Cancer is the second leading cause of death in America, responsible for 23 percent of annual deaths. The good news is that the five-year cancer survival rate is increasing: 68 percent for whites, 57 percent for African Americans, according to data supplied by the American Cancer Society (ACS). Still, a diagnosis of cancer is not what you want to hear. Mostly, you fear the unknown. You don't know what the future holds, or even if you're going to have much of a future. Uncertainty, fear, and pain can all contribute to depression.
Risk Factors for Depression
Cancer and depression seem to be logical partners. The National Cancer Institute (NCI) notes these risk factors for depression, associated with a diagnosis of cancer:
Depression at the time of cancer diagnosis
Poorly controlled pain
An advanced stage of cancer
Increased physical impairment or pain
Being unmarried and having head and neck cancer (a strange combination, it would seem, but probably is related to a lack of emotional support that marriage may supply)
Treatment with some anticancer drugs
If you've been diagnosed with one of the so-called “good cancers” such as thyroid, prostate, or some forms of breast cancer, you may be grateful that it's not any worse, but that doesn't mean you are worry free. If you've gotten the really bad news, all you know is that you're in for a siege. At this time, depression is probably the most normal emotion you can feel, apart from anger.
To say that you're going to have a reaction to a cancer diagnosis is the understatement of understatements. Whether or not this reaction develops into depression depends on many factors. Reactive depression is the term given to the way you feel after you get the diagnosis. You may withdraw from your normal activities, feel moody, and find your daily routine beyond your abilities. This usually passes and the coping mechanisms come into play. If the symptoms don't show signs of letting up after a couple of weeks, it's time to consider that depression has settled in.
You're going to be tired. Just adopting a new routine of doctor visits and treatments will take the stuffing right out of you. About 25 percent of all cancer patients are depressed, but only about 16 percent receive medication for the depression. If you're undergoing chemotherapy and radiation, you will experience fatigue. But if that fatigue becomes overwhelming, talk to your doctor to rule out depression. Antidepressants can help you get through the toughest parts of chemotherapy and radiation.
Medical Causes for Depression
Not all depression associated with cancer is the result of psychological changes. Pain that isn't under control can cause depression. So can abnormal levels of calcium, sodium, or potassium, thyroid hormone, or steroids in the blood; anemia; vitamin B12 or folate deficiency and fever (American Cancer Society). Your oncologist can help you here — but only if you explain what you're feeling.
Finding a support group can greatly help in managing depression associated with cancer. A Stanford University study of advanced breast cancer patients found that those who attended a weekly support group lived twice as long (eighteen months) as those who didn't. A UCLA study of patients with malignant melanoma found that those who attended support groups were three times more likely to be alive five or six years later.
When you're with others who are experiencing what you are, all the barriers are down. You can share and know you won't be judged. You'll be accepted and supported — after all that's what a support group is for. Loneliness and isolation can't live where there's camaraderie at the deepest levels.