There has long been this
popular notion that cancer patients must stay positive. In fact, the thinking
goes, if they don’t stay positive and smiling, it will have an adverse impact
on their cancer. Conversely, if they can just smile and remain consistently
upbeat through all the chemo treatments, fear, pain and exhaustion, somehow
everything will be okay.
For some, this can become a
huge burden — and it’s completely unrealistic. Even people who are not facing
cancer don’t stay smiling all day, every day. We all have daily hassles to
manage and stew about — financial concerns, deadlines at work, family
complications, even reading the daily headlines can darken a positive outlook.
If you then pile on worrisome medical scans, taxing treatments, and other cancer
issues, of course it’s not realistic to keep an unrelenting positive attitude.
What’s more, science tells us that a perpetual smile is not linked to better
medical outcomes. In fact, the opposite may be true—it was found [by Weihs
et al.] that those cancer patients who put a lid on dark emotions and worrisome
thinking instead of learning new techniques and skills to help manage the flux
of emotions normal with a cancer diagnosis actually had a poorer medical
How prevalent is distress
among cancer patients?
Studies suggest that the
rate of depression might be four times higher among cancer patients than it is
in the average population, and as many as 50% of cancer patients can experience
substantial emotional distress. Yet psychological distress often goes
undetected and, therefore, untreated.
First, it’s very common for
a patient to disregard psychological distress when discussing their health
concerns with their oncology team. In addition, there may be no outward signs
of this suffering; these patients may regularly show up for work, remain fully
involved in their children’s lives, continue in their daily routines and tasks
and thus appear to be doing fine. And because there might be little
social support for seeking help for psychological distress, it’s difficult for
many patients to come forward and seek appropriate professional supportive
help. Yet research continues to demonstrate the negative impact of chronic,
unrelieved stress, not only on patients’ quality of life, but on their
biochemistry and cancer microenvironment, response to treatment, and even on
And, in one scientific
review of 9,400 patients, published in the November 2009 journal Cancer,
researchers concluded that unrelieved, chronic depression was associated with a
25% increase in mortality. And if patients were diagnosed with minor or major
depression, the increase in mortality went up to 39%!
What can help?
The good news is more and
more research continues to show that interventions such as enhancing or
learning new coping and communication skills in supportive counseling, and
specific relaxation strategies such as Progressive Muscle Relaxation, relaxed
abdominal breathing, and comfort space imagery can provide patients with
significant relief not only from psychological distress, but can ease physical
symptoms and side effects such as fatigue, nausea, and pain as well. At the
Block Center, we work with patients to incorporate these biobehavioral
techniques into their individualized cancer treatment plan to enhance health
and help diminish potential cancer promoting factors.
Determination: you can get
knocked down, but you can get back up again.
We see a friend or loved
one struggling with a personal challenge, perhaps even a health crisis, and all
we want to do is reach out and help them. With the best of intentions, we
assure them that things will get better, and that they should “keep smiling!”
or “keep their chin up!” Well, current research is suggesting the keep
smiling dictum may be among the last things a cancer patient needs to
hear. Because putting on a happy face and ignoring the myriad of emotions,
specifically, the anxiety and distress—common following a cancer diagnosis or
accompanying taxing treatments—can actually impact their survival!
So rather than suggesting
that someone keep smiling, patients should be encouraged to acknowledge and
validate their feelings. In addition, equipping them with strategies and tools
to help them manage difficult thoughts and feelings can help create and
reinforce a sense of determination and resolve often necessary to move forward
even in moments of despair. Very importantly, patients who have a strong sense
of determination are aware that they will be able to find relief from
psychological pain, and that they won’t get stuck in a dark place.
information on The Block Center for Integrative Cancer Treatment, visit BlockMD.com.