As a developing country, Nepal may face special challenges in providing adequate mental health care to cancer patients. Cancer care often overlooks mental health issues
Cancer is a complex and challenging disease that not only affects an individual's physical well-being but also has a profound impact on their mental health. Dealing with a cancer diagnosis and undergoing treatment are emotionally challenging processes. These processes are stressful as well. Stress leads to the development of mental health issues.
The connection between cancer and mental health is a crucial aspect of a patient's holistic care. Addressing the psychological well-being of cancer patients and survivors is essential for their overall life quality, treatment outcomes, and long-term recovery. Understanding and supporting cancer patient's mental health is a matter of paramount importance.
The thoughts that affect a cancer patient's mental health include fears of death, uncertainty and worry about the future, negative self-perception, guilt and shame, feelings of loss and grief, catastrophic thinking, and concerns about the impact of cancer on relationships.
Several studies have shown that cancer negatively impacts mental health. According to a study published in Nature Medicine in March 2022, depression and anxiety were the most common mental illnesses among cancer patients. About 15-25 per cent of cancer patients are said to experience depression at some point during their cancer journey. The rates of depression may differ based on factors including cancer stage, treatment intensity and individual characteristics.
In addition to depression, cancer patients also suffer from anxiety, with estimates ranging between 20 and 50 per cent. Anxiety symptoms can be related to cancer diagnosis, treatment process and uncertainty about the future.
People who were treated with chemotherapy, radiotherapy and surgery were more likely to experience mental health issues, according to the study. A link between depression and the immune system's inflammatory reaction to tumors was found. The body's ability to fight against tumors emanates as per the condition of mental health. Researchers for this study also found an increased risk of self-harm in this population, which was highest in the first year following a mental illness diagnosis.
Another study, which also was published in March 2022 in Nature Medicine, found that patients with cancer had an 85 percent higher death rate from suicide than the general population. The suicide death rate was higher in patients with difficult-to-treat cancers of the liver, stomach, head and neck, and pancreas.
As a developing country, Nepal may face special challenges in providing adequate mental health care to cancer patients. Cancer care often overlooks mental health issues due to factors such as limited resources, shortage of mental health professionals, little understanding of their importance, as well as stigma associated with mental illness and economic factors. For cancer patients in Nepal, poverty and poor financial resources cause significant barriers in getting mental health treatment. Additionally, transportation to healthcare facilities and medication also pose obstacles.
Mental health conditions among cancer patients in Nepal may differ depending on the individual and the region. The availability and quality mental health services will also differ. For cancer patients, it is advisable to get the most accurate, up-to-date information and support concerning mental health care from healthcare providers, support organizations, and local resources.
Psychosocial support focuses on addressing the emotional, social and psychological aspects of cancer diagnosis. It can help patients cope with the challenges of cancer, enhance their resilience, reduce distress, improve treatment adherence and promote better quality of life. Providing resources such as counseling, support groups and education for better emotional well-being can contribute to a more positive experience for cancer patients.
While psychosocial support can improve the mental and emotional well-being of cancer patients, the direct effect on survival outcomes is not yet well-established.
Nonetheless, addressing cancer patients' psychosocial needs remains crucial in comprehensive cancer care. Providing appropriate support can help patients navigate the emotional and psychological challenges associated with cancer, improve their coping strategies and enhance their overall quality of life during and in the aftermath of treatment.
The focus on cancer patients and their mental health tends to be greater in developed countries compared to developing countries. Developed countries often have more resources, infrastructure and healthcare systems that can provide comprehensive cancer care, including psychosocial support services. These countries may have well-established support networks, specialised cancer centres and multidisciplinary teams to address the cancer patients' holistic needs, including their mental health. In contrast, developing countries often face significant challenges in providing adequate cancer care. Limited access to healthcare facilities, shortage of trained healthcare professionals and inadequate resources for psychosocial support barricade the cancer care services.
The primary focus in developing countries is limited to basic cancer treatment and survival, with less emphasis on mental health support services.
However, it is important to note that the situation can vary even within the developing countries. Efforts are being made to improve cancer care and mental health support for the patients in these regions. Awareness of the mental health impact on cancer is growing. Initiatives are being undertaken to integrate psychosocial support into cancer care programs in developing countries as well. Developing countries need the proper address to cancer patient's mental health to alleviate the disease. We should enhance effective advocacy, and research, develop and execute policies and plans for appropriate substantial development of support services.
A version of this article appears in the print on July 5, 2023, of The Himalayan Times.
