King Charles – Let’s talk about Cancer and Mental Health – written by Chris Graham (views expressed employees own)
*Trigger Warning this article discusses cancer and feelings it may provoke, this may be triggering for certain people and contains sensitive subject matter.
“I dimly heard the doctor say you have a one in ten chance of surviving. I felt numbness tingle across my mind. It took me one and a half years before I could take it in emotionally.” King Charles has been diagnosed with a form of cancer.
The British public wasn’t told that Charles’ grandfather, King George VI, had lung cancer before his death in February 1952 at the age of 56. For King Charles, the type of cancer has not been revealed but he broke centuries of royal tradition by disclosing his cancer diagnosis. This has led to worldwide speculation as to how the U.K. royal family are going to cope emotionally. The emotional response to a cancer diagnosis can impact your prognosis and longevity. King Charles by revealing he has cancer, has opened the gates of talking about cancer and how it can affect your Mental Health.
Feeling overwhelmed and out of control is common when you first have been hit with the realisation you have cancer living inside you. An internal foreign “poison” threatening your existence. You might disbelieve and ask, ‘why me?’ What will the impact might be on my family ? Simmering underneath, for some, is the smouldering resentment you feel towards your healthy friends.
The appearance of cancer is loss: intense grief. It’s like being attacked by a malevolent all-powerful being whose sole intention is to destroy you. Throughout each day, you are experiencing rolling grief waves of uncertainty. Your GP and your hospital consultant cannot give the details you demand of them of your diagnosis. At this moment in time, you find it intolerable that your medical team find it impossible to predict how your body will respond to treatment. This is a clear indication you are not coping well with the knowledge you have cancer. Uncertainty can be one of the hardest emotions to deal with. Feeling that we have some control over our lives makes us feel secure. Doctors may know the statistics for how many people will benefit from a treatment, but they cannot predict how it will uniquely affect you. You are unsure what their answers mean, so you shut down and block it out of your mind. You are not coping if you do not focus on that one in ten likelihoods of dying means nine chances of surviving and living.
Three in five people find the Mental Health emotional challenge of cancer is much harder to cope with than the physical consequences. The risk of suicide among people with cancer is higher than the general population especially in the first 6 months after diagnosis. It is estimated that up to one-third of people treated for cancer in hospitals have a diagnosable Mental Health condition.
Many people with cancer experience, say they get plenty of medical support for the physical body impact of cancer but little support for the emotional effects on their mind. Those that cope well, quickly accept the existence of cancer as part of them but also know that can get through this and live. Cancer survivors who are getting Mental Health support from their family, friends and work colleagues, often experience improvement in their overall medical condition and are more likely to follow through the medical care needed and have a better quality of life.
The experience of being diagnosed, particularly if the diagnosis has been delayed, can be a significant source of overwhelming distress that triggers anxiety and depression. More than two thirds of people with cancer experience low mood, sleeplessness and hard to control worry. Overthinking worry thoughts around a cancer diagnosis can disrupt healthy sleep patterns, which increases the risk of depression. Anywhere from 8% to 24% of people living with cancer are also living with depression. Depression tends to be highest during the initial diagnosis phase and decreases following treatment.
Fear of recurrence is an important unmet Mental Health need for cancer survivors. Recurrent fear feeling become much stronger post-treatment. 82% of people with cancer, live their daily lives with the dread of the fear of cancer returning. They may be hiding their feelings of low mood. Having that Mental Health conversation about their cancer can be for some, an emotional life saver.
Your hope to survive cancer (mental health recovery) depends on the stage of the cancer, when it was diagnosed.
- Stage 1 means the cancer is small and only in one area. This is also called early-stage cancer.
- Stage 2 and 3 mean the cancer is larger and has grown into nearby tissues or lymph nodes.
- Stage 4 means the cancer has spread to other parts of your body. How big it is and whether it has spread affects your Mental Health.
The type of cancer can also affect your survival hope. The type means which type of cell the cancer started from. To emotionally support a person with cancer means knowing a little bit about the type of cancer they have. Let’s take a deeper dive.
Lung cancer starts in the windpipe, the main airway or the lung tissue. 45% of people with lung cancer, survive for 1 year or more. Lung cancer can lead to feelings of personal guilt or public shame, which could contribute to the onset of depression. The link between smoking and lung cancer can lead to some, blaming themselves for their illness or others privately judge: “they only have themselves to blame”.
“When I first received a lung cancer diagnosis it felt so isolating. All of a sudden, I am in this new harsh reality: nothing makes any sense. My thoughts are whirling around my head… “Why me, and what did I do?” I knew I had to fight this so I could watch my boys grow up. That’s when I became determined to breathe easy and fight hard. Just keep yourself alive as long as possible so that you can benefit from the discoveries being made in the lung cancer research every single day”.
Prostate cancer is cancer of the prostate gland, when abnormal cells start to divide and grow in an uncontrolled way. Prostate cancer usually develops slowly, so there may be no signs for many years. Many men with prostate cancer will have signs of anxiety at some point. It could be during their diagnosis, treatment or after treatment. Anxiety is often triggered by repetitive uncontrolled worry thoughts about appointments, treatment side effects and living with those side effects. If you have urinary problems after treatment, you may feel anxious in public places. People with prostate cancer anxiety tends to be highest pre-treatment but less so during treatment and post-treatment. Some treatments for prostate cancer, such as hormone therapy and chemotherapy, can also increase your risk of depression.
“I was 42 and had no symptoms at all when I was diagnosed with prostate cancer. I had recently lost my father to the disease, that spurred me on to visit the GP who said the test will only takes 10 minutes. Little did I know that those 10 minutes of time was going to change the rest of my life. I did the test, then a further one two weeks later. I was asked to come in for a biopsy, followed by a scan. My doctor then sat me down and said my prostate was covered in cancer. I ran out of the room and sat in the car and I think the word ‘cancer’ hit me then. I just burst into tears. Cancer knocked me down but it did not knock me out. Fortunately, my cancer was picked up early.”
Breast cancer is when abnormal breast cells grow out of control and form tumours. The earliest form is not life-threatening but cancer cells can spread into nearby breast tissue, creating tumours that cause lumps or thickening. Depression in women with breast cancer can persist for over 5 years. Eight in ten with breast cancer was not told about possible impact on their Mental Health. A survey carried out by Breast Cancer Care, revealed that one in three experienced clinical anxiety for the first time in their lives after their diagnosis and treatment. Almost half experience continuous fear that the cancer may return. 8% have a panic attack for the first time.
“My last hospital appointment felt like a huge anti-climax. I’d been so caught up in the whirlwind of treatment, I didn’t anticipate how hard moving forward would be. I felt isolated from my friends, watching from the sidelines as they all got on with their careers and relationships. I completely stopped trusting my body and lived in fear of there being something wrong with me. To this day, there’s always a worry festering in the back of my mind about the cancer coming back”.
A fifth of women with breast cancer experience feeling isolated from their friends and work colleagues after their hospital treatment ends, with three quarters more socially isolated than they were at diagnosis, one in ten women, after finishing breast cancer hospital treatment. Of these, over one in three say it’s because they do not want to speak to other people, over one in four are too self-conscious about changes to their appearance.
Think of your body image three ways:
- the way you perceive how your body looks:
- how attractive you feel
- how attractive you think others find you.
The way you feel about your body image can affect your self-esteem. Some women talk of their body having let them down, feeling that they have no confidence in their body anymore.
“I feel OK about my body when I have clothes on but feel self-conscious about the changes when I don’t have clothes on. I was glad to get rid of the tumour. I didn’t realise that a lumpectomy would change the shape of my breast as it has done.’ When I went to a lingerie shop there was a beautiful set of cream lace lingerie. I felt ashamed to be looking at it and I still feel a sick lump in the pit of my stomach that someone like me could look at it.’
Stomach (gastric) cancer is cancer that starts in the cells lining the stomach. About 6 of every 10 people diagnosed with stomach cancer each year, are 65 or older. The lifetime risk of developing stomach cancer is higher in men. More than 3 in 20 people diagnosed with stomach cancer in England survive their cancer for ten years or more.
“I began having difficulty swallowing. Food like bread would stick in my throat. I was diagnosed with stage four oesophageal cancer. The rollercoaster ride began… scans, appointments, tests and signing forms: one had nine pages of chemotherapy side effects. There was no time to absorb new information in between appointments, everything went so fast. I had surgery and I was out of hospital after just seven days. Now, I needed to recover from the chemotherapy and get back to work. Then a biopsy result came back positive. I broke down into tears, thinking of my family. Surgery was tough. My whole stomach was removed. Getting used to life without a stomach was hard. I felt sick, living off pureed food for a long time. My cancer was caught early enough to be treatable and hadn’t travelled. It hasn’t limited my life, but it has altered it. To survive cancer means being resilient, fundamentally changing who you are and accepting enormous body function changes”
A brain tumour is a growth of cells in the brain that multiplies in an abnormal, uncontrollable way. In the UK, 16,000 people each year are diagnosed. 12% of brain tumour patients survive beyond five years of their diagnosis. Brain tumours kill more men under 70 than prostate cancer and more women under 35 than breast cancer. Cancer affects your income and expenditure. Brain tumour patients are on average £14,783 worse off per year, whereas for all cancers the average cost is £6,840 per year
“He looks solemn as he tells me I have a large brain tumour growing on my right temporal lobe. I was absolutely petrified. The next 24 hours were sheer terror. The next day, he is smiling, quick to tell me that although the tumour is large, it is operable, low grade and slow growing. I felt hope. He can operate and will “debulk” a large proportion of the tumour. After surgery I was out on my bike 4 weeks later. Something happened. I went from crying my eyes out to believing that I could do anything if I put my mind to it. This didn’t come out of nowhere; I got some hope. The part I struggled with post treatment, was that there was still something up there in my head. Other types of cancer get to ring a bell and get the ‘all clear’, but I didn’t. I had a lightbulb moment; it didn’t matter if there was something still up there. What mattered was my belief, my thoughts and actions on a daily basis, being positive, having fun and living life. The more you live your life, the more you live.”
Bowel cancer can start in the large bowel (colon cancer) or back passage (rectal cancer). Bowel cancer is the fourth most common cancer in the UK and the second biggest cancer killer. Nearly 43,000 people are diagnosed with bowel cancer every year in the UK. Around 268,000 people living in the UK today have been diagnosed with bowel cancer
“I was posted the screening kit. I have it done many times before. The result that came back was not good. My first thought was why me? I’m not overweight. I eat a sensible diet and exercise at my local leisure centre five times a week. The next month went in a total whirl. I had a colonoscopy, blood tests, fitness tests ending with an operation to remove the cancer. The operation went very well. When you have a colostomy or ileostomy the end of your bowel is brought out into an opening on your abdomen. The opening is called a stoma. My bottom had moved to an unfamiliar place”
Many people worry about how they will look and worry about how other people react and judge them. If you have a stoma, you may have strong negative feelings about the sudden and significant change to your body. You may worry that other people can see the pouch through your clothes. Over time, and with support you learn to adapt to your new body.
Some people see their cancer as a “wake-up call.” They realise the importance of enjoying the little things in life. They go places they’ve never been. They finish projects they had started but put aside. They spend more time with friends and family. They mend broken relationships.
Doing something new and different may help you feel better and more in control. I live in Bowness on Solway, it is the end of Hadrian’s walk, many do the walk to celebrate their cancer experience.
