Nearly one-third of cancer patients are affected by Anxiety, depression, and other mental health conditions, but they are frequently ignored and misdiagnosed. According to Kristin Kilbourn, a clinical psychologist at the University of Colorado Denver, many oncologists are reluctant to discuss these issues because they believe they are secondary or complex. Furthermore, mental health has historically received less attention, in part because medical facilities see treating psychiatric patients as not financially profitable.

There are severe repercussions for this carelessness. The death risk for cancer patients with depression can be up to 39% higher than that of cancer patients without mental disease. Research indicates that the probability of suicide is 13 times higher in the week after receiving a cancer diagnosis and stays three times higher than average, demonstrating the profound emotional impact of receiving a cancer diagnosis.

Cancer doesn’t just affect the body—it profoundly has effect on the psyche. Patients are frequently left to advocate for themselves, even though more mental health therapies are becoming provided in cancer care. When it comes to getting therapy for emotional difficulties, they have to take the initiative. “Unless you bring it up,” Kilbourn stresses, “your oncologist won’t automatically notice your mood changes or suicidal thoughts.”

The Link Between Mental Health and Cancer

According to Dr. Santosh Rao, an oncologist at University Hospitals in Cleveland, receiving a cancer diagnosis inevitably causes anxiety and depression. However, clinical anxiety and depression extend beyond these emotions. Loss of interest in things you used to enjoy, changes in eating and sleep patterns, or regular panic episodes that interfere with day-to-day activities are all signs of depression.

Cancer has the potential to create new mental health problems or increase preexisting ones. 10% of the 230,000 patients in a 2023 study reported having anxiety or depression prior to their diagnosis, whereas 22% did so after receiving a diagnosis, particularly in cases of advanced cancer. This connection frequently results from the emotional burden of receiving a cancer diagnosis, the psychological strain of confronting mortality, or the stress of broken relationships.

Although cancer might sometimes bring loved ones closer, Dr. Rao points out that it frequently fractures already brittle relationships. Cancer’s physical impacts and its treatment also have an impact. One’s mental health can be significantly impacted by unmanaged pain, exhaustion, mood swings brought on by hormone treatments, or significant physical changes brought on by surgery.

Sadly, mental health problems can continue even after cancer therapy is finished. Even five years after diagnosis, survivors had even less mental health resources than active patients, despite being more likely to experience anxiety and depression. “There’s not enough capacity to provide integrated care,” says Dr. Zev Nakamura, a psychiatrist at the University of North Carolina at Chapel Hill, highlighting the dearth of continuing mental health help for survivors.

Personal Stories Highlight the Struggle

At the age of 12, Logan Piz, who is now 25, received a diagnosis of Ewing’s sarcoma, a rare bone cancer. Three years later, he started having mental health issues. “You’re focused on surviving each day during the treatment,” he says. However, anxiety and PTSD took control when treatment was completed. He was always afraid that his cancer might return and was haunted by the loss of friends to the disease.

Piz recalls, “I would start crying all of a sudden and not know why.” Patients may find it more difficult to follow their treatment regimens or develop healthy habits, such as regular exercise or a balanced diet, as a result of such emotional challenges. Anxiety and depression may even deter patients from beginning treatment or cause them to discontinue because of adverse consequences. Therefore, addressing mental health issues becomes essential to raising survival rates. According to 2020 research of veterans with lung cancer, taking part in mental health programs decreased their chance of dying from the disease by 20% to 25%.

Challenges in Mental Health Care Access

Accessing mental health care is extremely difficult, despite its importance. Hospitals have long underfunded psychiatric services, and more than half of Americans reside in areas with a shortage of mental health experts. Patients may encounter financial barriers even after securing an appointment. Only 20% to 40% of mental health professionals take insurance, according to 2017 research.

Many cancer patients wait until their illness gets worse before realizing they need help. Oncologists rarely bring up mental health issues during consultations, frequently because they lack the necessary time or experience. “They don’t feel prepared to handle what might come out, so they’re afraid to open that door,” Kilbourn says.

Piz’s mental health wasn’t taken care of until he made the decision to go to his oncologist about his difficulties. “Mental health often feels like someone else’s responsibility,” he observes.

What Patients Can Do

Patients can take precautions to safeguard their mental health even though the system has gaps. An excellent place to start when recognizing symptoms and initiating conversations with medical professionals is via online self-screening tools. In order to guarantee that mental health is addressed during brief, hurried visits, Dr. Rao advises patients to write down their worries prior to sessions.

Oncologists can recommend other resources even in the absence of specialized mental health treatment. Research indicates that music therapy, yoga, and acupuncture can help cancer patients feel less anxious and depressed. Mindfulness-based techniques that emphasize being in the moment and being aware of emotional triggers are particularly effective.

Support groups also offer significant emotional benefits. These groups can focus on activities like cooking or creative writing, or they can be more general conversations about cancer. “In these spaces, survivors share their stories and offer hope, saying, ‘I’ve been where you are,'” Kilbourn says, highlighting the special value of support groups. Keep going.’”

Hope for the Future

It is difficult to close the mental health gaps in cancer care. Although they frequently receive little support, caregivers also experience high rates of anxiety and depression. But things are about to change. Access is being increased by new care models including supervised mental health programs, smartphone apps, and even experimental treatments like psychedelics.

Kilbourn believes that support groups and the resilience they promote provide promise, even though incorporating mental health into routine cancer care is still difficult. She claims that these relationships serve as a reminder to patients and caregivers that they are not alone. “And that can make all the difference at times.”