Where you go for eternity depends on what you do with Jesus now.
The Lord Jesus said in Luke 11:23
‘Those that are not with me are against me: and he that gathereth not with me scattereth
and is a done deal you are going to hell.
Emotional and Psychosocial Effects of Cancer.
The COVID-19 pandemic has impacted everyone.
Watch this special interview with Dr. Wendy Baer of the Winship Cancer Institute of Emory University.
Dr. Baer is a psychiatrist and she discusses mental health for cancer patients and caregivers – focusing in on the increased stress caused by the COVID-19 (SARS-CoV-2) pandemic. Psychological stress is a very important health concern for everyone, but especially cancer patients, their caregivers and their loved ones.
Just hearing the doctor say the word “cancer” can have a profound effect on a person.
A diagnosis of cancer begins a long journey that can affect physical health, mental well-being, and relationships with loved ones. While getting treatment for the physical aspects of cancer, patients should not neglect the emotional issues associated with cancer. One of the best things patients can do to improve their quality of life is to learn more about their cancer. This can make the disease seem less mysterious and frightening. Information from your doctor and other credible sources can be very helpful in this respect.
A patient’s financial, social and physiological situations may all change due to cancer and cancer treatment. Having a realistic attitude and realizing that cancer can impact many aspects of life is helpful. Patients should not be afraid to tell their doctor how they are feeling, especially when it involves worries. Studies have shown cancer care doctors misinterpret a patient’s distress or psychological disorders as much as 35% of the time. 12
For this reason, it is important to tell your doctor about any pain and feelings of anxiety or despair. Some people feel uncomfortable accepting psychological help because they feel it is only for weak or irrational people. The brain is like any other organ; illnesses in other parts of the body can affect the brain and impact the well-being of the individual.
It is important to seek help from a medical professional when there are changes that cause discomfort or unhappiness.
Social Support Network
Relationships
Intimacy, Body Image
Anxiety
Depression
Self Assessment Test for Depression
Uncertainty and Negativity
Anger and Fear
Additional Resources
Learn more about relationships from the Winship Cancer Institute of Emory University.
Social Support Network
Introduction
People in a patient’s social support network include family members, spouses, children and friends.
Social support can also take the form of support groups or therapists. 3 It is important for these caregivers to listen to the unique needs and concerns of their loved one. For instance, they should be sensitive to the desire of the patient to share and know information about their cancer, treatment options, and their prognosis. 3A support network can greatly help reduce the stress of dealing with cancer. Patients should not be afraid to ask for help from loved ones and friends. The people in a patient’s support network can help ensure that they get to appointments on time, pick up children or just be there to listen to the patient’s concerns. 4
Importance
A lack of social support has been associated with higher levels of anxiety and a lower quality of life in cancer patients. 5/6 A lower incidence of depression is associated with the ability of family members to openly express feelings and thoughts to the patient. Anxiety is also less common when patients are able to freely communicate information to their family members.7Most importantly, cancer patients who have a lack of social support have a greater desire to die and a higher risk of committing suicide. 8/9
Treatment
A good social support network has been linked with an increased quality of life for cancer patients undergoing treatment.3Information about cancer can also make the patient feel more empowered, giving them a sense of control. Nearly all studies have shown a psychological benefit for cancer patients who attend support groups. 10/11
Most patients attending support groups feel more emotionally fulfilled,
get help managing side effects and experience less pain and anxiety. 12
Support group attendance may also extend the life of cancer patients,
but more investigation is needed to verify this. 13/14
Dr. Michael Burke discusses the importance of support networks for cancer patients.
Relationships
Having cancer may change the way that a patient relates with family, friends, and colleagues. Patients may find that the stress going through a cancer diagnosis and treatment strengthens their relationships with loved ones. While some relationships provide much needed support, other relationships may unexpectedly lead to frustration. In many cases, stress in the relationship is caused by misunderstandings and confusion of how to offer support to a cancer survivor.
Many want to offer support, but they just do not know how.
With open communication, these issues may be resolved.
After treatment ends, some friends, family, or coworkers may appear to show less support due to their belief that the cancer is gone. They may seem unsupportive due to anxiety and other emotions; speaking with that friend, family member, or coworker can help to mend and strengthen relationships. As survivors work through relationships to figure out what matters most in their life, some may choose to let some casual friendships go as they focus more on those that are more valuable and meaningful.
In addition to dealing with their own feelings, a cancer survivor may also have to cope with their friends and families feelings of sadness and uncertainty. Everyone needs recovery time, both the cancer survivor and those close to them.
Family members and friends of different ages face different challenges. For example, young children may convince themselves that they were somehow to blame for the cancer. Teenagers, on the other hand, may find it difficult to cope because they may feel they have been forced back into the family just as they were beginning to break free and gain their independence. Remember that silence can block communication and that open communication is critical to maintain healthy relationships.
Intimacy, Body Image
Introduction
People undergoing cancer treatment may lose their hair, experience weight changes, get surgical scars or have body parts surgically altered/removed. It is normal for these events to change a person’s sex drive and body image. Cancer/cancer treatments affecting reproductive organs (breast, prostate, testicles, etc.) may cause patients to question their social and sexual identity as a ‘man’ or ‘woman’. 15/16 This is true for people of all ages, genders, cultures, cancer types, and is independent of partnership status. 15 Because doctors may not discuss this issue, patients may incorrectly feel they are abnormal to be concerned about
their sexuality and sex life. 17
In fact, most people going through cancer treatment feel that their needs and concerns about sexual and intimate changes are not adequately met by their health care professionals. 15Doctors trained in traditional Western medical schools learn ways to handle the functional aspects of patient sexuality such as fertility, erectile dysfunction, or menopause. Frequently, their training does not prepare them to provide guidance about sensuality and intimacy issues. 16Doctors often avoid the topic of intimacy because it is not a ‘life or death’ issue, there is not enough time, they themselves are embarrassed about the topic, or they do not have experience in this area. 18/19/20
Some health professionals also struggle to accept the fact that people with life-threatening illnesses,
particularly elderly people, have sexual concerns. 21
Importance
Desire for survival can take precedence over other concerns when people are first diagnosed with a life-threatening disease like cancer. 22 Cancer patients may lose interest in sex and even though few talk about it, this is quite normal. Over time, patients may wish to ‘get on with life’ and return to normal activities. 22 Sexuality can be important to a person’s identity and a change in body image can affect intimate and social relationships. 22Intimacy with a partner can also be an important way to communicate, alleviate suffering and
retain a sense of self. 21/22
Treatment
It may take time and patience to adjust to fatigue, altered sensations, or prostheses.
Patients should speak with their health care professionals about any concerns or
questions they may have.22
Unfortunately, there has not been much research about how to best deal with changes in sexuality,
body image and intimacy related to cancer. 16
for frequently asked questions about breast reconstruction surgery risks, benefits, and options.
Anxiety
Introduction
Anxiety is a normal reaction to a cancer diagnosis. When people feel threatened, their stress level naturally
goes up. Cancer can be very dangerous and so many patients become anxious. 23 Symptoms include shaking,
fast or irregular heartbeat, and extreme levels of worry. Anxiety can occur at any and all times during cancer screening, diagnosis, and treatment. 23 About 48% of cancer patients report high levels of anxiety and 18% experience anxiety disorders. 6 (Google Gentle yoga for seniors.)
Watch the video and find how lung cancer survivor Edward Levitt
deals with the stress of living with cancer.
Importance
Patients who are unmarried and undergoing treatment are at a higher risk of suffering from anxiety. 5
People who have anxiety at the time of diagnosis, severe pain, lack of social support, advancing disease,
and previous anxiety disorders are also at high risk to develop anxiety disorders during treatment. 6/24
The fears associated with anxiety may cause enough mental suffering to prevent patients from performing activities normally. 6Anxiety can interfere with a patient’s quality of life and the ability to follow through with their cancer therapy. 23 Higher levels of insomnia, pain expectation,
and depression may also be a result of anxiety. 23/6
Treatment
A patient can alleviate anxiety by learning more about their cancer, though psychological interventions and with the help of drugs. In cases in which anxiety is caused by pain, a hormone producing tumor, or side effects from medication, treating the source can relieve anxiety. 25
Depression
Introduction
Depression can be a very important mental issue for cancer patients. It is estimated that 16-25% of cancer patients develop depression. 26/27 Doctors do not recognize about 35% of these cases and many patients remain untreated. 28 Depression is also more common in cancer patients than the general population. 29 There are several categories of depression with major depression being the most noticeable type.
Major depression is defined as at least five of the following symptoms for two weeks or more: 30
Depressed mood lasting for most of the day, nearly everyday
Noticeable loss of pleasure or interest in normal activities for most of the day, nearly everyday
Significant weight loss/gain and decrease/increase in appetite
Sleeping much more than usual or much less than usual
Fatigue or loss of energy nearly everyday
Feelings of worthlessness or inappropriate guilt
Decreased ability to think or concentrate
Frequent thoughts of death or suicide
Watch the entire Interview with Tony LaRocco
Cancer can alter a patient’s life plans, body image, family/social role and financial status.
It is normal to fear these changes but this fear usually lessens over several days or weeks as people
adjust to the diagnosis 31. Depression can have different effects on each individual and patients with a more advanced disease are more likely to be depressed. It is normal to have feelings of grief and sadness but it is important for cancer patients to distinguish between normal degrees of grief and depressive disorders. 32
Below is a table highlighting some differences between grief and depression. 31
Characteristics of Depression & Grief
Patients experience somatic distress, loss of usual patterns of behavior, agitation, sleep
and appetite disturbances, decreased concentration, social withdrawal.
Patients experience similar symptoms, plus hopelessness, helplessness, worthlessness, guilt,
and suicidal thoughts.
Grief is associated with disease progression.
Depression has an increased prevalence (up to 77%) in patients with advanced disease; pain is a major risk factor.
Patients retain the capacity for pleasure.
Patients enjoy nothing.
Grief comes in waves.
Depression is constant.
Patients express passive wishes for death to come quickly.
Patients express intense and persistent suicidal thoughts,
Patients are able to look forward to the future,
Patients have no sense of a positive future.
Importance
Current depression, poorly controlled pain, advanced stage cancer, a lack of family support and diagnosis with particular cancer types (i.e. pancreatic cancer) are all associated with an increased risk of
depression in cancer patients. 33/34/35
Causes of depression include:
Psychological stress
Biological problems
Side effect of medication
Reaction to chemotherapy 36
Dysfunctional thyroid gland
Inadequate diet
Studies have shown that if depression goes untreated it can have negative effects on other health issues. 37/38/39 Depression can make it difficult for patients to make decisions about treatments, slow recovery, and increase a patient’s risk of dying. 3340Older patients and women tend to suffer from cancer related depression more than younger patients and men, respectively. 5 Breast cancer patients with depression do not live as long as other breast cancer patients. 4142 A study of renal cancer patients showed that those with depression had reduced survival. The authors of the study linked depression with changes in the inflammatory responses in the patients.43 Depression is also important to avoid because it is recognized as a major risk factor for suicide. 44
Treatment
There are two distinct types of treatment for depression: psychotherapy and pharmacotherapy.
In psychotherapy, patients are helped to deal with their emotions and worrisome thoughts. This type of intervention can include counseling, relaxation techniques, cancer education, hypnosis, and support groups.
Pharmacotherapy involves the use of prescription antidepressants. This aspect of treatment deals with the chemical and biological aspect of the brain. Studies have shown that the best way to treat cancer related depression is with both pharmacotherapy and psychotherapy. 45/46
NOTE: These are general guidelines not medical advice. If you or a loved one believes
they may be depressed you should contact a licensed health professional.
Uncertainty and Negativity
It is common that a survivor may feel uncertainty in planning the future because they are not sure what will happen in terms of their cancer treatment. If a cancer survivor experiences negative feelings, it is important to remember that everyone has low times and that acknowledging and recognizing feelings of tiredness, anxiety, anger, and depression is actually a positive thing. Expressing feelings openly and honestly can often help to relieve stress and tension. Strong feelings ranging from self-blame, need to blame others, overwhelming stress, and guilt may be frightening but are common.
Anger and Fear
Anger is a natural reaction to the loss of normalcy that may accompany a cancer diagnosis.
It is likely that friends and family are feeling the same emotions. When strong feelings like anger are held in, problems such as depression, tiredness, hopelessness, and a lack of motivation can develop. It is very important to release these feelings by speaking with friends, family, or a licensed healthcare professional.
Learn more about emotions and cancer from the Winship Cancer Institute of Emory University.
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