Struggles of Survivorship: Part 2 – Psycho-Social Implications
The mental status of cancer survivors can be fragile and destabilized. Psycho-social complications often arise, such as fear of recurrent illness, financial hardship, anxiety, difficulty handling the end of treatment, fatigue, lasting “brain fog”, broken relationships and even post-traumatic stress disorder. In order to navigate this myriad of challenging issues which are just some of the factors that fuel a wide range of depression symptoms, it’s vital that survivors and their circle of support be aware of what the risks are and what to look for.
A Matter of the Mind
According to a recent cancer survivorship initiative, of those patients who’ve survived cancer, 60% have physical or psychological needs left unmet, 30% have issues maintaining close relationships and 90% suffer some type of financial hardship, just to name a few common challenges. Chief among psycho-social factors include some of the following symptoms which are spread over various cancer types:
- Fatigue: The toll that cancer and its treatment take on the body leaves many patients complaining of tiredness years after their treatments have ended.
- “Damocles Syndrome:” Named for the mythological figure who was positioned with a sword dangling over his head, preventing him from enjoying a feast laid before him. Many cancer survivors live overshadowed by the ghost of cancer and thus they retreat from making major life decisions, feeling too frightened to engage and falling into deeper fear and sadness.
- At the other end of the spectrum is survivor’s guilt. Real bonds are developed in chemotherapy infusion centers and therapy groups, yet the fact sadly remains, not everyone survives. Patients who do can sometimes harbor guilt that they reached remission when others did not, thereby triggering a reversal of their previous “Why me?” at diagnosis to a “Why not me?” now that they’ve survived.
- Fear of recurrence can be terrifying to survivors. Many patients become paralyzed by fear prior to returning for routine tests or scans fearing their cancer may have returned. These bouts of terror can, in some, lead to avoidance of doctor’s appointments and missing opportunities to thwart any potential metastases. Conversely, patients risk missing receipt of a renewed clean bill of health and the peace of mind such a diagnosis can bring.
- General depression: Survivors experience depression for diverse reasons. Frequently, over the course of cancer treatments, the bodies they once knew are changed irrevocably and the implications of missing or altered limbs, changes in speech, cognitive ability, sight, hearing or general mobility can dim the good news of remission.
Helping to Heal
Healing is best done before, during and after treatment so that patients can maintain some semblance of equilibrium during their trying set of circumstances. Patients generally tend to under-report symptoms and so having a medical and support team surrounding them throughout the process allows for more timely and consistent detection of abnormal behavior or symptoms of depression. This team can include family, friends and other trusted loved ones or acquaintances; cancer support groups; health care team members; faith-based groups and clergy; counselors and therapists; and other cancer survivors.
References:
https://www.cancernetwork.com/view/addressing-psychological-challenges-after-cancer-guide-clinical-practice
