overjoyed and keep urging her to “embrace her second chance at life.” But Corina, though she does feel relief at being through with treatment, does not feel as if she has cancer “beat.” She dreams often about getting chemo or being prepped for surgery and wakes up anxious, with a pounding heart. She returned to her job as a veterinary technician, but she often feels tired and as if she could fall asleep standing up. She sometimes feels out of place at work, or slow and sluggish. She realizes that part of her thought she’d die from cancer and that she hadn’t planned on life after cancer. But because her loved ones are so happy, Corina doesn’t know how to talk about how she’s feeling or share her difficulties readjusting to life. She begins to avoid others so she doesn’t have to talk about how she’s feeling. Pushing people away leaves her even lonelier, so she decides to reach out to a counselor. Her doctor gives her a referral to a therapist, and Corina makes an appointment. The therapist helps Corina begin to work on ways to readjust. Corina learns to challenge negative thoughts through CBT. She also begins keeping a dream log and daily journal and finds that just writing her thoughts down helps reduce their effects on her. Eventually she begins to enjoy the company of her family and friends again and begins to be able to tell them when she is struggling, and her distress becomes easier to cope with.
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