Published Jul 24, 2019

Mental Health and Cancer: New Survey Shows Over a Third of Patients Aren’t Getting the Support They Need

Thirty-four percent of people who need psychological care during or after cancer treatment said that support services were "not available to them," according to a new international survey.

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Members of the SurvivorNet community often stress to us just how important it is to address the mental health burden that comes with a cancer diagnosis.

One survivor, Steve Silverstein, for instance, told SurvivorNet that he was able to cope with the emotional burden of his stage IV melanoma diagnosis through a combination of diet and exercise changes, acupuncture, meditation, relaxation, and consistent visits to a psychologist, who helped him find the right prescription medication to address his mental health. Other survivors have told us that they were able to cope with the psychological trauma of cancer through support communities, deliberate mindfulness, and activities that bring them peace of mind and joyfrom blogging to dancing to painting to air guitar.

And while every cancer survivor has their own unique coping mechanism, the majority (69 percent) say they need some sort of psychological support during or after their cancer care.

Unfortunately, though, over one-third of patients who need psychological help during or after their cancer treatment (34 percent) say the support isn't available.

Of patients who need psychological support...

34%

said that help was "not available" during cancer treatment.

The troubling statistic comes from a new international All.Can survey, which also found that over 40 percent of people “were not given any information by their care team about patient advocacy groups, charities, or other organizations which could support them.” And in cases where mental health support was available, the survey found, patients and survivors didn't always find it to be "appropriate or helpful."

These findings are especially problematic given the mental health burden that comes with a cancer diagnosis.

"When someone is sort of struck or hit with that shock of initial diagnosis, which I've talked about before as being a trauma, it's hard to know [how they will respond]," Sarah Kelly, an oncology social worker at Cancer Care, told SurvivorNet in a previous conversation about mental health and cancer. "Your mind can go completely blank. If we think of fight or flight or freeze, freeze is a big one that happens."

Cancer and Depression Risk

In some cases, cancer’s emotional trauma can progress into serious depression or anxiety, making it all the more crucial to get adequate help. According to the National Cancer Institute, roughly 15 to 20 percent of patients with cancer develop depression, and suicides are nearly twice as common in people with cancer than they are in the general population.

Dr. Scott Irwin, a psychiatrist and Director of Supportive Care Services at Cedars-Sinai Medical Center, explained to SurvivorNet that caring for patients psychologically can lead to better physical outcomes, tooin part because conditions such as depression and stress can make it harder to tolerate treatments.

"Actually, there is data [that show] that if you have extra stress or depression that you may not recover or you have a higher risk or recurrence," Dr. Irwin said. "So in treating the depression, we're actually impacting the cancer care outcomes."

Many comprehensive cancer centerssuch as Cedars-Sinai, where Dr. Irwin worksdo have supportive care centers and teams of specialists dedicated to helping people going through these experiences.

At the MD Anderson Cancer Center in Houston, for instance, Dr. Ishwaria Subbiah, a medical oncologist and palliative care physician, previously told SurvivorNet that care teams usually include palliative care physicians, nurses, pharmacists, nurse practitioners, dieticians, physical therapists, occupational therapists, counselors, and psychologists, among others.

"Having these members of the team is essential to delivering whole-person care," Dr. Subbiah said. "That's fundamentally what supportive care is."

But while many cancer centers (especially the major, comprehensive ones) do offer this type of whole-person care, the All.Can survey's findings go to show that not all patients are accessing them. The issue could also be rooted in an awareness gap; that is, in cases where psychological services are available, patients aren't always told about them. Information is power, and this is especially true during a cancer journey.

How Can I Make Sure I'm Getting the Psychological Care I Need During My Cancer Treatment?

In an ideal world, everyone diagnosed with cancer would be informed about their psychological care options right off the bat. They would be introduced to psychologists, referred to supportive care teams, and invited to join community groups and organizations that could help them through their emotional challenges.

To be sure, many patients do have this experienceand it’s worth noting the All.Can survey also included a section urging providers and policymakers to make this experience a reality for everyone.

But in the meantime, for the 34 percent of people with cancer who need psychological help but aren't able to access it, the importance of the phrase "be your own advocate" cannot be overstated.

"People who are struggling with coping with cancerâ€¦ should reach out to their doctors, and find a therapist in the community," Dr. Irwin said.

Steve Silverstein, the stage IV melanoma survivor, told us that it was his own self-advocacy that brought him to the combination that worked.

"You know, I went out and found a psychiatrist and got myself on happy pills," he said. "Because this was a challenge."

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