By Hamid S. Shaaban, M.D.
Medical Director, The Cancer Center
Saint Michael’s Medical Center
May is Mental Health Awareness Month. Since it began in 1949, this designation has brought vital conversations to the forefront regarding stigma, shame, and equitable access to mental health services. As the U.S. Substance Abuse and Mental Health Services Administration reported in 2022, 57.8 million Americans are suffering from mental health challenges every day.
A United Kingdom study of more than 20,000 cancer patients found that only 5% with major depressive disorder were receiving care from a mental health expert (Walker 2014). This discrepancy between how common mental health disorders are among patients with cancer, yet the rarity that they are being treated actively is of serious concern to doctors who are providing cancer care. Not only do inadequately managed mental health symptoms impact a person’s quality of life, but untreated symptoms can decrease a patient’s acceptance of cancer, their ability to comply with and tolerate cancer therapies, and their overall survival.
Cancer Brings a Range of Emotions
People with cancer may feel stressed and overwhelmed both after a diagnosis and during treatment. It’s normal for them to feel anxious, afraid, angry, or depressed. Coping with cancer treatments such as chemotherapy and radiation therapy also can cause patients to have problems with memory and concentration. These emotional difficulties can make it difficult for them to function normally or do regular daily activities. While most emotions are healthy and to be expected, some cancer patients can have an increased risk of anxiety, depression, and suicidal thoughts.
It is well known by oncologists and leading cancer centers that patients within racial and ethnic minority groups, those with low incomes or without health insurance or underinsured, and those living far from cancer centers experience worse outcomes. We also know that our health care system has not done an ideal job of integrating psychosocial cancer care into a discussion of health disparities. Although there are many studies looking into the impact of socioeconomic factors on health outcomes, there are very few studies that are investigating the impact of psychosocial or behavioral factors on health care disparities.
Patients with mental illness are less likely to go for recommended cancer screenings, such as mammograms or PSA tests for prostate cancer, than patients in the general population. This statistic is even more magnified in patients with severe mental illness (schizophrenia, bipolar disorder), who die 15 to 30 years earlier than the general population. Cancer is their second leading cause of death. This can be related to: being diagnosed with advanced or metastatic cancer, untreated other conditions that impact cancer treatment’s effectiveness (such as heart disease or diabetes), decreased access to quality health care, and high levels of poverty, social isolation, and stigma.
We Can Help Our Loved Ones with Cancer
If you are caring for someone with cancer, you play an important role in helping them cope mentally and physically. Here are some ideas that you can do:
- Be sensitive to the person’s feelings and encourage them to talk with you, other family, and friends. A person’s mental health affects how they behave not how the cancer behaves. Not everyone is a fighter or a constant optimist, so give the person permission to identify the personality traits and life factors that can support or challenge the coping process.
- If the person is worried about cost, there are a list of resources on the websites of the Centers for Disease Control and Prevention (cdc.gov) and the American Cancer Society (cancer.org).
- Encourage the person to join a support group at Saint Michael’s Cancer Center or another community site.
- Ask the patient’s doctor for a referral to mental health and social support services. Saint Michael’s provides an inpatient behavioral health program and an outpatient substance abuse treatment program.
- Encourage the individual to stay as active as possible. Physical activity has been linked to a decreased risk of depression, as well as lower rates of recurrence of certain kinds of cancer among survivors.
A cancer diagnosis is a major life disruption. We all can do more to help our loved ones with cancer who may be struggling with mental health symptoms or diagnosed behavioral health issues.
To find out more about the services and programs of the Cancer Center at Saint Michael’s Medical Center, or to find an oncologist, call 973-877-5620.
Dr. Shaaban is board-certified in hematology and medical oncology. He was honored in 2023 by the American Cancer Society for his commitment to his patients and to the ongoing pursuit of quality care at Saint Michael’s Cancer Center.
