Stress points during the course of cancer
At the time of diagnosis
Being diagnosed with cancer is a major life event for both the person affected and their family and friends. People may have difficulty getting to sleep and staying asleep, have poor appetite and be unable to concentrate. These are symptoms of mood disorder but also of appropriate anxiety in the face of a frightening diagnosis. Some may develop an acute anxiety state requiring urgent treatment in addition to cancer treatment. It is hard to know what ‘normal’ distress is and when psychological distress becomes psychological illness. Usually sleeplessness and feelings of acute anxiety improve when a clear plan of treatment is arranged or started.
During treatment
There are various times during cancer treatment when feelings of distress may occur. These are commonly when tests have been carried out to assess progress; people are waiting for results or trying to make decisions:
- Pathology results to see if a course of chemotherapy is needed.
- Scan results and blood results during or at the end of treatment.
- Blood results to see if treatment has been successful or to allow further treatment to take place e.g. recovery of white cell count prior to chemotherapy.
- When cancer recurs.
- When experiencing unpleasant symptoms which are hard to control e.g. pain, cough, shortness of breath.
- When it becomes clear the cancer cannot be cured.
The effect of the cancer on home life, work and finances may cause significant distress at any time.
At the end of treatment
Some people may undergo cancer treatment for many months or more than a year. During this period they have been to the hospital regularly for treatment and follow ups, receiving regular medical attention and support. At the end of treatment when no further appointments are planned for some time, it is common to feel low, anxious or abandoned to get on with things. Recent research on cancer survivors has shown that it is ‘normal’ to feel low at the end of cancer treatment and the first year of ‘being well’ is spent getting through the emotional aftermath of the disease and re-adapting to normal life again.
Summary
Cancer causes psychological distress that sometimes leads to mental illness. Mental illness in people with cancer is no different to that in people without cancer. Treatment can significantly benefit these people. Particularly stressful points that may trigger depression are at the beginning and end of treatment. Some drugs used to treat cancer may cause serious mental illness. Adapting to being a ‘cancer survivor’ may be the most stressful period of all, particularly if a person is adapting to a disfigurement or altered body image in addition to their normal pre-illness life roles.
