Mental Health Care During And After Cancer
Difficult decisions, loss of control, reminders of your mortality, financial fears. That’s just some of the baggage that goes along with a cancer diagnosis. For the 18.1 million Americans who have survived or are living with cancer today, it’s always present. Triggers are everywhere: your reflection in a window, a headline popping up in your news feed, pants that no longer fit, or a curious friend asking how you’re doing.
How you cope with these constant reminders, during and after treatment, has a big impact on your mental health, and it should be part of your overall care plan. Beginning in 2007, the National Institute of Health added the psychosocial aspects of a cancer diagnosis to their prescribed treatment. Healthcare providers now screen for signs of depression and anxiety during therapy, but what happens after?
Generally speaking, your personality and coping ability will not change with a diagnosis of cancer. If you were a gloomy person before your illness, you’ll come through just as morose. If you are perpetually perky with a sunny disposition, you’ll take your bad news and treatment with the same optimistic outlook.
Can your attitude affect your outcome? Despite popular belief, research has been inconclusive. In a conversation with Dr Gregory Garber, Administrative Director for the Division of Supportive Oncology at the Sidney Kimmel Cancer Center at Jefferson Health he noted, “There is really no good evidence that one’s attitude impacts how long they’re going to live after a cancer diagnosis or what their response to treatment will be.”
“There are entirely miserable people who go through breast cancer or any kind of cancer treatment, and they do fine,” he continued. “And, there are wonderful Pollyanna folk who go through it and do fine.”
What is affected by attitude is your quality of life during the treatment. That’s where your personality and coping skills can make a difference in how you do.
John Kincade, award-winning sports host of Kincade and Salciunas’ on Philadelphia’s The Fanatic, has experienced this first-hand several times. “I was diagnosed with non-Hodgkins lymphoma in 1995, testicular cancer in 1997 and colon cancer in 2023. That’s three survival stories in 28 years. Every one of them a different journey.”
“After my first and second journeys in the late ‘90s, I was in my early 30s and single. I was convinced that my life would be a short one, so I left a full-time career in the business world to pursue my passion as a talk show host and TV personality. It gave me the courage to pursue my dream jobs because I felt it was the end” he explained. “Fast forward 25 years later, I’m married, a father and built my dream career. When cancer revisited me for a third time I had the most amazing support system and my confidence was high. ”
“My Mom had a saying that ‘a pity party should never see the sunrise,’ so if I had a bad day I dusted myself off and got back to it. I find outdoor time, even a stroll in the fresh air which was challenging, helped to clear my brain.”
Taking a walk is actually one of the top recommended stress relievers. The National Alliance on Mental Health (NAMI) has suggestions to help you develop your own personalized stress management strategy.
Learn to recognize your triggers and the situations that cause you stress, and then experiment with and combine coping methods to find what works best for you.
Prioritizing your needs and time by making a schedule can help you feel less overwhelmed by the demands of your limited energy. Take a break for deep breathing, meditation, and gradual muscle relaxation. Get back to daily exercise as soon as possible, doing what you can. Even low-impact activities such as walking and biking produce stress-relieving hormones in your body. Set aside time for yourself to read a book, go to the movies, or work on a coloring book.
Eating well and getting enough sleep have a huge impact on your mental well-being. While it can be rough during cancer therapy, making an effort will make it easier to keep good habits after treatment has ended.
Finally, talk to someone. Research shows that support groups helps reduce tension, anxiety, and tiredness and may lower the risk of depression.
“One of the ‘kind of’ upsides of the pandemic is that it has made so many support resources for cancer patients available virtually,” says Dr. Garber. “Everyone knows how to use Zoom now, everyone can pick up a phone. People are much more facile with the internet, so it is out there!” The American Cancer Society is one of many offering free online groups for patients with different diagnosis and at different points of treatment.
The National Institute of Health, NAMI, and Living Beyond Breast Cancer also offer peer-based support.
These coping skills will stay with you post-cancer, a time when many patients discover they feel adrift. It can take time to recover from treatment after months, even years, of being told what to do and where to be. One survivor may feel relief, another sad or even depressed.
Coping with your new normal after cancer – the National Institute of Health offers help with life post-therapy.
While friends or family may assume that it’s time for you to move on and pick up where you left off, not everyone is ready. Many describe this time as getting used to a “new normal.” You may have changed your goals, you may have permanent physical reminders of your journey or you may have created a different support group around you. It’s not “getting back to normal,” it’s finding out what’s normal for you now.
Tina, a Broadcast Marketing Strategist and a triple-negative breast cancer survivor, finds herself worrying over every new ache or pain, every twinge. “I sometimes go into the black hole of worry,” she says. “I start googling my symptoms and then worry. I must step away and live in the moment, and if I am concerned, reach out to my oncologist to schedule a test.”
Which leads to another phenomenon, “Scanxiety,” the anxiety experienced while waiting for test results. Tests that may stretch out over the years, especially for those living with cancer.
John knows it’s a real condition. “I have a major testing milestone for one year after my colon surgery coming up. To be honest, I’m terrified that they will find new polyps. I’m tested quarterly to see if any cancer cells have invaded my lymphatic system, and I’m clear in my first six months post-treatment. Staying positive and resting are two good ways to dull that anxiety, but it’s absolutely real!”
Of course some fear of a recurrence is normal, but extreme fear can negatively impact your quality of life.
Is it severe enough to seek help? If it’s affecting your relationships, your ability to work or be a parent, your ability to sleep or enjoy your daily activities, call your healthcare provider, NAMI, or the American Cancer Society.
As with any mental health concern, if you wonder if you should ask for help, ask. And remember, you’re not alone. With 18.1 million people sharing this journey with you, there are plenty of peers and organizations ready to step up and walk with you!
