Psychosocial Effects of How Cancer Affects Families and Their Mental Health

In 2019, it is estimated that over 40,000 women will die from breast cancer in the United States alone and 1 in 8 women will develop breast cancer over her lifetime (National Breast Cancer Foundation, 2019). Cancer is an illness that affects everyone, and has a psychosocial effect on the patient, and those around the patient as well. Usually the focus of breast cancer is mainly on the physical burdens of the disease and sometimes the psychosocial factors that come along with diagnosis, treatment and remission of the disease; but not always show emphasis on how these can impact mental health.

Understanding how a chronic illness affects a patient’s overall mental health and wellbeing is crucial. Psychosocial is defined as: the mental, emotional, social and spiritual effects of a disease, which in this case, the disease is breast cancer. Psychosocial factors can impact mental health so it is important to understand some of the psychosocial effects of breast cancer, as it can affect the progression and outcome of disease (Shapiro et al.

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2001). The focus of this paper will be on the following psychosocial factors: self esteem, alterations to hormone and stress levels, which affects the overall quality of life and lastly, changes in emotions, and mood which are often negative ones.

Once again, these psychosocial factors affect not only the patient but the relationships surrounding the patient. Cancer can affect a woman’s coping ways and creates concerns and worries about body image and sexuality. It can also lead to feelings of depression, anxiety and worry, which all affects social interaction, and interpersonal relationships, and oftentimes the focus is mainly on the physical effects of breast cancer may bring so it would be interesting to analyze the literature on how these different psychosocial effects of breast cancer can affect mental health and increase the likeness of developing a mental illness such as depression and anxiety.

Breast cancer affects body image, sexuality and overall self-esteem of a woman, this can lead to psychological distress, and depressive symptoms and decrease overall mental health. Studies show that body image is a major post-treatment concern for breast cancer survivors (Paterson C et al., 2016). Poor body image has been linked to overall more distress in these women and has also been associated with greater risk for depression and lower quality of life (Begovic-Juhant A, Chmielewski A, Iwuagwu S & Chapman L., 2012). With breast cancer, there are procedures that often take place such as mastectomy, chemotherapy and radiation. These procedures cause major alterations to a woman’s body. For instance, chemotherapy has several side effects, some which include hair loss, fatigue, weight changes, lower sex drive (American Cancer Society, 2016). Also, if a woman is put on menopause after diagnosis there can be effects on fertility (Oktay, 1998), effects on fertility can play a major role in a woman’s self-worth feelings and negatively affect marital relationships. These different changes affect the femine aspects of a woman which lowers self-esteem and increase stress levels (Oktay, 1998). Women will often have lower self- esteem and this is partially due to our society today idolizing how a woman should look. This not only has an affect on the woman, but it affects social relationships and once again, romantic relationships as well. Understanding how breast cancer affects body image and self-esteem will allow for better education and awareness for support system of patients who are currently going through cancer and/or are survivors of breast cancer.

Educating and bringing awareness to caregivers and patients about risks of depressive symptoms due to self-esteem and body image can go a long way. Supporting patients and their caregivers and guiding them to find support groups, start therapy can overall improve their mood, and coping mechanism. There is no way to stop some of the negative effects but with the right resources and health professionals measures can be taken so there is not a drastic effect on mental health and therefore it will cause distress but not take a mental toll over the course of the treatment and remission. Lower self-esteem also causes major distress, and can increase depressive symptoms during and post-treatment. These alterations in mood and emotions can have a negative effect on a woman’s mental health.

Breast cancer plays a major role in psychological health as previously seen, and besides self-esteem due to body images; breast cancer also causes alterations to hormones, and mood. In an observational cohort study, nearly half of the women with early breast cancer developed depression, anxiety or both in the first year (Burgess C et al., 2005). Breast cancer can cause women to become depressed and anxious due to the changes in hormones, mood and stress levels, which all also alters emotions. After diagnosis of breast cancer, stress levels are likely to increase and if pressistent will have a negative affect on physical health, as well as increase chances of developing depression, anxiety, and psychological distress (DeLongis, Folkman, & Lazurus, 1998). This stress can also affect the immune’s response in postsurgical breast cancer woman (Andersen et al., 1989). Stress as learned has major health outcomes and it is important for women undergoing breast cancer treatment to not be overstressed as it can increase chances of psychological distress, as this stress may show up as anxiety or depression (Baqutayan S. M., 2012), so it is important to attempt to control these stressor and the stress levels that may occur.

However, even with controlled stress levels, another important issue to recognize is the anxiety that comes along due to fear even after treatment is completed. Cancer is a disease that causes the body to attack itself, and this brings fear and anxiety to patients and their families (Baqutayan S. M., 2012), which often leads them to feel anxious to find a “cure”. Anxiety is only of the most prevalent psychological symptoms perceived in breast cancer patients (Takahashi T, et al., 2008), and persistent and prolonged anxiety can trigger feelings of depression and helplessness. Cancer patients are likely to experience anxiety like feelings, such as feelings of uncertainty, worry especially after diagnosis and during treatment. There is also a fear of recurrence which is a major trigger for anxiety. A study showed that 77% of patients within 2 years of treatment recalled experiencing some anxiety (Ashbury et al., 1998). This can be due to numerous reasons but it becomes a major issue when it has a negative affect on daily function (Baqutayan S. M., 2012), this is when it may be an anxiety disorder.

Cancer patients will face some stressors and distress throughout their treatment course, and even after. Developing a coping strategy can elevate these anxious feelings and decrease the chances of it affecting mental health. It is crucial for cancer patients to develop good coping mechanisms because it can help with the anxiety related symptoms (Reuter et al, 2006). Thus, developing a plan with a therapist or psychologist can be very beneficial to breast cancer patients.

Anxiety may also trigger depressive symptoms but even if it does not, women are still likely to feel major distress and increase feelings of anger and hostility (Jamison, Wellish, & Pasnau, 1978), which can lead to depressive emotions and negatively affect relationships. This can be due to hormonal changes in the body, and the different surgical procedures women go through depending on stage of breast cancer. Studies also show that major depression and depressive symptoms, are commonly encountered in patients with medical illnesses and frequently underdiagnosed and undertreated in women with breast cancer (Somerset W, Stout S, Miller H & Musselman D, 2004), which illustrates how the changes that comes along with a chronic illness like breast may be associated with greater risk for depression. Breast cancer patients are likely to encounter feelings of hopelessness and loss of control which can cause deep psychological distress, as well as those surrounding the patients. Studies have also shown that hopelessness can increase the risk of relapse and death (Watson, Haviland, Greer, Davidson, & Bliss, 1999).

However, the studies also show that the risk of these emotions and feelings causing depression and anxiety, depends on the risk factors. For instance, younger age, lack of social support, and previous psychological problems will cause greater risk of these altered negative feelings and distress to linger (Burgess C et al., 2005). Thus, it can be stated that although breast cancer brings great distress and alters hormones, mood and stress, it does not mean all women with breast cancer will develop depression, as data shows, but it is important to study and know how to lower these negative emotions to bring overall a better quality of life and a barrier for the chances of developing depression and/or anxiety.

Although breast cancer brings major psychological toll in women’s lives and affects their stress levels, mood and emotions, there are some ways to lower the risk of developing depression in the long run. Healthcare professionals should focus on advising women going through breast cancer to also attend therapy, to join support groups and even practice mindfulness. A study illustrated how optimism has also predicted lower distress in many populations (Scheier et al., 2001), including breast cancer patients, thus educating women on these different traits and mindfulness can go a long way. Again, there are interventions in place that can be used to combat these issues. For instance, individual psychosocial support, psychological therapy, support group and cognitive-behavioral stress management can be very beneficial to women and even to surrounding support systems such as family and marital relationships (Reich M, Lesur A, & Perdrizet-Chevallier C., 2007). Maintaining a strong mental health improves treatment outcomes, and having a healthy support system that is aware of the risks and psychological downfalls of breast cancer will also bring a sense of hopefulness and thus, stronger mental health status.

As it has been mentioned throughout the paper, a women’s mental health is affected throughout her journey after diagnosis of breast cancer, and this chronic disease does not only affect the patient, but those surrounding the patient. Lack of social support decreases survival chances in patients with breast cancer (Reynolds & Kaplan, 1990). Therefore, it is key to have a strong social support group during the entire process, treatment and even after to assure and support patients with breast cancer. Often times, women undergoing cancer treatment will feel alone, and even sometimes isolate themselves from friends and even family. Identifying and helping patients deal with their emotions, and depressive symptoms is key to survivorship. Patients and their ies should seek mental health professionals to find a treatment route that best fits their needs (Legacy Community Health), but it is also important to understand how crucial it is to have a strong support system to reassure and support women in treatment. This is linked to better overall outcomes for survival rate of cancer.