The Psychology of Cancer Recovery
This year alone, nearly 2 million Americans will be newly diagnosed with cancer, according to the American Cancer Society, and more than 600,000 will die from cancer. While survival rates for many types of cancer have gone up and new treatments have been developed to increase the odds that patients will beat the disease, cancer remains the second-leading cause of death in the United States.
There’s been a general increase in awareness surrounding many types of cancer and resulting increases in the rates of early detection, but there’s a rarely discussed aspect of cancer recovery that could potentially help even more people survive — mental health.
Not all that long ago, a cancer diagnosis was a certain death sentence. But today, many more people are undergoing treatment to send their cancer into permanent remission, essentially being cured, and many people whose cancer does not go away are living longer, happier lives while they undergo treatment.
In addition to studying the psychological effect of cancer, researchers have also sought to determine whether stress and negative mental health can contribute to the development of cancer in the first place.
Importance of Positive Mental Health
Many people make the false assumption that mental health is something to be concerned about only in cases of depression or serious mental illness. But the truth is that mental health is not a binary term — we all have mental health, just as we all have physical health. A person may have a physical health condition that creates specific symptoms in them. The same is true of mental health. We all have a state of mental health, whether positive, negative or mixed.
About 18% of U.S. adults experience mental illness in a given year. This includes issues like depression, addiction or anxiety as well as more serious illnesses like schizophrenia or bipolar disorder. More than half of those who experience a mental health crisis do not undergo treatment, and more than 9 in 10 suicide victims display signs of mental illness before their deaths.
For every person, a good mental health state means not only are you more content and happier with your life, but the lack of mental illness actually extends a person’s life. Estimates show that those with serious mental illnesses live on average 25 years less than those without such illnesses, and those with mental illness are at higher risk of chronic health conditions.
One study found that people with positive overall mental health are 60% less likely to suffer premature death than those with negative overall mental health. So even for those without serious physical health problems, such as cancer, a healthy mental state can improve and extend the lifespan.
Psychology & Cancer
Some studies have indicated a direct link between psychological problems and the development of cancer, but those connections are not present in the majority of scientific literature on this subject. However, several behaviors that people commonly do to reduce their stress and mental discomfort include behaviors that greatly increase the risk of developing cancer.
- Using drugs
- Engaging in risky sex
Nicotine, the main ingredient in cigarettes, is actually a stimulant, but habitual smokers most often report that smoking relieves their stress and calms them down. Smoking cigarettes is the single biggest risk factor for developing lung cancer, with as many as 90% of lung cancer deaths being connected to smoking.
Emotional eating, whether by overindulging in so-called comfort foods, or seeking out unhealthy, sugar-filled foods, is strongly correlated with the rate of obesity. People with an inclination for emotional overeating may turn to food as a way to comfort themselves in times of emotional stress. About one-third of American adults are obese and about 70% are overweight. Several studies have linked obesity to increased risk of various types of cancer, including breast, liver, colorectal and more.
Heavy drinking and alcoholism are a very common mental health problem, with about 1 in 4 American adults regularly engaging in heavy drinking. In addition to causing chronic liver disease, alcoholism and heavy drinking are associated with breast cancer, colorectal cancer, stomach cancer and pancreatic cancer.
While substance abuse is considered by many to be a mental illness unto itself, alcoholism, drug abuse and mental illness are strongly correlated. In fact, about half of drug addicts will be diagnosed with another mental illness at some point in their lives. While the science isn’t yet conclusive, some studies have shown a link between opioids and elevated cancer risk.
Engaging in risky sex
Many studies have established the connection between psychological problems and the prevalence of risky sexual behaviors, such as unprotected sex, sex with individuals infected with sexually transmitted diseases and more. While it’s, of course, not the case that all those who have unprotected sex are mentally ill, the literature draws a clear correlation between an increase in sexual risk behavior and the presence of mental illness. In addition to increasing the risk of STIs, unprotected sex raises the risk of contracting human papillomavirus, a leading cause of cervical cancer.
Terminal Cancer & Mental Illness
Between 1975 and 2007, diagnosis of cancer went up by more than 15%; in that same time period, the death rate for these cancers dropped by about 11%. In other words, more people are being diagnosed with cancer, yes, but more people are surviving. That’s owing largely to early detection and the major improvements in cancer treatment options.
Today, the five-year survival rates for more than 20 of the most common cancers average more than 60%, and some of the most common cancers have five-year survival rates over 90%.
5-year relative survival rate (all stages)
- Pancreas: 8%
- Liver: 18%
- Lung: 18%
- Esophagus: 19%
- Stomach: 31%
- Brain: 34%
- Ovary: 47%
- Myeloma: 50%
- Larynx: 61%
- Colorectum: 65%
- Oral: 65%
- Cervix: 67%
- Non-Hodgkin lymphoma: 71%
- Kidney: 74%
- Bladder: 77%
- Uterus: 81%
- Hodgkin lymphoma: 86%
- Breast: 90%
- Skin cancer: 92%
- Testis: 95%
- Thyroid: 98%
- Prostate: 99%
Still, about 600,000 people will die from cancer this year, and for those whose diseases are very advanced when they’re diagnosed, the outlook is very grim indeed. In fact, about 40% of newly diagnosed cancer patients report mental distress symptoms like depression, panic attacks and even PTSD.
That’s why a new field is emerging in cancer treatment, psycho-oncology, or combining cancer treatment with psychological healthcare. This is particularly important for patients for whom cancer treatment is likely to be ineffective. These patients should receive mental healthcare treatment from the start, but several behavioral markers are particularly urgent:
- Skipping cancer treatments over feelings of sadness or anxiety
- Self-blame over cancer
- Thoughts of suicide because of cancer prognosis
- Anxiety attacks over fears treatment regimen isn’t being 100% followed
Mental Health’s Impact on Cancer Recovery
We’ve already addressed the connection between cancer diagnosis and psychological problems, but what about the reverse? Can a positive psychological picture improve a cancer patient’s prognosis?
Some animal studies have indicated that elevated stress levels can encourage tumor growth, and observations of people with cancer have indicated that lower levels of anxiety and depression can help alleviate symptoms of cancer. Still, though, the jury is out on whether reducing stress and improving mental health can boost survival rates.
Despite the lack of clear evidence that good psychological practices can lengthen a cancer patient’s lifespan, there’s no doubt that positive mental health improves day-to-day life for these individuals.
So what can cancer patients and their caregivers to do ensure a positive mental state despite the physical ailments? Here are a few tips:
- Talk therapy
- Support groups
- Healthy eating
- Medication for depression or anxiety
Even for those who are able to beat their cancer into remission, any cancer diagnosis is like a grenade going off in your life. Many people find that their conception of self changes forever. And for those whose cancer will be more of an uphill fight, those changes can be even more acute.
While the scientific literature is split on whether a positive psychological state can increase the chances of a person surviving cancer, there is no doubt that it can improve their day-to-day life. Beating cancer won’t mean much if you’re suffering depression and anxiety the remainder of your life.
- American Cancer Society, Cancer Statistics Center. (2019). Retrieved from https://cancerstatisticscenter.cancer.org/#!/
- National Alliance on Mental Illness, Mental Health By the Numbers. (Undated). Retrieved from https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers
- National Institute of Mental Health, Mental Health Information, Statistics. (2019). Retrieved from https://www.nimh.nih.gov/health/statistics/mental-illness.shtml#part_154785
- Centers for Disease Control & Prevention, What Are the Risk Factors for Lung Cancer? (2018). Retrieved from https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm
- National Cancer Institute, Obesity and Cancer. (2017). Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet
- National Institute on Drug Abuse, Comorbidity: Substance Use Disorders and Other Mental Illnesses. (2018). Retrieved from https://www.drugabuse.gov/publications/drugfacts/comorbidity-substance-use-disorders-other-mental-illnesses
- National Institute on Alcohol Abuse and Alcoholism, Alcohol Facts and Statistics. (2018). Retrieved from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics
- American Cancer Society, Alcohol Use and Cancer. (2017). Retrieved from https://www.cancer.org/cancer/cancer-causes/diet-physical-activity/alcohol-use-and-cancer.html
- U.S. National Library of Medicine National Institutes of Health, Substance abuse and cancer. (2017). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29072187
- Psychiatric Times, Psychiatric Disorders and Symptoms Associated With Sexual Risk Behavior. (2004). Retrieved from https://www.psychiatrictimes.com/psychiatric-disorders-and-symptoms-associated-sexual-risk-behavior
- Anxiety and Depression Association of America, Serious, Chronic, or Terminal Illnesses – Tips for Patients and Caregivers. (Undated). Retrieved from https://adaa.org/serious-chronic-or-terminal-illnesses
- National Cancer Institute, Psychological Stress and Cancer. (2012). Retrieved from https://www.cancer.gov/about-cancer/coping/feelings/stress-fact-sheet