by Daniel C. McFarland, DO and Michelle Riba, MD
Cancer brings significant and enduring life changes. The impact ripples through every facet of a person’s life. A cancer diagnosis, along with the accompanying life changes, can even affect people psychologically. How could it not? The difficult part is figuring out how to manage the psychological effects of cancer so that you can have the best quality of life possible.
Your Initial Reaction
Cancer is a universally life-altering experience. However, everyone reacts differently upon hearing the words “you have cancer.” Many people experience a sense of shock, yet some are actually relieved to finally know what’s been causing their symptoms. Others may feel anger, resentment, numbness, sadness, or a combination of emotions that may evolve over time. Cancer has a way of turning your world upside down, up- ending the daily rituals that bring you comfort, and forcing you to live in a state of perpetual uncertainty.
Emotional Responses vs. Symptoms & Side Effects
Emotions are complex. Your emotional response to cancer is largely influenced by your psychological composition – in other words, your past experiences, important relationships, and patterns of dealing with stress or trauma. Emotions speak to a psychological evolution that involves processing loss, coping with trauma, adjusting to new roles and social changes, and dealing with the existential meaning of cancer. Emotional reactions to cancer include feelings of sadness, guilt, loneliness, becoming overwhelmed, hope, and gratitude.
Symptoms and side effects, on the other hand, are a direct result of cancer or its treatment. They are often amenable to short-term treatments, either behavioral or pharmacological. The psychological symptoms and side effects of cancer and its treatment include sleep disturbances, poor appetite, memory and concentration problems, and anxiety. It’s important to make sure that your cancer-related side effects and symptoms are addressed and adequately treated so that you can better manage your emotional response to cancer.
Cancer is considered a traumatic event. As such, it can lead to symptoms of post-traumatic stress.
The Psychological Consequences of Cancer
Cancer is considered a traumatic event. As such, it can lead to symptoms of post-traumatic stress, such as intrusive, persistent negative thoughts, avoidance behavior, and becoming excessively vigilant. If you are experiencing any of these symptoms, talk to your doctor. Your doctor can connect you with the psychological help that you need.
Cancer survivors may also experience fear of recurrence or increased anxiety about scans or follow-up tests. Some people experience survivor’s guilt, which is guilt stemming from a sense of injustice in knowing that you have survived cancer while some people with cancer do not. In addition, your relationship with your body can be altered. Cancer survivors often feel a sense of betrayal from their bodies. These negative feelings about your body can affect your self-image, your confidence, your relationships, and even your sexuality.
Maintaining Quality of Life
Cancer, and its treatment, can cause disruptions in a person’s ability to function in their daily life. In other words, it affects your quality of life. For many cancer survivors, maintaining a good quality of life during and after treatment is paramount. And this requires a good partnership with your care team, as well as coordination among specialists.
Take heart in knowing that human beings have a tremendous capacity for resilience and coping. As a cancer survivor, it’s important to tap into your own innately useful coping mechanisms to manage the psychological impact of cancer. These are the coping strategies you tend to turn to intuitively in times of distress. And don’t hesitate to reach out for professional help when needed. You don’t have to face cancer alone. Help is available.
Dr. Daniel McFarland is a psychiatrist and medical oncologist at Memorial Sloan Kettering Cancer Center in New York, NY. He completed a combined residency program in internal medicine and psychiatry at Rush University Medical Center in Chicago, IL, followed by a fellowship in medical oncology/ hematology at the Icahn School of Medicine at Mount Sinai in New York.
Dr. Michelle Riba is an associate director of the University of Michigan Comprehensive Depression Center in Ann Arbor, MI, codirector of the Depression Center’s Workplace Mental Health Program, founding director of the PsychOncology Pro- gram at the U-M Rogel Cancer Center, a professor of psychiatry and director of the Psychosomatic Medicine Fellowship at the U-M Medical School, an attending psychiatrist at Michigan Medicine, and chairs the Distress Guidelines for the National Comprehensive Cancer Network.
This article was published in Coping® with Cancer magazine, September/October 2020.