Cancer impacts more than the body. The disease changes an entire life. Seemingly overnight, patients enter a foreign realm where they have to learn a new language and cope with new uncertainties, a shift that exacts an emotional toll. Approximately one in three cancer patients suffers from psychosocial symptoms, such as anxiety or depression.

It is well established that support programs for cancer patients can lead to markedly better outcomes. Yet, patients face a number of obstacles in accessing such care. Physicians are often very focused on treatment, and they often don’t acknowledge, much less treat, the emotional cost of cancer. Patients may often be left to find programs on their own. 

The gap in mental healthcare is particularly problematic for those in historically underserved communities. Racial and ethnic minorities, individuals on low incomes, or members of the lesbian, gay, bisexual, and transgender communities, already face inequities in the healthcare system and a lack of access. Cancer amplifies those burdens.

Why is mental health so often overlooked in cancer patients, and what can be done to relieve it?

Seeking support

In a recent study, researchers found that nearly 40% of breast cancer patients experienced distress, while 34% and 20% suffered from anxiety or depression, respectively. We’ve seen such results in many breast cancer patients who come to the Cancer Support Community San Francisco Bay Area, where we provide a range of psychosocial services.

Triana is a good example. When diagnosed with breast cancer, she was a single mom of two teenagers and an entrepreneur. Over the years, Triana had coped with her share of challenges and uncertainty. But when she went through treatment, she was overwhelmed. She lost her hair; her body was physically changed by surgery; and she was tired and depressed. Triana came to the Cancer Support Community for help, so she could continue her treatment. By connecting with other patients with similar experiences, she increased her understanding of her cancer, the impact it had on her life, and how to cope. She began to participate in yoga and meditation classes, and she learned how good nutrition can offset the negative impact of treatment. The support that she received helped improve her quality of life throughout treatment.

Even the most driven cancer patients can need mental-health support. Bob is an outdoor enthusiast, and had climbed one of the tallest mountains in the United States, just a month before he was diagnosed with stage 4 colorectal cancer. Enduring his treatment, going through a divorce, and worrying about his ability to care for his son brought Bob to the Cancer Support Community. There, he connected with other parents living with cancer and found support for his young son. In addition, counseling helped him cope with his long, difficult treatment. Despite a terminal diagnosis, Bob found  that support programs could help him continue to spend quality time with his son.

The treatment process causes anxiety in many patients. Don came to our program when his chemotherapy regimen wasn’t controlling his stage 4 lung cancer. He suffered from severe anxiety about getting out of breath, even with minimal exertion. His wife wanted to learn specific techniques to more effectively communicate with their medical team so Don could address this challenge and get more out of treatment.

Through an evidence-based Cancer Support Community program called Open to Options, a licensed mental-health professional helped them prepare for their upcoming appointment with their physician. As a result, Don and his wife were able to focus on their greatest concerns and ask for the additional resources to help ease anxiety.

Much more work to do

This  type of support is not the standard for most cancer patients and their families. In fact, a 2020 survey by the National Coalition of Cancer Survivors found that fatigue and mental health issues are the most common side effects from cancer treatment, but few patients felt that their medical providers addressed these issues.

​​Physicians and other oncology staff need to be educated about the critical need for psychosocial support, and then routinely refer their patients to those services. And, because many psychosocial support services are not reimbursable by insurance, hospital systems and oncology practices may neglect providing those services. We need advocacy for making those services reimbursable.

We have made great advances in medical treatment for cancer, but the oncology community must ensure that mental health is available and accessible to any cancer patient and family member who needs it.

Bio: Margaret Stauffer is the Chief Mission Officer for the Cancer Support Community San Francisco Bay Area. She manages Cancer Support Community’s high-quality, comprehensive support services. She develops new programs, provides clinical supervision to therapists and counseling interns, conducts program evaluations, serves as a community resource, and conducts outreach through community and professional presentations to increase accessibility to all people impacted by cancer. Stauffer is a nationally known trainer of the evidence-based program Open to Options and is a noted psychosocial-oncology expert.

US-65086 Last Updated 6/22