Medical advances have empowered patients to survive cancer and chronic illness decades beyond what was previously possible. As a result of medical advances the purpose of treatment is no longer limited to surviving alone. Rather, the goal is to survive, thrive and to live a deeply fulfilling life thereafter. Even if there isn’t a complete cure. Even if there is a chance that the illness or disease could come back or get worse. What is known from the current research is that factors that lead to a better quality of life often lead to a longer, healthier life as well.
What does this translate to in medicine?Focus on thriving in survivorship has supported funding for mental health professionals to take on increasingly active roles as members of, or adjuncts to, medical treatment teams; emphasized the importance of addressing combined physical, psychological, and relational challenges; and inspired individuals managing cancer and chronic illness to overcome challenges that detract from their quality of life. In hospitals and medical settings mental health may also be referred to as behavioral health, psychiatry, social work, neurology, or other titles depending on the circumstance. Patients should feel encouraged to ask questions about the kinds of mental health professional they may work with and the services they provide.
Are mental health professionals only helpful for patients who have mental health issues? Patients wonder if a mental health professional can only help them if there are mental health issues. The answer is: Not at all! Most patients who talk with mental health professionals who are part of their treatment team do not have a history of serious mental health issues.
The moment that someone is diagnosed with cancer or chronic illness quite a bit changes. Decisions must be made about treatment without any finite certainty about what the outcome will look like. Treatment then brings on a cascade of changes that may range from mild to severe or last for days, months, or years. Inevitably, the consequences of cancer and chronic illness have the potential to affect patients physically, emotionally, and spiritually. These consequences may influence how people experience themselves and their relationships. The role of mental health professionals is to support patients to cope with and overcome the many and complex potential challenges that anyone managing cancer and chronic illness could face. Mental health professionals in medical settings typically meet with patients during a single 15 to 30 minute meeting, for a brief series of meetings, or over the course of several weeks for the purpose of short-term therapy.
What kinds of topics do psychologists and other mental health professionals typically address related to cancer and chronic illness? Psychologists, andothermental health professionals, are there to support and equip patients to work through experiences such as worry and sadness, pain, and physical, relationship, or sexual changes. Mental health professionals may also provide resources for patients to seek out on their own, such as reading and educational materials. As indicated, issues that cannot be addressed in the context of medical treatment may warrant a referral for a longer term or specialized psychologist or mental health provider.
Anyone managing cancer or chronic illness may feel anxious worried, or sad at times. Sometimes intense fear leads patients to avoid the things that bring up these feelings such as medical appointments, scans and tests. Avoidance can lead to serious consequences as a result of not receiving treatment or delayed detection of illness related changes or recurrence. Similarly, even the most determined patients may feel overwhelmed at times by everything that comes with managing cancer and chronic illness. While help from a psychologist will not take the worry or sadness away, the help may provide strategies that make things feel more manageable.
Pain. Even if pain is physical in nature, our mind plays a powerful role in how we experience pain. In order for us to experience pain a signal must be sent from a sensory receptor (i.e., a pain receptor or nociceptor) to our spinal cord, which sends the signal to the brain, where the brain translates the signal to a message that our mind can interpret. Think of the mind as the “gateway” to pain. Individuals have a say in how much or how little pain they let into their conscious experience through either opening or closing the mental gateway. Psychologists may be able to provide information, strategies, or tools to help manage pain in conjunction with the medical treatment a patient may receive.
Physical changes. Cancer and chronic illness may lead to physical changes that alter appearance, the physical experience of one’s body, or limit movement, mobility, and physical activity. Psychologists may provide tools to cope with and manage these physical changes.
Relationship changes. What affects one person is likely to also affect relationships in some way, whether with family, an intimate partner, or with other relationships. Psychologists may be able to provide a platform to talk about relationship changes and provide recommendations for additional resources or a referral to a therapist specialized in relationship therapy (also described as couples or marriage therapy) if needed.
Sexual changes. A number of health conditions have been linked to sexual changes including, and not limited to, cancers, diabetes, stroke and other cardiac illness, arthritis, enlarged prostate, bladder problems and incontinence, brain disorders, depression and anxiety. Just like physical, emotional, and relational health, our sexual health may have a substantial impact on our quality of life, sense of well-being, and overall ability to thrive. Mental health professionals may be able to provide information about sexual changes, recommendations for managing those changes, or a referral to a sex therapist or educator if needed.
The take-away. Overcoming cancer and chronic illness is about more than surviving—it’s about thriving and getting the most out of the life you live.Advances in research and opportunities to work with psychologists both during and adjunct to medical treatment may offer useful perspectives and tools to help in the journey.
Alishia Kalos, PsyD, CST, is an individual, relationship, and AASECT certified sex therapist in private practice and with the Council for Relationships in Philadelphia.
