How Your Diagnosis Affects Your Mental Health
- A woman, 31, diagnosed with stage 4 colon cancer, admitted despite experiencing symptoms such as bloody stools for years, she was afraid to get a colonoscopy, which screens for colon cancer sooner.
- Colon or colorectal cancer affects your large intestine (colon) or the end of your intestine (rectum). Typically, colorectal cancer symptoms involve a change in bowel habits.
- Colonoscopies are the most effective way to screen for colon cancer, according to our experts. The advantage of a colonoscopy is that your doctor can remove any polyps found during the test. Many colon cancers can be caught on colonoscopy before they develop or when the polyps are small enough to be removed without surgery.
- The woman’s mental health suffered while coping with her diagnosis. Research published in Epidemiology and Psychiatric Sciences found that “35 to 40 percent of cancer patients have a diagnosable psychiatric disorder,” patients battling late-stage cancer tend to face even more significant mental health challenges.
- Anxiety is triggered by many stressors, such as a diagnosis or the fear that your cancer will return. Experts tell SurvivorNet that tips for coping with anxiety may include finding hobbies that bring you joy or rationally managing your extreme thoughts.
- Genetic testing can help determine the best course of mental health treatment for people struggling with anxiety and depression. The test can give doctors a profile of how a person will likely respond to different psychiatric medications.
A woman, 31, who was diagnosed with stage 4 colon cancer finds reason to have hope amid a flurry of positivity from cancer survivors online. The woman noted although she had experienced concerning symptoms for years, she was reluctant to get a colonoscopy. Research published in JAMA Network Open last year evaluated the rise in cancer among people under 50, also called early onset of cancer. Gastrointestinal cancers, including colorectal, had the “fasted-growing incidence rates.” Among the 562,000 participants in the study, people between the ages of 30 and 39 saw an increase of 19 percent in the early onset of cancer.
Online support is creating a community for her, boosting her mental health in the process. Her story highlights the added value of mental health support for cancer patients after a diagnosis.
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The 31-year-old began her social media post feeling pessimistic about her long-term outlook.
“I’m only 31 and just sad that I couldn’t do more with my life. I just found out I’m infertile. I also never followed my dreams; I just failed this lifetime,” she said.
She also indicated she began experiencing concerning symptoms in the bathroom before her colon cancer diagnosis. Typically, colorectal cancer symptoms involve a change in bowel habits. This ranges from constipation or diarrhea to differences in the size or shape of bowel movements. A change in stool color, mainly black or tarry stools, can indicate bleeding from a tumor that lies deep in the colon.
“I’ve been pooping blood for three years…I was too scared to get a colonoscopy… that’s on my guys,” she said.
She also hesitated to share her diagnosis with her family, worrying it would burden them. However, the vulnerable Reddit user was flooded with positive comments and encouragement from other cancer survivors.
“I don’t know your local setup, but counseling is offered to cancer patients in a lot of places,” a fellow Reddit user commented.
Shortly after that, the 31-year-old replied, “I appreciate your comment, and yes, I’m spiraling and panicking a lot. I’m seeing my therapist on Friday and requested a longer session.”
Other cancer survivors chimed in, fueling the 31-year-old’s growing desire to keep fighting and consider treatment.
“I did the treatment, and I’ve been alive for 2.5 years now. Please try it,” another user wrote.
More than a hundred people encouraged Tea4vendetta to reconsider her options, which appears to have worked.
“I’m going to get treatment and am not going to give up just yet. Thank you for your understanding and support. I really appreciate it and am so thankful for your compassion and words of wisdom. I really needed it and am so grateful. Yesterday was rough, but today is better, and it’s because of you all getting me out of my head and giving me some good advice,” Tea4vendetta said, adding she’s also including her family in her journey.
We know among cancer patients, mental health needs often go unmet. Luckily, some resources are available to help fuel your cancer journey physically and mentally.
Helping Patients with Mental Health Resources
Emotional Care Is as Important as Physical Treatment
According to Mental Health America, “56% of adults with a mental illness receive no treatment, and over 27 million individuals experiencing a mental illness are going untreated.”
While millions of people have unmet mental health needs, the need for mental health resources is even greater among cancer patients and their families.
WATCH: Managing your mental health.
Research published in Epidemiology and Psychiatric Sciences found that “35 to 40 percent of cancer patients have a diagnosable psychiatric disorder,” and the number of people experiencing mental health challenges is “higher among cancer patients with advanced stages of cancer and in palliative care settings.”
“For long-term mental health and living with cancer, flexibility is really at the core of how to manage long-term mental health,” says New York-based psychologist Dr. Samantha Boardman.
Dr. Boardman suggests asking yourself questions about how you deal with stressful situations to see if they’re working or need adjusting.
“Are your coping strategies in the way that you’re using them now? Are they as effective as they were in the past? Take a look at your beliefs. Do you have any fixed beliefs that are counterproductive and are impeding you from taking positive steps?” Dr. Boardman said.
To keep your mental health in check, it’s important to be aware of subtle signs that something is affecting your mind. These signs include:
- A change in eating or sleeping habits
- Losing interest in people or usual activities
- Experiencing little or no energy
- Numb and/or hopeless feelings
- Turning to drink or drugs more than usual
- Non-typical angry, upset, or on-edge feelings
- Yelling/fighting with loved ones
- Experiencing mood swings
- Intrusive thoughts
- Trouble getting through daily tasks
If you struggle in any of these areas, talk to your doctor or a mental health professional to begin your emotional journey alongside your other cancer treatment.
“Depression and stress make it harder to treat cancer [and] make it harder to tolerate the treatments,” Dr. Scott Irwin, director of supportive care services at Cedars-Sinai Medical Center, previously told SurvivorNet.
“There’s data that if you have extra stress or depression that you may not recover or you have a higher risk of recurrence, so in treating the depression, we’re actually impacting the cancer care outcomes,” Dr. Irwin added.
How Genetic Tests Can Help Your Mental Health
Genetic testing is successful in matching patients with the proper medication to offset bouts of anxiety or depression.
WATCH: Understanding genetic testing and its connection to mental health.
“This test covers all of the psych medications, essentially, and it also covers pain medications. It’s such a great test,” Dr. Lori Plutchik, licensed psychiatrist, previously told SurvivorNet.
“Depression affects about 20% of women at some point in their life and about 10% of men at some point in their life. That’s a very prevalent illness, and then when you’re working in the cancer population, which I’ve worked in extensively over the years, depression can be up to 50% in patients who are having impairments in their life due to their illness,” Dr. Plutchik continued.
The Genomind test Dr. Plutchik uses looks for multiple factors before determining the medication with successful results and minimal side effects.
To do this, there are two parts to the test. First, the doctor will test for certain genes associated with responses to a medication commonly prescribed for mental health issues. Secondly, the patient’s ability to metabolize medication will be tested. Doing this reduces the chance of adverse side effects and allows patients to respond well to medication on the first try.
“About 95% of the time, the first medication that I choose for them ends up being the right medication,” Dr. Plutchik explains.
Understanding Stage 4 Colon Cancer
Colon cancer, or colorectal cancer, affects your large intestine (colon) or the end of your intestine (rectum).
The cancer starts when abnormal lumps called polyps grow in the colon or rectum. If you don’t have these polyps removed, they can sometimes change into cancer. It takes up to 10 years for a colon polyp to become a full-blown cancer, according to SurvivorNet experts.
Most colon cancers can be prevented if people are regularly screened. The screening usually involves a colonoscopy, in which a long, thin tube attached to a camera is used to examine the colon and rectum. If no polyps are discovered, the following screening won’t be needed for about ten years.
The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45.
A preliminary staging workup is done after diagnosis with imaging studies, such as a computed tomography (CT) scan, which can show whether the cancer has spread. If you have had surgery to remove your cancer, a pathologist will look at it under a microscope to determine your stage.
- Stage 1 cancers are those in which the tumor has only penetrated the superficial layers of the colon and hasn’t gotten into the deeper layers.
- Stage 2 cancers involve the deeper layers of the colon wall
- Stage 3 cancers have spread to the lymph nodes around the colon
- Stage 4 cancers have spread to other organs, such as the liver, lungs, or peritoneal cavity (the space in your abdomen that holds your intestines, stomach, and liver)
The Value of Colonoscopies
A colonoscopy is a procedure doctors use to screen for colon cancer by looking inside your colon.
This procedure requires your colon to be “cleaned out.” To clear out your colon, your doctor will prescribe a “bowel prep,” a liquid you drink the night before the procedure. The prep acts as a laxative that causes you to have multiple loose stools before your procedure.
Once your colon is cleared out, the gastroenterologist performing the procedure can have a clear look to evaluate if any polyps or masses are present.
Depending on the size and number of polyps found, it is recommended that patients undergo a repeat colonoscopy within three to five years.
Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center, previously explained the colonoscopy procedure to SurvivorNet.
“When we see a polyp, we actually physically take the polyp out through the colonoscope,” he explained.
“What does that mean? That means we basically put a wire through with a little bit of a flange at the end, and we pull the polyp out. Now, note there is no pain with that. Inside the colon, there are no pain fibers. So, there’s no pain,” Dr. Murrell added.
The advantage of a colonoscopy is that your doctor can remove any polyps found during the test. Many colon cancers can be caught on colonoscopy before they develop or when the polyps are small enough to be removed without surgery.
Questions to Ask Your Doctor
If you are facing a colon cancer diagnosis, here are some questions you may ask your doctor.
- What are my treatment options based on my diagnosis?
- If I’m worried about managing the costs of cancer care, who can help me?
- What support services are available to me? To my family?
- Could this treatment affect my sex life? If so, how and for how long?
- What are the risks and possible side effects of treatment?
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