Siteman Psychology Service

Patients with cancer often feel “distress:” powerful, unpleasant emotions that can affect them mentally, socially and even spiritually. Some patients experience more intense distress than others. Mild distress might take the form of feeling sad or vulnerable, while severe distress can include panic attacks, social isolation, and existential grief. At its worst, distress can seem all-encompassing and inescapable. Some of the most common manifestations of distress are symptoms of depression and anxiety, such as:

• Worry
• Sadness
• Fear
• Low mood
• Loss of appetite
• Difficulty focusing or concentrating
• Fatigue
• Mood swings
• Inability to sleep

These symptoms don’t necessarily mean that a patient has an anxiety disorder or clinical depression, but their impact cannot be underestimated. Sometimes, patients come to Siteman Psychology Service who have previously been diagnosed with a mental illness. Our doctors are fully equipped to handle both their existing mental illness and the distress caused by cancer.

For anyone in crisis and/or having thoughts of suicide, talk with someone immediately by calling 988.

Like cancer patients, those who love them and care for them can experience negative emotions and distress, including symptoms of anxiety and depression. Caregivers may also struggle with “caregiver stress,” a condition in which they feel overwhelmed by caregiving duties and concern for the patient’s wellbeing.

There are several simple strategies that can help cancer patients and those who love and care for them develop a greater sense of well-being during treatment and recovery:

• Mindfulness
• Relaxation techniques, such as deep breathing and guided imagery
• Assembling and relying on a strong support system, such as family members,friends, and community groups
• Talking to your medical team about physical and emotional distress

Patients should know that they may experience heightened distress at certain stages in their cancer journey.

• Diagnosis: The time of diagnosis is an extremely stressful one for patients and caregivers. They are suddenly confronted with a major life disruption, and wonder about questions such as, “Will I survive?” “How much will the treatment change me and my body?” “How will I care for my family while going through treatment?” and “Will things ever be normal again?”
• Immediately before treatment begins: Before beginning treatment, patients may worry about pain and side effects, as well as the disruptions to family life brought on by regular visits to the hospital or outpatient clinic.
• Remission: It’s a relief to be told that your cancer is in remission and you no longer have to undergo treatment. However, many patients find it difficult to leave the constant supervision and protection offered by their doctors and nurses. They may worry how they will cope on their own, fear the recurrence of the cancer, or feel in shock from all that they have gone through. Some survivors experience symptoms of PTSD, or post-traumatic stress disorder, at this time.

It’s important to recognize that your mental wellness is often directly tied to your experience of treatment, and that emotional distress can make your treatments seem more painful and difficult to bear. Don’t hesitate to discuss your mental health with your medical providers. They may be able to make your treatments more comfortable for you both mentally and physically. Our staff is available to provide support at all stages of treatment and recovery, and we can be present for you in your treatment location if need be. We will work with your oncologists and other providers to integrate your mental health care into your treatment for cancer.

Patients and caregivers should feel free to seek help at any point, even if they don’t feel that their symptoms are “bad enough” to deserve attention. Though most patients and loved ones do learn to cope with their feelings in a healthy way, they can still benefit from psychological care as they navigate the fears and distress that are a normal part of being treated for cancer or caring for a cancer patient. However, patients or caregivers should seek additional support if they experience:

• A lingering low mood
• Lack of interest or engagement in things they once enjoyed
• Significant worry that interferes with their ability to live or sleep

At Siteman Psychology Service, we can treat the psychological issues causing these problems as well as their physical effects, such as insomnia.

We offer a variety of therapies and treatments. Patients are first seen at an intake appointment, where they are assessed through questionnaires and provided with a treatment plan. Our treatments will include evidence-based practices, such as:

• Supportive therapy: In talk therapy, you will discuss your fears, concerns, and experiences with a psychologist. He or she will use the conversation to help you better understand your situation and find ways to work through it.
• Mindfulness interventions: Mindfulness is a process of bringing your full attention and awareness to the present moment, with an attitude of non-judgment and compassion for your own experience. This practice can help manage negative emotions, boost positive emotions, and enhance quality of life.
• Cognitive behavioral therapy (CBT): Cognitive behavioral therapy teaches patients to replace harmful patterns of thought or behavior with healthier alternatives. For those with cancer, cognitive behavioral therapy can reduce fears and distress surrounding medical procedures.
• Acceptance and commitment therapy (ACT): Acceptance and commitment therapy can be particularly helpful for patients who try to cope with cancer by ignoring or rejecting their feelings. In ACT, patients learn to accept the emotions they are experiencing without getting caught up in them. Then, patients are guided toward behavior change that is consistent with their own life values.

No, as clinical psychologists, we do not prescribe medication to our patients. If a patient would likely benefit from medication, we refer him or her to the cancer psychiatry department. Sometimes the combination of mental health medications and counseling is the most effective treatment for cancer-related mental health distress.

If you or a loved one wish to consult with a member of our team, call 314-747-5587 to reach our scheduler. You can also request a referral through one of your physicians. Appointments are available at our outpatient clinic and on inpatient units. If you prefer, you can click here to schedule an appointment online.