Almost all cancer survivors will face psychological and emotional issues that can show up many years after treatment. The good news is that you don’t have to suffer alone. Therapy, support groups, social media and community resources are available to help you cope with these issues. The first step in coping with psychosocial changes is realizing that you have an issue and having the courage to reach out for help.
Here are some of the most common psychosocial issues that cancer survivors may deal with:
Fear of recurrence: Many survivors worry that their cancer will come back at some point. Milestone events in their cancer journey can often trigger these feelings. Knowing your own body can help distinguish between normal physical changes and more serious symptoms that need to be reported to your doctor.
Grief is a natural result of loss. Loss can include your health, sex drive, fertility and physical independence. Support groups and counseling can help you work through these issues.
Depression: It is estimated that 70% of cancer survivors experience depression at some point. Know the symptoms of depression and seek treatment as soon as possible. MD Anderson’s Psychiatric Oncology Center provides counseling and medication for anxiety and depression. Call 713-563-6666 to request a referral.
Body image: Cancer survivors who have experienced amputations, disfigurement or a major change in physical function can suffer from a lack of self-esteem. A negative body image can affect your desire for intimacy and social interaction. Honesty and open communication with loved ones can minimize negative feelings.
Spirituality: Many survivors find that life takes on new meaning after cancer and will renew their commitment to spiritual practices or organized religion. Research suggests that spirituality improves quality of life through a strong social support network, adaptive coping, lessened depression and better physiological function.
Survivor guilt: Some people wonder why they survived cancer when others don't. If you suffer from a prolonged sense of guilt, seek help from a psychotherapist, clergy member or support group.
Relationships: You may find that friends, coworkers and family members treat you differently after a cancer diagnosis. They may avoid you or won’t discuss your cancer It can help to seek new relationships with other cancer survivors who know what you’ve been through.
The workplace: Cancer survivors often feel that they can no longer relate to co-workers who haven’t experienced cancer. You may be reluctant to talk about your cancer treatment to employers or coworkers for fear of being treated differently. See if your employer has a support group or other resources for cancer survivors.
A new cancer diagnosis can change your priorities and day-to-day routines. Many patients and their caregivers feel a range of emotions, including shock, sadness, anger, disappointment and confusion. The added anxiety of awaiting test results and appointments can cause even more stress.
“Having an emotional response to a cancer diagnosis is a normal reaction to an abnormal situation,” says licensed clinical physcologist Catherine Powers-James, Ph.D. “Negative emotions aren't inherently bad. It's when they get out of control when therapy is helpful. The earlier we initiate help for our mental health, the better.”
We asked Powers-James to walk us through what cancer patients and
their caregivers can expect during therapy and what else patients can
do to protect their mental health before and during cancer
Addressing emotions and finding coping tools
“Right after a new cancer diagnosis is a crucial time to seek help,” says Powers-James. “When I see cancer patients during their first therapy session, a lot of people tend to say, ‘I wish I knew about you sooner.’”
Her main goal is to provide a listening ear for patients and caregivers who need to talk. She also is there for patients and caregivers to bounce ideas off of regarding their care and how to manage emotions surrounding their diagnosis and treatment.
“When I have my first session with a cancer patient or caregiver, I let them tell their story and talk about what they’re experiencing as much as they want to. Some people are tired of telling the story of their diagnosis over and over again, and that’s OK, too,” Powers-James explains.
After that, she’ll work with patients and caregivers to explore different tools that might help them, like deep breathing, organizing their support system or reframing negative self-talk. “I like to work toward things that are important to them – quality of life, faith and/or family,” Powers-James says. “In a way, they can become their own therapist.”
By helping patients get a support system in place, she says early therapy sessions can shape the rest of a patient’s cancer experience.
“Many patients reevaluate their support system through this process. Some people step up; some disappear. Some people are better emotional support; others thrive at task support. Identifying who those people are early on gives patients a better understanding of whom to ask for help from during treatment,” says Powers-James.
Caregivers benefit from joining therapy sessions
In addition to focusing on the patient, Powers-James says it’s common for caregivers to join therapy sessions as well.
“People are usually eager to have a caregiver come join us for a session or two and learn the coping techniques we’ve discussed. Some patients are afraid to share what they’re feeling with their loved ones because they don’t want to burden them. But it can be very helpful to bring your caregiver with you to therapy so you can really explore your emotions,” she says.
Therapy is just one piece of protecting your mental health
Along with providing therapy, Powers-James and her team will work with a patient’s medical team if there is a physical need to address, such as maintaining a healthy weight or facing fears about diagnostic procedures.
“Your mood can impact your physical health. It’s the mind/body connection,” explains Powers-James. “We want to manage our stress response to allow our immune system to work the way it’s supposed to work.”
Powers-James often refers patients to MD Anderson’s Integrative Medicine Center to help them build a well-rounded, healthy lifestyle.
“Activities like yoga, massage, tai chi and meditation are wonderful tools for regaining peace during a stressful time,” says Powers-James. “There are also free virtual group classes, like nutrition and exercise, available to anyone touched by cancer.”
Some people also find it helpful to connect with other patients and caregivers through support groups and/or myCancerConnection, MD Anderson’s cancer support community that offers free, one-on-one support to patients, caregivers and survivors regardless of where they receive treatment. “It can be very powerful to make social connections with others who are facing the same things you are,” Powers-James says.
Mental health care during cancer treatment isn't one-size-fits-all
Some patients and caregivers
may only want to attend a few sessions and then use their new coping
tools to manage their mental health. But many patients continue
therapy throughout their treatment and even as they adjust to survivorship.
“I have noticed that our clinic is busier than ever because therapy appointments are now virtual due to the COVID-19 pandemic,” notes Powers-James. “More people are continuing therapy after they have completed cancer treatment because it’s so convenient now.”
Whatever route you choose, Powers-James stresses that there’s no one-size-fits-all approach to managing your mental health. The most important thing is to make sure you don’t let your mental health take a backseat to cancer treatment.
“Don’t feel like you have to face your cancer diagnosis alone,” Powers-James says. “Regardless of where you’re receiving treatment, there are a resources to help you.”
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