Experts say the unexpected diagnosis of cancer and the unknown factors that come with it can cause fear, potentially resulting in depression and harmful anxiety. Patients may experience feelings of hopelessness, despair, failure, and grief as their opportunity for a lengthy and healthy life is jeopardised.

By Ndivhuwo Mukwevho

Nomsa Tshingowe’s first thought after doctors told her she could have cancer was to end her life.

Tshingowe was just 23 years old and had landed a job as a social worker when she found out she had Osteosarcoma, a type of bone cancer.

“As soon as I was told I might have cancer, my blood pressure was uncontrollable, and I was treated. At some point, I thought of ending my life. I struggled to sleep and to eat. To be honest I was depressed. The worst part of all this was happening before the actual cancer diagnosis was made,” explains Tshingowe who is now 32.

Her reaction is not uncommon. The South African Society of Psychiatrists(SASOP) says more than 30% of cancer patients are diagnosed with depression. 

Cancer also causes fear, anxiety and grief

SASOP Specialist Psychiatrist Dr Michelle King says the mental health of cancer patients needs more attention. She says some people may go through a period of grief before being able to accept their diagnosis.

“The sudden nature in which the cancer is diagnosed, and the uncertainty associated with it can trigger fear which could lead to depression and maladaptive anxiety. Patients may feel hopeless, despair, a sense of failure and grief as their chance to a long and healthy life is under threat,” says Dr King.

Tshingowe’s experience echoes what Dr King says. “Throughout the entire journey, I was always scared, and anxious. I thought my life was ending. But I went through counselling during my second operation, and it helped me prepare for the worst.”

She ended up having to use a walking assistive device. “It became a sudden challenge and the fact that I had to use public transport to move from one place to another became a challenge on its own putting more strain on my mental well-being.” 

Now 32, the resident of Mulima Village in Limpopo, outside Louis Trichardt, has completely fought off cancer. She says the support she received from her family and friends, gave her the mental courage to fight cancer.

Cancer survivors also need support

Dr King agrees with Tshingowe’s sentiment when she says cancer survivors also need support as it’s one of the most difficult things any human being can experience.

Dr King says cancer survivors might alternate between disheartenment, isolation and fear, to times of hopefulness when returning from a successful follow-up screening.

The most recent statistics in South Africa indicate that 108 168 men and women were diagnosed with cancer in 2020. According to the World Health Organisation, the cancer burden continues to grow globally, exerting tremendous physical, emotional and financial strain on individuals, families, communities and the health system. 

Triple-negative breast cancer survivor, Mawisa Chauke, who was diagnosed with the disease in 2019 at the age of 30, had to deal with her anxiety, treatment and a toxic work environment. 

“I remember there were days when I would just break down and cry alone. I think the reason behind my mental breakdown was because I did not give myself enough time to digest the diagnosis since I had to focus on the healing part and everything was happening so fast,” explains Chauke.

Emotional and financial burden

She says that although she tried to remain positive, it was difficult and sometimes she thought she might not be able to fight off the disease.

“I would have some mixed emotions where I would even picture my death. But I used to gather courage from seeing my mom, who is a breast cancer survivor. I used to tell myself that if she made it, I can also make it,” says Chauke.

The mother of two, says she had to stay home for a year as she underwent treatment. But this caused a breakdown in the relationship with her manager. 

“I was on incapacity leave, but at one stage my ‘team leader’ instructed me to apply for a leave without pay and I refused which led to a bad working relationship. This put an added strain on my already drained mental health. At that moment when I was treated as if I did not exist at my work, I felt like I was going to lose my job,” says Chauke.

For the sake of her mental health, she resigned from her job, “I had to resign without a job due to the treatment I was receiving from work, just after recovering from cancer. I had to save myself and my mental health by quitting work,” she says.

Dr King says undiagnosed or untreated depression and anxiety can impact the patient’s ability to function daily, which can impact treatment.

“Undiagnosed depression and anxiety can impact the patient’s ability to cope emotionally. These conditions may also worsen physical symptoms such as pain and fatigue, impacting the quality of life relationships and daily functioning,” says Dr King.

This article was first published on health-e.org.za