Advice from an expert in oncology and psychiatry
It’s hard to talk about a cancer diagnosis without thinking about the emotions that can come from it: fear, anxiety, anger, shame.
Even those who appear to have excellent mental health will likely feel shaken after a cancer diagnosis. Adding in a mental illness, a history of unhealthy coping mechanisms, or a fragile support system, it can be even more difficult.
The Wilmot Cancer Institute is dedicated to treating the whole patient, not just their cancer. Daniel McFarland, MD, Associate Professor in the Departments of Psychiatry and Medicine, Hematology/Oncology, joined Wilmot’s faculty in 2022. As a medical oncologist specializing in the treatment of head, neck and lung cancers that also has a background in psychiatry, he directs the psychosocial oncology program at Wilmot.
We asked her a few questions about what cancer patients and their families should know about mental health.
Can poor mental health cause cancer?
The short answer is no, not directly. This is still an open question, but most large population-based studies suggest there is no direct association.
That being said, having poor mental health can mean lifestyle choices associated with cancer. It would be things like smoking or obesity. These create an indirect route.
I will say that paying attention to mental health once you have cancer is extremely important. But his relationship to cancer itself is still being worked out.
What are the signs that you may need to seek professional mental health help?
Depression can pass for many different things. Sometimes I see patients who know what their depression is like, but then in the cancer world we often see someone who has never dealt with mental health issues and all of a sudden they find themselves in a place where they’re overwhelmed or what they usually use to cope with isn’t working. Or, they have symptoms that they attribute to the stress of having cancer or treatments. And even as clinicians, those are tricky things because if you look at the endpoints of depression – appetite, sleep, energy – they’re all related to depression, but they’re all things that can be affected by treatment. .
Some particular issues to watch out for include self-esteem. This should not change in theory. Changing thought patterns can warrant attention. People can withdraw from their social group.
Sleep is like a barometer of mental health. You almost can’t be depressed and not have trouble sleeping. It’s like the window of the mind.
Appetite problems can be a concern and relationships become more nervous and behaviors that are not characteristic of the person.
These are all signs. The spirit lets us know when it is in trouble. If we can get depression under control, it contributes to outcomes, including quality of life and survival.
What is the most important advice you would give to cancer patients when it comes to coping with cancer?
The communication problems are enormous. When you are diagnosed with cancer, people are expected to rally around. More often than not, it doesn’t quite look the way people wanted it to look.
What can help is that instead of waiting for your spouse or someone else to do the right thing, tell them exactly what they need to do for you. It alleviates a lot of distress.
Your world has been turned upside down and you don’t know how to relate to yourself and others don’t know how to relate to you. What’s happening is that you as the patient become the expert on your disease and it’s helpful for people to understand that and for you to own that.
Cancer changes everyone. It’s always a crisis in life and life seems different afterwards. It’s about defining what it will look like and what it means. And by the way, just because a person has cancer doesn’t mean they don’t also have all these other problems that they already have in their life. Then it gets really overwhelming. You may need to take some time to take care of these other things.
Should people with cancer strive to stay positive all the time?
Being positive is helpful if it’s real. The real problem is to understand your emotions, to connect to what they really are and, if you need to, to move. To be sad. Cry. Take it out. It’s a trauma. It is something that provokes a lot of emotion. It’s OK to have emotion. I worry more about people who don’t quite enjoy that emotion. But it will come out eventually.
Once in a while I will meet someone who will tell me, I know I’m supposed to be positive all the time. I will say, well, nothing against positivity. It is a very good thing. But you have to deal with those emotions.
Can you share some examples of healthy coping mechanisms? Are there any that are particularly innovative for cancer patients?
I think you do what feels right to you, and it’s different for everyone. People usually know what makes them happy, what they like to do, and sometimes they just need a little permission to do it.
It’s hard to be too prescriptive because ultimately people will find the things they do to alleviate stress. Maybe it’s going for a walk, going to the gym, exercising, talking to a good friend. These things are still available to them, hopefully. I would encourage all of these types of healthy adaptation.
Other times people really need help managing symptoms, understanding the meaning of cancer, etc. If you follow up with a mental health clinician, they will tell you what their assessment is.
Should cancer patients see only therapists or psychiatrists who specialize in oncology? What if a patient cannot enter?
Access is a challenge, that’s undeniable. Stick to it and defend yourself when you need to.
Patients are often reluctant to discuss mental health issues with their oncologists and team, but people should address these issues so their team knows and has an idea of what is going on.
Often people are ambivalent about whether or not they should seek mental health treatment. The stigma is real, but we should normalize that it’s something a lot of people do and then advocate for it ourselves. I would not discourage anyone from seeking mental health care wherever they can.
Provided by University of Rochester Medical Center
Quote: Cancer and your mental health: Tips from an expert in oncology and psychiatry (2023, May 26) retrieved May 26, 2023 from https://medicalxpress.com/news/2023-05-cancer-mental-health-expert-oncology . html
This document is subject to copyright. Except for fair use for purposes of private study or research, no part may be reproduced without written permission. The content is provided for information only.