Dr. Zachary Klaassen remembers this patient well.
He’d beaten the odds—he was in remission for prostate cancer. But he kept coming back to Klaassen, his oncologist, with problems ranging from chest pain to headaches.
He was cancer free—“but he was consumed with the idea of re-occurrence of his cancer,” said Klaassen.
Klaassen told him, “I think you’ve got an anxiety disorder.” Surprised, the man said, “You think so?”
Klaassen referred him to the psycho-oncology team at the Georgia Cancer Center, who worked with him for six weeks, providing both medication and therapy. After that, “he was a new person,” said Klaassen. “He was running again, working.”
For Klaassen, that patient is his best example of the mental toll that cancer can take—and the need for physicians to recognize that and to send patients on to appropriate mental health treatment.
How Mental Health Impacts Cancer
Klaassen is a urologic oncologist by trade. He treats adults with cancers of the bladder, prostate, kidneys, and testicles. But he has always been interested in mental health.
Two of his latest studies focus on mental health and cancer. A study in Cancer confirmed this sobering statement: The very fact that a person has cancer increases his or her risk for suicide.
In fact, in certain cancers like bladder cancer where patients can lose their bladders and experience a significant life change, risk of suicide doubles compared to the general population. For cancer in general, there’s a 50 percent greater risk.
Another study in the British Journal of Cancer took a closer look at patients with cancer who had sought help for mental issues in the past, whether that was an outpatient clinic visit, an emergency room visit or an inpatient admission. Patients could have experienced anything from simple anxiety to something more serious, like a schizophrenic disorder.
Klaassen found that patients who’d had any mental health issue in the past had worse outcomes overall in terms of their cancer.
It’s not entirely clear why that is. It could be because of a biological reason. It could be patients with a mental health issue have a tougher time showing up to appointments and following a treatment regimen. Or it could be because some of these patients can be more difficult to interact with, creating a challenging physician/patient relationship.
“But knowing these problems, we as physicians can make the appropriate referrals to make sure these patients continue to get help from an experienced professional,” said Klaassen. “And patients too need to recognize that good mental health plays a strong role in their cancer treatment and overall well-being.”
What You Can Do
A cancer diagnosis is a life-altering event—and for many patients, they’re afraid that it could even be life-ending. “So you may feel depressed, guilty, empty, and even at the far extreme, suicidal,” said Klaassen.
Then, after patients are in remission, there can be a constant fear of cancer coming back—as Klaassen’s patient found. “There’s lots of emotional turmoil on the surveillance pathway,” said Klaassen. “Patients may also be dealing with side effects of treatment and changes to their quality of life.”
That’s why it’s so important for patients to lean on their social structure, whether that’s family, friends, church or all of the above. Support groups where you can talk with other patients with similar diagnoses can also really help. And staying active and healthy can help uplift mood, too.
However, if someone is feeling suicidal, don’t wait, but get help right away. And know the warning signs of suicide risk, such as missing follow-up appointments or losing contact with friends and family. Specific to cancer patients, “the white, unmarried male is at highest risk for suicide–in fact, anyone without a social structure,” said Klaassen.
Finally, for anyone who is struggling, remember that you don’t have to handle it alone. “Mention it to your oncologist or physician, who will provide a referral to a mental health provider and can help with side effects and quality of life issues, too,” said Klaassen, who regularly refers patients to the Georgia Cancer Center’s psycho-oncology team. “Know that you’re not the only one going through this, and it’s common to feel this way with this huge, life-changing event.”