Surviving cancer: The psychological challenges, from the Harvard Mental Health Letter

Surviving cancer is generally a cause for celebration. Yet some cancer survivors struggle with symptoms of depression, anxiety, and post-traumatic stress disorder. These problems are often significant enough to cause suffering and disrupt lives, sometimes for years, reports the December 2008 issue of the Harvard Mental Health Letter.

The psychological terrain of survivorship has ups and downs. The most difficult times occur during transitions, particularly the period immediately following the completion of intensive (primary) cancer treatment. Individuals may feel they are losing the support system and structure provided by regular contact with an oncology team and fellow patients undergoing similar treatments. Friends and family may not fully appreciate what a loved one has gone through and expect that he or she will return to “normal.” But cancer survivors typically feel more vulnerable, anxious, and uncertain about the future after treatment ends.

Cancer survivors contend with several ongoing psychosocial issues, notes Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter:

Fear of recurrence. Although this tends to subside with time, events such as follow-up medical visits and unexplained pain can trigger bouts of anxiety and fear.

Fatigue. One of the most common legacies of cancer treatment is a persistent lack of energy. This remains poorly understood. A general guideline is that for every month of cancer treatment, it will take a month to recover previous energy levels.

Stress responses. Long-term effects of dealing with the stress of cancer can include difficulty sleeping and concentrating, physical symptoms such as heart palpitations, and fearfulness or hypervigilance.

Cognitive changes. Problems with attention, concentration, and memory—sometimes referred to as “chemo brain”—may persist for months after chemotherapy ends.