A cancer diagnosis and its subsequent treatment may understandably compromise a patient's emotional stability; at least half of those with advanced cases suffer from some form of mental illness, but less than half of those affected receive appropriate treatment. Whether their cancer is terminal, operable or in remission, all patients experience some degree of the personal upheaval so common to the cancer experience, from asking impossible questions (why me? why now?) to considering the future implications the cancer treatment process carries for friends and family: will they be secure if the disease proves fatal? Can I rely on them to support me if my condition requires it? What can I myself do to ensure the best possible outcomes? Rates of depression, anxiety, insomnia and other psychiatric afflictions run considerably higher among cancer patients than in the general population, and yet treatment models specifically designed for such cases receive little attention or funding. Cancer experts, in a recent statement, suggest that this practice must change and that all cancer patients should receive mental health assessments.
The mind often responds to the prospect of early death or lengthy physical trauma with an almost counter-intuitive sense of positivity - not quite amounting to denial but rather an underlying desire to diminish the potentially incapacitating fears brought on by a sober glimpse at mortality. Still, such reactionary responses do not often extend throughout the entirety of the treatment period, and they often turn into either outright despair or a smiling mask meant to placate friends, family and doctors, assuring them that the patient has accepted the diagnosis but remains confident that it will resolve itself in a good way. The fact that positive emotions do not affect survival rates or surgical outcomes is hardly reason enough to remain inattentive to these obviously crucial issues; a patient's mental state can dramatically affect his or her quality of life and allow for a more or less nuanced perspective on life and death. While a patient remains in treatment, he or she should be allowed to live the most stable and fulfilling life possible, and though physical care is, of course, the foremost element of cancer treatment, mental health care may also prove crucial in a considerable number of cases.
Patients need the support of family, friends and, if their persuasions prefer it, religious representatives (religious beliefs often intensify in the wake of cancer diagnosis, 90% of cancer patients surveyed have reported that their personal faith plays a role in their recovery, and regular prayer has been proven to lighten the mood of those affected by serious illness). Care providers should not shy away from bringing these relationships about. Mental health services are available to cancer patients in many hospitals, and they often come free of charge, but many are either unaware or not encouraged to pursue them. 28% of families affected by cancer report that their doctors did little to help them beyond attending to medical necessities. The doctor is not a social worker or personal therapist, but treating a patient and his or her family in a cold and clinical manner in the name of professional responsibility carries few benefits.
The services recommended by the Institute of Medicine panel are not particuarly expensive or time-consuming: simple mental health questionnaires issued to cancer patients could give providers a considerable advantage in determining how to conduct their treatments (aside, of course, from the primary cancer concern). Yet very few cancer centers offer psychological screening options. At at time when technological advances allow an increasing number of patients to survive potentially deadly cancers, the disease's ripple effects grow more prominent, and they should not be dismissively relegated to another department. A few small steps can, at the very least, make these patients aware of additional treatments that could help them improve their lives and escape cancer's influence.
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