Madrid, February 13, 2023-. In the same way that a cancer diagnosis has an impact on physical health, it can also affect the emotional health of patients and those around them. The most common reactions include feelings of anxiety, anguish and depression, and these emotions can change daily, hourly, or even by the minute. "To find out the emotional impact cancer has on a person, we take into account the way it interrupts their routines and life plans and then we can measure the psychological impact and the intervention they need," says Maribel Gonzalez, psycho-oncologist at MD Anderson
The impact may be greater in young people. In psycho-oncology we can differentiate the young adult, from 19 to 30 years of age, and the mature adult, up to 45 years of age.
The young adult goes through a stage when they begin to have a certain degree of autonomy and begin to make their life plans. The educational stage of their life comes to an end, and they begin to spend their time and energy on professional development, and that could all be interrupted by illness. "In adolescence, relationships with our peers are very important, but at the adult stage relationships with others in the couple aspect begin," explains the psycho-oncologist. “Intimate relationships and the development of sexual identity, still under construction, is what will be most put on hold and will cause the greatest impact.”
Sexuality, autonomy, fertility and body image have a huge impact on the young cancer patient
If we take into account the types of cancer that are most common at this stage, we see these are Hodgkin’s lymphoma, brain cancer or leukemia, among others1. But if we look at the frequency of cancer based on the sex of the patient, in women the most common is breast cancer and in men, testicular cancer.
All of this is closely related to the sexuality of the patient. Both the disease and its treatment can directly affect the sexual organs, and the patient’s body image. “This is going to influence the way I show myself to others and build my intimacy and relationships. Perhaps these are the things that we work most on and are what patients want most”, states Ms. Gonzalez.
Fertility is also something that many cancer processes have a direct impact on. There are some types of cancer, and, above all, many treatments used to fight them, which directly affect fertility, and that is an important cause for concern and anguish in the young patient who includes becoming a parent in their life project.
Body image plays another important role in these processes, not only due to the mutilations or scars caused by some surgical procedures cancer patients must undergo, but also due to the treatments and their side effects, like hair loss, premature aging or weight changes, which can affect the confidence with which we face relationships with others or sexual intimacy.
In addition, a young person’s autonomy is often affected by cancer and cancer treatments. That has a substantial impact since, while ill, the patient may become more dependent on others again. "Everything you have gained and learned about independence may be lost," the psycho-oncologist warns.
Helping a young patient cope with the emotional chaos caused by a cancer diagnosis
The most common psychological symptoms are anxiety and depression, which do not always lead to a clinical diagnosis, but it is important to work on these aspects. Emotions like anger, sadness, guilt, or problems with sleep or appetite are typical of a cancer diagnosis. In that regard, the family of the cancer patient has a fundamental role, "we psycho-oncologists usually say that cancer is a family disease because, after all, it is a scenario in which not only the patient is affected, but everyone around them too.”
Psychological intervention is always tailored to the patient’s needs, taking into consideration the phase they are in (diagnosis, treatment, if there has been metastasis, etc.). "When the diagnosis is recent, there is a lot of emotional chaos, a lot of feelings we do not know how to handle and the patient feels lost, and that is where our work focuses on psychoeducation, to explain to the patient that what is happening to them is normal," says Ms. Gonzalez. Helping to guide the patient through that initial chaos is essential and working with them to focus on what they can control during the process, such as self-care, taking care of their diet, exercise, time or personal relationships.
Be careful with the models of perfection on social networks
Cancer is one of the diseases that circulates most on social networks because it is so common. Making the disease visible can help, but there are certain risks associated with this public exposure. The patient can lose control and other spectators who are also ill can get frustrated with the stories of others.
“Exposing experiences and situations on social networks is positive, but it must be looked at carefully and worked on with patients. We must be careful because that can lead us to hold the patient responsible”, states the specialist. According to Ms. Gonzalez, there is no scientific evidence that a positive or negative attitude is related to the development of cancer or the prognosis, and "sometimes, this type of message gives the impression that attitude can affect the outcome and that can cause confusion." In these coping models where everything focuses on the positive, it seems that there is no room for "giving yourself permission to feel sadness, anger or guilt, or to feel frustrated at times, and that must be validated, because only from a point of view of acceptance and normalization will we be able to work on overcoming things”, says the expert.