Protecting your emotional wellbeing after a cancer diagnosis

World Cancer Day is a global event observed on February 4th each year to raise awareness and educate people about cancer, its causes, prevention, and treatment. The theme for World Cancer Day 2023 is “I am and I will” which encourages individuals to take personal action and make a difference in the fight against cancer. 

It is an unfortunate truth that most people have been either directly or indirectly affected by cancer. According to the Singapore Cancer Society, an average of 44 people were diagnosed with cancer every day between 2016 – 2020 in Singapore and an estimated one in four people will experience a cancer diagnosis in their lifetime. 

After being diagnosed with cancer, a treatment process is usually initiated, and the focus naturally turns to fighting off the sickness. The psychological stress accompanying such a diagnosis is often neglected even though the journey with cancer has a major impact on mental wellbeing for the patient and their loved ones. 

The emotional toll of living with cancer

Living with cancer and undergoing cancer treatments often has a negative effect on a patient’s quality of life. Experiences such as uncertainty, worries, fear, grief and a sense of loss can cause intense stress, anxiety and depression. While it is perfectly normal that these emotions will come and go, such experiences can feel overwhelming and interfere with daily life, with relationships, and the ability to make everyday decisions including those regarding treatment. It is always a good idea to keep an open line of communication with your doctor and share your experiences, and/or to seek psychological support to help you manage the psychological discomfort.  

Some common worries of patients are:

Will my cancer treatment work?
Will there be pain and side effects from treatment?
How much will the treatment cost and what happens if I lose my income?
Is my cancer curable? 
What are the chances my cancer will come back?
What will happen to my family if I die? 
Common symptoms of anxiety and depression in cancer patients:

– Sense of grief and loss
– Withdrawing from usual activities and social interactions
– Irritability and impatience
– Feelings of hopelessness or worthlessness
– Inappropriate sense of guilt
– Lack of ability to experience enjoyment and pleasure
– Heart palpitations, nausea, trembling, feeling hot
– Issues with sleeping and eating
– Decreased sex drive

Uncertainty

The uncertainty that goes hand in hand with a cancer diagnosis has been identified as one of the most distressing aspects for the cancer patient and their caregivers to handle. It has been established that uncertainty in relation to a cancer diagnosis directly and indirectly influences coping strategies and quality of life negatively. 

A common coping strategy in response to uncertainty is avoidant behaviour. For example, a patient may go into denial about a diagnosis, withdraw from relationships or simply bottle up their feelings. All of these behaviours can increase distress and lower resilience. Learning coping strategies to manage and tolerate uncertainty can improve resilience and lower the negative impact  on quality of life. 

Living Losses

It is also common for cancer patients to experience so-called “living losses.”  Living losses can be related to a change in self-confidence and body image after losing one’s hair for example, or a loss of mobility and self-sufficiency after being confined to a wheelchair. Less obvious losses can include loss of work or school opportunities. Loss of role for example, from being the caregiver in the family, to now being taken care of. These losses are often not acknowledged by cancer patients even though they can be painful and devastating to a sense of autonomy and wellbeing.  

Actional steps to help maintain your psychological well being

While there are many aspects of a cancer diagnosis that are beyond your control, there are steps you can take to maintain your psychological wellbeing and quality of life. An important part of this will be to reach a kind of acceptance of your situation and adjust to the circumstances. Allow yourself to be vulnerable and to have bad days while also trying to maintain as much normality as you can.

Withdrawing from social interactions is common for many people with cancer and chronic illnesses. Social connections are important for mental wellbeing and quality of life.

Every person’s journey, difficulties and needs are different. Trust yourself and try to figure out which coping strategies work best for you. Some people enjoy having visitors, others allow themselves a rare break from work while some start yoga or another exercise. Indulge in whatever brings you a sense of peace and enjoyment.

Coping Skills and Self-care:

– Share your worries and thoughts with a friend and your doctor.
– Ask someone to accompany you to appointments.
– Maintain social connections. 
– Stay physically active at your current level, i.e. yoga, walking, swimming, qigong.
– Immerse yourself in nature.
– Enjoy relaxing activities like music, reading or listening to audiobooks.
– Give meditation or mindfulness a try.
– Attend individual or group therapy.

Benefits of seeking therapy

Seeking therapy while you go through cancer treatment can be helpful in order to help manage and tolerate the emotional distress and help you develop coping skills to guide you through this difficult journey that can often feel very lonely. 

Receiving a cancer diagnosis can be frightening and overwhelming for both the patient and their family. In fact, depressive disorders are two to three times more likely to occur in cancer patients than in the general population. Be aware of the warning signs of depression and try to take extra-special care of your mental and emotional health as you navigate this unexpected path.  

References:

Embracing Uncertainty: An Exploration of the Experiences of Childhood Cancer Survivors by Parry, C.

Illness uncertainty, coping, and quality of life among patients with prostate cancer by Guan, Santacroce, Chen & Song

MD Anderson Cancer Centre, University  of Texas, Patients & Family

National Cancer Centre Singapore, Patient Care

The Singapore Cancer Society

The Singapore Cancer Society

To meet with a professional psychologist or counsellor, call The Other Clinic at 8809 0659 or email us hello@theotherclinic.sg.


– Written by Bjørg Plougmand