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Don’t Dismiss Your Distress

Maintaining emotional wellness is an important part of cancer care.

by Michelle Riba, MD, MS

Wellness image

Esophageal cancer survivor Dennis Serras learned that his experiences with both cancer and depression were more common than he imagined.

For all the physical side effects that cancer can impose on the body, its psychological toll is often just as distressing. Though it’s not as frequently and openly discussed. Potential triggers for depression and anxiety lurk through­out the cancer journey, from the stress surrounding diagnosis to the physical and mental demands of treatment to the persistent uncertainties that accompany the possibility of recurrence.

The stigma surrounding mental health issues combined with the confusing overlap of anxiety and depression symp­toms and those of other cancer-related side effects, as well as a host of other factors, often push the attention that belongs to the emotional impact of cancer to the back burner. It shouldn’t be this way, and it doesn’t have to be. Monitoring and caring for both your physical and your emotional well-being is essential for successful treatment.

Because of the way the medical field is organized, clinicians can sometimes have a hard time attending to their patients’ mental and physical health needs simultaneously; however, these needs shouldn’t be separated. Integrating mental health­care with physical healthcare is the ideal approach to cancer care.

Having an open conversation with your healthcare team about the potential psychological challenges of cancer can help prepare you for what may lie ahead.

Author of Article photo

Dr. Michelle Riba

Having an open conversation with your healthcare team about the potential psychological challenges of cancer is a crucial first step that can help prepare you for what may lie ahead. Because depression shares many of the symp­toms of common treatment-related side effects – including decreased appetite, poor memory, fatigue, sadness, irrita­bility, and difficulty with concentration and decision-making – it can be difficult to determine their cause. The best strat­egy is to discuss any symptoms you may be experiencing with your doctor to ensure they are addressed promptly.

For restaurateur Dennis Serras, the discovery that two seemingly success­ful surgeries for esophageal cancer still had not rid his body of the disease was the trigger that plunged him into a deep depression. What helped Dennis man­age the new uncertainties about his cancer prognosis – and the psychologi­cal distress that it generated – was sharing his story with others who had fought through cancer and made it to the other side and with those who were still actively engaged in their battles. In doing so, Dennis learned that his experiences with both cancer and depression were far more common than he could have imagined.

“Having depression associated with cancer is something that, from my own personal experience, I believe most people go through,” Dennis says. “Can­cer turns your life upside down, and it sucks in your whole family, too. It re­ally takes you down some paths. You really have a bond with people who have cancer. Other people just can’t imagine what you are experiencing.”

While everyone’s cancer experience is unique, Dennis has seen time and time again how people at all different stages of treatment and with different diagnoses can learn from one another.

Now, two years after his third sur­gery, Dennis is cancer-free. He credits the ongoing care of a psychiatrist, the support of friends and family, as well as the guidance he received through cancer support groups for helping him overcome his depression. He is grateful for what he has learned through his journey and is eager to share his story with others who can benefit.

“I’ll never be truly back to ‘normal,’ and I have reminders of my cancer ev­ery day,” Dennis concedes, “But having people to talk to who have been through what I have and understand – that’s what helps the most.”

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Dr. Michelle Riba is an associate director of the University of Michigan Depression Center, the founding director of the PsychOncology Program at the U-M Comprehensive Cancer Center, and a pro­fessor and associate chair of psychiatry at the U-M Medical School in Ann Arbor, MI.

This article was published in Coping® with Cancer magazine, May/June 2013.