Psychological distress in cancer survivors

Cancer survivors are more likely than their healthy peers to suffer serious psychological distress such as anxiety and depression, even a decade after treatment ends. Those who were relatively young at the time of diagnosis, unmarried, had less than a high school education, were uninsured, had other illnesses or had difficulty doing the activities of daily living are at the highest risk of psychological problems.

Researchers from America analysed mental health and medical data of 4,636 adults who had survived cancer for 5 years or more and 1,22,220 as controls to determine the long-term psychological impact of the disease. The data was collected between 2002 and 2006 by the National Health Interview survey done in America.

During a follow-up period of at least 12 years, about 6 percent of cancer survivors were found to have experienced severe psychological distress within the previous month, compared with 3 percent of those without cancer. Also, 9 percent of long-term cancer survivors and 6 percent of individuals without cancer reported seeing or talking to a mental health professional within the previous year.

One-third of cancer survivors with serious psychological distress reported using mental health services, while 18 percent said they could not afford mental health care. And those who are younger, single, have less education and no insurance may suffer more because they have fewer resources to draw from to get through it. This is because the younger you are, the less experience you have in dealing with stressors. The lower your education, the more difficult it is to understand the complex nature of the disease. If you're unmarried, you may have less support.

The physical and emotional fallout of cancer treatment, including fatigue, pain, nausea and vomiting, mouth sores and hair loss, can contribute to feelings of anxiety and depression. While many of these symptoms may subside or disappear after treatment ends, some, including fatigue, can linger for months or years.

Chemotherapy can also cause delayed problems that aren't apparent until months or years later, including peripheral neuropathy (nerve pain or numbness), infertility, organ dysfunction, hearing loss, muscle atrophy and cardiovascular disease.

Cancer can also bring about job loss and changes to relationships, including family roles and sexual intimacy. Survivors also may fear the cancer will recur, worries that may contribute to psychological distress.

The researchers concluded that long-term survivors of cancer are at increased risk of psychological distress. They suggested that screening for psychological distress in cancer survivors by primary-care physicians and oncologists may help direct people to services that can help them cope. Some may find benefit from anti-anxiety medications, cognitive behavioral psychotherapy and stress management techniques, such as deep breathing and progressive muscle relaxation. And eating a proper diet, maintaining a healthy weight and staying physically active would help too.