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The Psychology of Cancer 

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How we can minimise our chances of developing cancer, and maximise our chances of survival if we do. 

Almost half of all people with cancer experience depression and or anxiety. Their close friends and relatives are also affected similarly. The suicide rate for people diagnosed with cancer is higher than for the rest of the population. 

Not all cancer diagnoses are the same. For example, around 70% of men die with prostate cancer but not of it. Some cancers are benign or low risk. Others are malignant, fast growing and rapidly metastasise. 

Not all people receiving such a cancer diagnosis are the same. A few stoics, accept a terminal diagnosis with grace, set about ensuring all is in order, and make the best of what time they have left. Others are rendered unable to function by the trauma of the diagnosis.

How each person responds to a cancer diagnosis will depend on many factors: age, prior acceptance of mortality, outlook on life, lifestyle, family network and support, economic situation, the type of cancer and prognosis, the treatment options. Indeed, just about any human variable could impact the way a person responds to the words few want to hear. 

Alas, around 45–50% of us will hear those unwelcome words in our lifetime.

Communication of, and about the diagnosis, is massively important. If it is the worst possible diagnosis, many people, upon being told that news, probably don’t process much beyond the confirmation or their worst fears. For many, it may be days or weeks after the diagnosis before they can have a meaningful conversation about the implications and options. 

Even after the diagnosis and meaning is understood, many people are reluctant to talk about their emotional distress (anxiety, depression…) with their health carers, because they don’t want to distract the carers from the treatment. Recent studies found that a very large percentage (upwards of 70%) of cancer patients who had developed mental health problems were receiving no treatment for the mental health challenges brought on by the diagnosis. 

Some cancer patients conceal their emotions because they don’t want to distress family and friends, either. When people can’t speak to their carers, friends or family, being a cancer patient can be the loneliest place on earth. 

Most people in western cultures find it difficult to talk about death and dying. Few have accepted their own mortality, as anything other than an abstract notion. When confronted with a dying friend or relative wanting to talk, most people are in no position to do so, because of their own emotional issues. Many people who receive a cancer diagnosis find that friends ‘offer help’ and then promptly keep their distance. It is too painful for them to deal with; staying at distance is the easiest coping strategy. Stories of cancer patients seeing friends crossing the street to avoid having to talk are common.

Cancer confronts friends and relatives with their own mortality, and the person with cancer symbolises that. Few  people want to be near such a reminder. Those few who have reached emotional maturity, and have really accepted our universal mortality, are more likely to understand and empathise with someone who has a cancer diagnosis – the helplessness, the fear, the anxiety, the depression that follow in so many cases. All of those emotions are entirely rational and normal responses to the most difficult of circumstances. 

What can you do to help? Listen, really listen, let the person talk if they want to, sit in silence if they wish. 

It would be a person of unusual disposition who would not be traumatised by a serious cancer diagnosis. Remaining traumatised, depressed or anxious is entirely understandable, but counter productive. Our immune systems are suppressed by many forms of mental distress, and with cancer present in the body, the immune system needs to be fighting fit. That reinforces the need for the mental health effects of cancer to be addressed ASAP.

Many people, after they have come to terms with their imminent demise, want a dignified death. It appears that many cancer patient suicides are motivated to ensure that the time, place and means of their death is both within their control, and as dignified as possible. If they have previously seen relatives die of cancer, in horrible ways, perhaps their motivation for a controlled and graceful exit is higher.

Whether a cancer is survivable or not, mental health support makes a huge difference. Having strong support for the mental health impact of a cancer diagnosis is massively effective at reducing recurrence; patients who receive proper support are around 50%+ less likely to have a relapse. And where the cancer is not survivable, those patients who receive effective support live, on average, around 18 months longer. 

Over the last few decades, the understanding of the causes of cancer has increased. It is now thought that the vast majority (around 90%) of cancers are caused by factors other than genetics. That is, most are caused environmentally and or behaviourally.

What does that mean? If we make safe choices about how we live, we can dramatically reduce our chances of developing cancer. Alcohol is associated with around 4% to 9% of all cancers, and the more someone consumes the higher their risk of alcohol induced cancer. One of the mechanisms is: alcohol is metabolised, in the liver, into acetaldehyde, which is a known carcinogen.

There can be few people who are not aware that smoking causes cancer, in vast numbers, every day. Fewer people will know that the more meat a person consumes the higher their chances of developing cancer. Similarly, those who do not eat fruit and vegetables regularly have a higher risk of cancer, as are those who do not exercise regularly. Keeping our weight within safe limits also reduces our personal risk.

Armed with such knowledge we can make choices that increase our quality and quantity of life. If we do develop cancer, adopting healthy behaviours increases our chances of survival, and the duration of our survival.

Here are the big five tips to reduce the chances of developing cancer and increase our chances of survival if we do:

  • Eat five or more fruit and vegetables each day.
  • Avoid smoking and any other lung contaminants.
  • Avoid alcohol and any other carcinogenic chemicals.
  • Keep your weight within healthy limits.
  • Exercise regularly, but not to the point where the exercise presents a risk. 

Professor Nigel MacLennan runs the performance coaching practice PsyPerform.


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