Cancer causes excess mortality in those with mental illness, and while incidence rates have been found to be comparable between people with and without a history of mental illness, cancer-related mortality is higher in people with mental illness. In addition to the physical impacts of cancer, fear of disease recurrence, alteration of one’s identity, and perceived loss of support from friends, family, and one’s providers can exacerbate pre-existing mental health issues and increase long-term risks associated with more severe psychological disorders. Supporting individuals with mental illness around their cancer diagnosis is an essential component of holistic care that can affect an individual’s long-term prognosis and outcomes.
Effect of a Cancer Diagnosis on Mental Health
There can be significant psychosocial effects of a cancer diagnosis, especially amongst patients with a pre-existing mental health condition. According to The National Cancer Institute:
- One in three people with cancer experience mental or emotional distress. It is most common in breast cancer (42%) and head and neck cancer (41%) patients.
- Up to 25% of cancer survivors experience symptoms of depression and up to 45% experience anxiety.
- Many cancer survivors also experience symptoms meeting the criteria for Post-Traumatic Stress Disorder (PTSD).
- Cancer survivors are twice as likely to die by suicide than the general population.
Managing the Mental Health Consequences of a Cancer Diagnosis
The stress that comes with a cancer diagnosis can be overwhelming. Managing the psychological effects can be key to ensuring longer survivorship. Studies have shown a decrease in symptoms of depression was associated with longer survival in patients with metastatic breast cancer. In another study, researchers examined the impact of psychologist-led small group sessions that offered strategies for reducing stress, improving mood, changing health-related behaviours and adhering to treatment and care. The breast cancer patients who participated in the groups had a 45% lower risk of their cancer coming back and a 56% lower risk of dying from breast cancer.
The Role of Mental Health Providers in Helping Patients Cope with a Cancer Diagnosis
Mental health professionals are an integral part of the care team for their patients managing a cancer diagnosis. They are able to work with their patients to identify positive coping mechanisms to manage stress, mitigate risky behaviours around smoking or other substance use, and encourage an active lifestyle which ultimately can lead to a better quality of life and survivorship post-cancer treatment. Mental health professionals can also encourage patients to manage their stress with effective coping strategies that have been proven to lead to lower levels of depression, anxiety, and symptoms related to cancer and treatment including:
- Mindfulness
- Relaxation techniques
- Cognitive Behavioral Therapy (CBT)
- Meditation
- Antidepressants and anti-anxiety medications
Other support services shown to improve mental health outcomes include:
- Counselling and engaging patients in problem-solving strategies in a supportive environment can help patient work through their grief, fear and other emotions.
- Leading and/or referring patients to support groups provides patients with a chance to give and receive emotional support and learn from the experiences of others.
- Collaborating with the oncology care team to help patients communicate more effectively and ensure care coordination with all health care providers.
- Providing and explaining more information about the diagnosis to help patients make informed choices about treatment, enhance their understanding of the disease and treatment options and encourage adherence to treatment and follow up.
Source: National Behaviour Health Network