Cancer is a disease that affects millions of people worldwide each year. While cancer mainly impacts the physical body, the emotional and psychological effects of cancer often get overlooked. In this article, we’ll explore whether cancers can have emotional components and how a cancer diagnosis impacts mental health.
What are the emotional effects of cancer?
Receiving a cancer diagnosis leads to a rollercoaster of emotions. Common initial reactions include shock, fear, anxiety, depression, anger, and denial. As patients undergo treatment, they may grapple with feeling out of control, hopeless, isolated from loved ones, and uncertain about the future. Emotions can fluctuate daily, even hourly at times.
According to the National Cancer Institute, up to 1 in 3 people with cancer have anxiety, depression, or both before, during, and after treatment. Feelings of distress are incredibly common in cancer patients. Distress involves negative emotional responses like sadness, fear, anger, and despair triggered by the cancer experience.
Why does cancer stir up such difficult emotions? A cancer diagnosis means dealing with the possibility of death and disease. It also often involves debilitating physical symptoms and side effects from treatment like pain, fatigue, and nausea. Patients grieve the loss of normalcy and control in their lives. Treatment is grueling and emotionally taxing.
On top of that, cancer patients must cope with the cost of medical bills, time away from work, family responsibilities, and stigma around the disease. They may feel like a burden on loved ones. Isolation can worsen emotional troubles; it’s common to feel alone and unsupported.
Do cancers themselves cause emotional symptoms?
While situational factors certainly explain much of the distress around cancer, there is growing evidence that cancers themselves may directly cause certain emotional changes through physical processes. Here are some of the ways cancer may contribute to mood symptoms:
- The immune system responds to cancer by releasing pro-inflammatory cytokines and other signaling molecules that cross into the brain, causing inflammation, irritability, fatigue, foggy thinking, and mood changes.
- Some cancers disrupt hormonal processes like the HPA axis that influence stress response, anxiety levels, and overall mood.
- Brain tumors and metastases can physically damage emotional processing centers of the brain, leading to personality changes.
- Paraneoplastic neurological syndromes from lung, breast, gynecological, and other cancers cause psychiatric symptoms like irritability, anxiety, depression, restlessness, unstable mood, psychosis, and obsessive thoughts in up to 60% of patients.
- Cancer treatments themselves, like cytokine and hormone therapies, chemotherapies, surgeries, medications, and radiation can alter brain function in areas like the limbic system that control emotions.
The takeaway is that for some patients, cancers can instigate inflammatory, hormonal, and structural brain changes that sway emotions or contribute to mental health issues like anxiety and depression. The cancer has direct biological effects on mood.
How are emotions impacted at different stages of cancer?
Emotional reactions to cancer often depend on the stage of the disease and treatment:
At diagnosis:
Getting diagnosed induces feelings of shock, anxiety, fear, denial, anger and can lead to acute stress disorder or clinical depression. Existential questions around life purpose, meaning, and mortality also commonly arise.
During active treatment:
Undergoing therapies like chemo, radiation, surgery and more can provoke intense stress, self-image issues, and uncertainty. Symptoms like fatigue, pain, and nausea worsen mood. Feelings of losing control and isolation are also common.
In remission:
The transition into remission brings some relief but also worries about the cancer returning. Some experience “survivor’s guilt” and post-traumatic stress from the experience. Lingering physical and cognitive effects may contribute to anxiety or depression as well.
At recurrence:
Facing cancer again can worsen trauma and fears of death. Grief, anger, and a sense of futility are common reactions that require support.
At end of life:
Facing terminal cancer involves grappling with one’s mortality and making end-of-life decisions. Existential distress around leaving loved ones can occur. However, some also experience acceptance and peace around death.
Mental health needs and capacity to cope fluctuate during the ups and downs of the cancer journey. Accessing emotional support is crucial at all stages.
What mental health disorders are linked to cancer?
Here are some of the most common specific psychiatric conditions that arise in cancer patients either from the cancer itself or the distress of the experience:
| Disorder | Symptoms |
|---|---|
| Depression | Persistent sad mood, loss of interest, changes in appetite and sleep, fatigue, guilt, trouble concentrating, suicidal ideation |
| Anxiety disorders | Excessive fear, panic attacks, muscle tension, restlessness, concentration issues |
| Adjustment disorders | Emotional distress and inability to cope after a stressful life event like a cancer diagnosis |
| Delirium | Sudden confusion, disorientation, agitation, perceptual issues, sometimes caused by cancer treatment effects on the brain |
Other possible issues include post-traumatic stress disorder, mania, obsessive-compulsive disorder, and substance abuse as a coping mechanism. Personality changes like irritability may also occur.
How can the emotional impacts of cancer be managed?
Despite how intertwined cancer and distress often are, the emotional fallout of a diagnosis doesn’t have to be an inevitable part of the experience. There are many ways to gain support and cope psychologically with cancer’s challenges:
- Seeking counseling and psychiatric treatment for disorders like depression and anxiety that develop
- Joining cancer-specific support groups to share experiences with others who understand the unique challenges
- Practicing self-care through nutrition, light exercise, relaxation techniques, adequate sleep, and stress management
- Fostering relationships and asking for help from loved ones for practical assistance and emotional support
- Exploring complementary therapies like art, music, and dance therapy that soothe the mind/body
- Finding spiritual comfort through religious/philosophical beliefs about mortality, meaning, and resilience
- Communicating openly with the care team about any distress so they can connect patients to help
- Expressing feelings creatively through journaling, art-making, or other creative outlets
While cancer inevitably takes an emotional toll, actively working to process feelings, access support, and nurture mental well-being can help mitigate the psychological burdens of the disease.
Conclusion
Cancer is a complex disease that impacts both the body and mind. Mood disorders like depression and anxiety are very common but not inevitable parts of the cancer experience. Emotional reactions vary along the course of the cancer journey based on factors like treatment status, prognosis, and coping abilities.
Research suggests cancers themselves can directly contribute to emotional symptoms through inflammatory effects, hormonal changes, brain alterations, and treatment side effects. However, many situational and psychological factors also influence the development of disorders like adjustment and post-traumatic stress disorders in patients.
Seeking counseling, participating in support groups tailored to cancer, using complementary therapies, fostering open communication with healthcare providers, and practicing regular self-care are key ways patients can get help with the emotional challenges of cancer. With proper support, it is possible to cope effectively and minimize the psychological imprint of the disease.
