Mental health during oncological treatment. Interview with a Psycho-oncologist

Cancer evokes fear even greater than any illness with equally serious or worse prognosis. Life of a person who has been diagnosed with cancer is tremendously stressful from the very start. They are forced to come to terms with a new, completely unwanted situation. In most cases the stress passes after a few weeks when the patient learns how to emotionally cope with cancer.

It’s crucial to understand that time depends on multiple factors such as support from our loved ones, a sense of empowerment, willingness to search for possible solutions or if the patient decided to be passive instead, being in denial. Dr Ewa Wojtyna said that 47% oncological patients develop various mental disorders. If, for example, adjustment disorder occurs during critical times of the disease, it may take even to 12 months before the patient fully adapts.

WCancer diagnosis triggers a wide range of emotions related mostly to pain. Such health loss is the beginning of the mourning process for the patient. They ask themselves a question that causes overwhelming fear: “Will I be able to beat cancer?”. Sorrow and anger lead to a follow-up: “Why did this happen to me?”. Shame and guilt happen often as well, because “I could have led a healthier life”.

All emotions are important since their role is to be an “emotional GPS” in our lives. Anger which is commonly perceived as bad informs us that we actually feel some sort of pain: unmet needs, for example. It’s worth drawing attention to the real meaning behind this emotion. Our mind is responsible for these emotions and while we cannot control our thoughts, we can choose if we act upon them and for how long. Only we can decide if our mind creates thoughts which will make the day better and our life better, here and now. A closer look at our beliefs can make us understand where certain emotions come from. Alone or with a help of a Psychologist or Psycho-oncologist it’s possible to create a healthier way of thinking and therefore change emotions. This can lead to a calmer, happier life without fear and boost the immune system as a result. Healthy thoughts, for example “I have a chance to get better no matter how ill I am” bring about serenity and hope while more endorphins – the happiness hormones – are created in our body helping the immune system work as it should.

I believe it’s good to work on our emotions by looking deeper into thoughts which caused them. Next step is working on a better emotional state with more physical activity in our lifestyle or as dr Carl Simonton says, developing vital activities by discovering those which bring joy, peace of mind, a sense of fulfilment and a purpose in life. It’s worth to mention that joy is not the same as pleasure. Joy is always in line with our biology, beliefs and important relationships so it doesn’t bring pain, shame or guilt. It’s pure happiness of living close to our nature – being kind and empathetic (nature of Love); doing what we really value in life, not only fulfilling whims or necessary tasks.

Yes, many of them. Cancer impacts the career and family life of the patient. It changes the social circle from household members and co-workers to other patients. Treatment results in a significant change in appearance, for example hair loss which is a painful issue to cope with, especially for women. Body deformation as an aftermath of surgery is also a crucial factor that affects the patient’s self-esteem, along with being dependent on others. 

According to medical literature about 40% of oncological patients suffer from depression. Symptoms may vary. Dark thoughts aren’t always the case, the same goes for a sense of desolation, loss of interests or motivation. Frequent anger or irritation may be a symptom as well which impacts close ones the most. Notice when it all has started and then shift this uncomfortable state to a level of caring conversation. First thing to do is to ask “How can I help you?”. Then suggest support from a specialist: Psychologist or Psycho-oncologist who decides if a Psychiatrist is needed in order to prescribe an additional pharmacotherapy.

Best way to help someone with a depressive disorder is psychotherapy and in some cases also pharmacotherapy. Right pharmacotherapy is especially important for patients diagnosed with cancer since there is risk of serotonin syndrome - a part of drug-induced reaction. Oncological patients often take various drugs therefore it’s crucial to know which ones and what dosage is recommended by the Psychiatrist. Attempts to treat depression pharmacologically on one’s own is extremely dangerous.

Unfortunately they do tend to forget completely about their needs such as right amount of sleep, food or active recreation. Changes that happen in lives of patients’ loved ones often come with additional tasks and taking care of themselves isn’t considered as a quality of being a good “supporter”. Being well-rested and refreshed means being more optimistic. The role of a person who supports a cancer patient is a marathon, that’s why they have to distribute strength in a smart way so that both of them could run to the finish line: better health. Vital activities as previously mentioned are equally important. It’s impossible to support our loved ones without energy.

It depends on the purpose of these visits and the patient’s needs. Usually I work individually with the patient or a person who wants to support someone with cancer. It does happen however that both arrive at their first meeting. I’ve also experienced a situation where a young adult patient preferred to visit with their mom. He needed her support so it was a good solution. While I work with a group during the Simonton program workshop participation of a person close to the patient is helpful. Together they can learn while completing exercises, answering important questions in my presence and recharge their batteries with positive energy which improves the quality of their lives.

Humans are composed of mental, physical and spiritual spheres. If one of them is weakened a domino effect happens and other spheres are affected too. When a patient experiences physical pain, his mood drops and firstly we need to ease this pain in order to improve other issues. If someone lives with chronic stress it may cause physical health problems as well.

The only possible one that comes to mind is finding access to a Psycho-oncologist. If a Psychologist isn’t available in the patient’s place of treatment but the patient would like to receive help from such specialist it’s worth to ask the attending physician. While working at the Marrow Transplantation and Haematology unit I’ve tried my best to know about my patients but if they are treated on an out-patient basis they might not be aware of such possibility.

Many patients experience emotional pain after finishing the pharmacological treatment because during that process they felt that they’ve received help in order to be cured. After the treatment fear and uncertainty if everything’s okay appear along with intense self-observation. The patients are unsure about what they should and shouldn’t do in an effort to avoid any possible harm. I remember one of my patients who loved riding motorbikes and swimming. A few months after finishing the treatment he was worried those activities might be too risky so he quit. He missed them ever since and that was the reason why he decided to go to therapy.