Cancer has become much more treatable in recent years due to new advances in medicine that often lead to earlier detection and more effective options for treatment. However, a diagnosis of cancer is still likely to be frightening, and it often brings up a wide range of difficult emotions and may significantly impact many areas of a person's life. The support of a mental health professional may help one cope with the psychological impact of cancer and may be an important aspect of treatment for both those who have cancer and their loved ones.

How Do People Get Cancer?

One-third of American women and nearly half of all American men will develop cancer in their lifetime. According to the American Cancer Society, avoiding certain risk factors such as tobacco and alcohol, maintaining an active lifestyle, and eating a varied diet that includes plenty of fruits and vegetables may help reduce the likelihood of one developing cancer, but there is no known method to prevent cancer.

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This disease occurs when abnormal cells, or cells that have experienced damage to their DNA, grow out of control. Normal cells in the body grow, divide into new cells, and then die, but cancer cells do not die when they have been damaged. Instead they continue to grow, replicating the damage and sometimes invading other parts of the body. Typically, these cells grow together into a tumor, but some cancers affect blood cells instead and circulate through the bloodstream.

One cause of cancer is genetics. It may be more likely for an individual to develop a certain type of cancer if one or more close relatives also have that type of cancer. Certain gene mutations can also be passed down through families, causing many members of a family to develop the same type of cancer. This is called family cancer syndrome, and genetic testing may help those who are at risk for an inherited cancer to become more informed about their risk and develop future health care plans if necessary.

Although sometimes cancer has no discernable cause, exposure to a known carcinogen, or cancer-causing agent, often makes it more likely that a person will develop cancer. Some known carcinogens are tobacco, alcohol, asbestos, steroidal estrogens, soot, some types of dyes, and radiation. A poor diet that contains large amounts of processed food and lacks a variety of nutrients has also been shown to be a risk factor for cancer, as has a lack of physical activity. Consumption of alcohol, especially excessive consumption, has been shown to increase one's risk for several types of cancer, including cancers of the mouth, throat, pancreas, liver, colon, and breast.

Types of Cancer

The National Cancer Institute recognizes more than 100 types of cancer. Cancer can affect almost any part of the body but may do so in a variety of ways. Some cancers grow and spread more quickly than others, and some cancers may not be as serious as others, especially when detected early. Different types of cancer cells also respond to treatment differently, which means that treating cancer often requires multiple approaches toward treatment. Cancer treatment might include surgery, radiation therapy, chemotherapy, targeted therapy, and others.

All cancerous tumors are malignant: they can invade tissue in other parts of the body, forming new tumors as they spread, in a process called metastasis. Surgery to remove the tumor may be sufficient treatment in some cases, but not all tumors can be removed safely, and many cancers often require additional forms of treatment such as chemotherapy or radiation therapy. When cancerous tumors go undetected or untreated, they are very dangerous and are often likely to be fatal.

There is no cure for cancer. Many types of cancer are treatable, and partial and complete remission are both possible, but cancer may return at any time, a fact that may cause continued anxiety or worry even in those individuals who experience complete remission.

Counseling and Therapy for Cancer

A diagnosis of cancer is likely to be frightening and life-altering, especially if the diagnosed type of cancer grows quickly or has already spread to other parts of the body. A person diagnosed with an advanced stage of cancer may begin to think about and possibly fear the approaching end of life. Individual, family, and couples counselors can all provide support as a person attempts to better understand their diagnosis and come to terms with it.

Some counselors may be trained specially to help those diagnosed with cancer during their treatment. Oncology social workers, for example, have received specialized training to help people cope with the effects of a cancer diagnosis, and they typically provide counseling and education to those who have been diagnosed with cancer. Oncology social workers can also help individuals better understand the health care system and their options as they pursue treatment, which is often a source of stress for many with long-term illnesses such as cancer. 

Many doctors encourage their patients to seek out a therapist after a diagnosis of cancer. In counseling, many people are able to explore ways to cope with their diagnosis, manage any emotional concerns—such as depression, anxiety, anger, and confusion—that may result after receiving news of their illness, and discuss ways to address and cope with any life changes that may occur during the treatment process. For example, many of those diagnosed with cancer may fear becoming unable to work and losing their income and health insurance. Those with families may experience distress over sharing the news with a partner or spouse and any children they may have.

Family counseling may be beneficial in helping the family members of those diagnosed with cancer learn ways to manage the varied emotions they may feel, such as anger, sadness, stress, and grief. Partners, spouses, and children may also be able to learn how to better support the member of the family who has cancer, and family members can address any areas of conflict, which may be more likely to arise in a difficult time. Group therapy, where a person with cancer can meet others who have cancer or another life-altering illness in a large counseling session, has also been shown to be helpful to many of those who live with cancer. Those having or who have had similar experiences may be an important source of information and support, and support groups may provide this benefit as well.

Art and group therapy programs have been shown to be helpful for children and teens diagnosed with cancer as they receive treatment. Counseling is also often recommended for any siblings of a child with cancer, as when a child has cancer, the dynamics in the child's family can often shift in a way that other children may find difficult or frustrating. Parents may devote much of their energy to the child who is ill and have little time or energy to spend with the other children. In counseling or family therapy, these concerns can be addressed.

A subspecialty of oncology, psychosocial oncology, works to better understand the impact of cancer on those who have cancer and their families and explore and treat the effects that a diagnosis of cancer can have on mental health. Psycho-oncology has helped increase awareness of the mental health effects that may occur with physical illnesses and of the necessity for treatment of these concerns. Until the mid-1970s, there was such a stigma surrounding cancer that many times, those diagnosed with cancer were not even informed of their health condition. At the time, mental illness and other conditions that may have been helped by counseling or therapy were also stigmatized, and the connections between physical health and mental health were not widely understood or discussed. Now, while cancer is still a disease that is feared and mental illness is still often stigmatized, awareness regarding mental and emotional health needs has increased.

Case Examples

  • Grieving limited time left with family: Roberto, 53, is a survivor of cancer, but now, after three years in remission, doctors have found that his cancer is back and has spread throughout his body. Roberto's doctor tells him that he is not likely to live longer than six months. Not sure of how to tell his family, he turns to his counselor, an oncology social worker, to ask for help. In a family therapy session, Roberto shares the news with his husband and their two adolescent children, who are shocked and grieved. The social worker refers them a family therapist who specializes in treating the family members of those with cancer so that Roberto and his family can discuss his options for further treatment and determine how to make the most of their remaining time together. Roberto's family is significantly helped after two sessions with the therapist, and Roberto is able to come to terms with the approaching end of his life. On his own with the therapist, he mourns the fact that his life will be cut short, regrets the times when he feels he could have been a better husband and father, and expresses anger at the unfairness of his illness. He resolves to enjoy the time he has left and decides not to pursue treatment options, stating that he is tired of hospitals, and returns home with his family. Roberto lives for four and a half months after his diagnosis, and his grieving family continues with the therapist for several sessions as they cope with his death.
  • Teen with cancer resents excessive attention from overprotective mother: Marjorie, 16, sees a counselor occasionally as part of her cancer treatment, and she also participates in group therapy with other teens. She has leukemia but is responding well to treatment, and she often feels well enough to go to school and resume much of her ordinary daily activities. She reports in a counseling session that her parents do not approve of this, however, because they do not want her to "strain" herself and potentially reverse the effects of her treatment. Marjorie also expresses her frustration with the way her mother is always ready to do everything possible for her, saying that she has told her mother when she feels well enough, she wants to live as normally as possible, but that her mother will not listen. She appreciates her mother's help and does not want to hurt her feelings, so the counselor and other teens in the group therapy session help Marjorie explore ways she can bring the topic up for discussion with her mother. The counselor encourages Marjorie to share with her mother her belief that resuming, as much as possible, the life of a normal teen will help her continue to get better. Marjorie does so, also telling her mother that her constant hovering causes stress, which is not beneficial to recovery, and her mother agrees to try harder to let Marjorie do more things for herself when she is able, as long as she promises to be aware of her limits.

Resources Related to Cancer

  • National Cancer Institute (NCI) - The NCI is the United States Federal Government's primary agency for cancer research, information, and training.
  • American Cancer Society (ACS) - The ACS is a nonprofit organization that works to eliminate cancer and support people who are facing the disease.
  • KnowCancer - KnowCancer is an online social network dedicated to connecting, educating, and empowering all people affected by the many forms of cancer.

References:

  1. American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention. (2015, April 9). Retrieved from http://www.cancer.org/acs/groups/cid/documents/webcontent/002577-pdf.pdf
  2. Counseling. (2012, July 23). Retrieved from http://www.cancer.net/coping-and-emotions/managing-emotions/finding-support-and-information/counseling
  3. Known and Probable Human Carcinogens. (2015, March 26). Retrieved from http://www.cancer.org/cancer/cancercauses/othercarcinogens/generalinformationaboutcarcinogens/known-and-probable-human-carcinogens
  4. Questions People Ask About Cancer. (2015, May 13). Retrieved from http://www.cancer.org/cancer/cancerbasics/questions-people-ask-about-cancer
  5. Siblings and Cancer. (2012, July 24). Retrieved from http://www.cancer.net/coping-and-emotions/communicating-loved-ones/siblings-and-cancer
  6. What Is Cancer? (2015, February 9). Retrieved from http://www.cancer.gov/about-cancer/what-is-cancer