Importance of mental and physical well-being with post therapy recovery among cancer patients
The diagnosis of cancer is on the rise globally. With more and more effective therapies, many cancers,
when diagnosed early, are being considered as “curable”. Despite a good prognosis, cancer survivors face many unique challenges during recovery and thereafter. Both short-term and long-term challenges to physical and mental health, family functioning, and maintenance of a healthy lifestyle are paramount in their overall recovery process. The diagnosis and treatment effects can last throughout a person’s lifetime. Most cancer survivors need close monitoring to look for any signs of either recurrence or the development of new cancers. Therefore cancer is considered a chronic condition and remaining healthy both physically and mentally can provide a good quality of life.
Physically, different cancer treatments will lead to concerns including fatigue, sleep disturbances, pain, nausea and/or vomiting, diarrhea, neuropathy, skin rashes, loss of appetite, joint pains, muscle pains, swelling of limbs (lymphedema), and/or impaired sexual functioning. These symptoms can impact cancer survivors’ quality of life significantly. These symptoms will, however, depend on the type of cancer and staging, the kind of treatments endured, the prognosis, patient’s age and previous medical conditions, if any.
Mental health and well-being for cancer survivors was not given much importance till two decades ago. However, as with other chronic illnesses, the mental health and well-being is being given its due importance. Research has indicated that cancer survivors are twice as likely to suffer poor mental health compared to those without cancer, and the risk increases to 6 times in the presence of other chronic illnesses. Anxiety and depressive symptoms including emotional, social, occupational and financial stress is common especially in the first 1–3 years after treatment.
Early post-treatment period includes “fighting cancer” to surveillance, and recovery, but also includes fear of recurrence, resumption or alteration of life roles – job and family life
Better adjustments have been observed with older age, being married or having a significant other to share the stress with, greater optimism, greater self-efficiency, better social support, less rigorous or no chemotherapy, less pain and less intrusion of illness on daily life. The field of psychosocial oncology includes the diagnosis and management of psychological, social, and behavioral dimensions of cancer.
Currently, the American Society of Clinical Oncology (ASCO) has guidelines and recommendations for the screening, assessment, and treatment of anxiety and depressive symptoms in adults with cancer. These address symptom screening, screening tools and follow-up care for depression and/or anxiety. Another interesting finding that has been noted is that involvement in spiritual/religious activities enhances mental and physical health, coping with illness and medical outcomes.
Timely identification and treatment of mental health concerns can greatly improve both the mental and physical health of cancer survivors and annual mental health screening using the ASCO guideline is strongly recommended. Liaisons with social workers or special patient mentors who can identify appropriate symptoms and improve patients’ mental health status are important in order to maintain continuing optimal physical health in cancer survivors.