Impact of Cancer on the Mental Health of School-going Cancer Patients

Studies have shown that almost all forms of cancer have multiple physical and mental effects (Miller et al.). A cancerous tumor, especially one that is advanced, will most likely cause serious health issues. Although the physical defects can be easily diagnosed and addressed, the mental effects of cancer are usually harder to diagnose and treat (Purushotham et al.). Cancer diagnosis and the consequent lengthy treatment and management process often affect the mental health of cancer patients (Purushotham et al.). Most of the time it is the diagnosis that causes emotional distress (Purushotham et al.). The constant need to take medication and attend chemotherapy sessions and its related side effects also cause major depression. Depression, in turn, often reduces interest in day-to-day activities ("Coping With Your Feelings During Advanced Cancer"). Various types of cancer also cause cognitive impairment and related problems (Jean-Pierre). These multiple physical and mental effects of cancerous tumors frequently make it extremely difficult for school-going cancer patients to continue with their normal educational activities (Parsons et al.). This paper investigates the effects of cancer on the mental health of students and proposes the use of student-specific cancer support groups to help mitigate some of these effects.

Background

As of 2007, there were approximately 11 million people in the United States who were living with or had previously been diagnosed with cancer (Institute of Medicine). Furthermore, the same study projected that nearly one and a half million Americans are diagnosed with cancer almost every other year. In short, cancer already affects millions of Americans (Miller et al.). And while tremendous efforts have been made to find effective cures for the various forms of cancer, about half a million Americans still die from the disease every year (Institute of Medicine).

Even though cancers were not previously regarded as chronic diseases, more and more experts are agreeing that the effects of cancers are increasingly meeting the description of chronic diseases. There are over 100 different types of cancer (Institute of Medicine). The most common type of cancer among men and women is colon and rectum cancer (Miller et al.). Most types of cancer have devastating effects that cause some form of mental, physical or social disability and require long-term observation, care, and management. Treatment often lasts for months and even after completing treatment patients still have to be supervised for long periods to manage any cancer-related effects (Institute of Medicine).

Diagnosis of cancer often causes stress and depression ("Depression"). Patients and their caregivers must find ways to handle the challenges of treating and managing cancer. Cancer comes with pain, emotional distress, tiredness, and sometimes physical disability ("Depression"). A significant portion of those diagnosed with cancer cannot continue with their normal social lives. Working, going to school, and participating in other daily activities become extremely difficult or impossible tasks.

About 1% of those diagnosed by cancer are below 19 years old (Institute of Medicine), while approximately 39% are between 20-64 years old, and 60% are above the age of 65 (Institute of Medicine). It is clear from these statistics that those affected are mostly adults in their sixties. However, these statistics also reveal the fact that cancer is not only a disease for the old. It affects young school-going children and youth as well.

Impact of Cancer on the Mental Health of School-going Patients

Diagnosis of cancer often brings about psychological distress for patients. This is because most patients are often shocked when they find out they have any form of cancer ("Adjustment To Cancer: Anxiety And Distress (PDQ®)"). And there is also the uncertainty that comes with diagnosis with patients trying to figure out how they survive with the disease and what the diagnosis means for them. Multiple studies have reported psychological distress as one of the major mental effects of cancer on patients ("Adjustment To Cancer: Anxiety And Distress (PDQ®)"). Various studies have reported that between 0% and 58% prevalence rate of depression among cancer patients (Massie). These are significant percentages that obviously shows that the mood and fighting spirit of patients can be significantly affected.

Depression is an emotional disturbance that is characterized by symptoms such as loss of interest in day-to-day activities and persistent low mood ("Coping With Your Feelings During Advanced Cancer"). If not addressed early, depression could lead to young cancer patients committing suicide ("Depression"). While anxiety is a feeling of fear and apprehension that is characterized by symptoms such as stressfulness and sweating. Both of these mental affective disorders have been observed among cancer patients ("Adjustment To Cancer: Anxiety And Distress (PDQ®)").

Hopelessness is a cognitive state whose main symptom is a negative expectation about the future (Gil, and Gilbar). Cancer diagnosis also brings about a feeling of hopelessness among patients. Most people often think various forms of cancers as untreatable, which makes them regard diagnosis of cancer as a death sentence (Gil, and Gilbar). In 2007, Mystakidou et al investigated whether clinical characteristics, socio-demographic characteristics, grief, depression and anxiety could be considered as factors which led to hopelessness among cancer patients at an oncology unity in Athens. Using multiple scientific scales of mood and depression and methodologies, the researchers came to the conclusion that age, depression and grief did indeed act as predictors of hopelessness. They also concluded that there was a significant relationship between hopelessness, depression, anxiety, grief, and the desire for a quick death among cancer patients.

Another study by Rodin et al (2009) that investigated 406 cancer patients found that there were several predictive factors that led to psychological distress among patients. The researchers in this particular study were in agreement that low spiritual well-being, low self-esteem, high disease burden and insecurity were some of the risk factors for depression and hopelessness among cancer patients.

Apart from the well-demonstrated psychological effects of cancer, cognitive impairment/ dysfunction has also been noted to be significant among cancer patients (Jean-Pierre). Cognitive impairment among cancer patients is often thought to be a side effect of chemotherapy although there is evidence that other factors also play a part (Hermelink). Cognitive functions include visual-motor coordination and integration, sequencing abilities, the speed of processing information, working memory, concentration and attention (Institute of Medicine). Cognitive impairment related to cancer and its treatment has been directly linked to learning impairment with the affected patients having problems in successfully completing complex math problems, problems in language development, and problems in reading (Institute of Medicine). These learning impairments are especially true among children. Mild to severe cognitive impairment can make it difficult for children to attend school or to successfully complete assignments at home. Problems in other areas such as handwriting, completing test forms, and organizing material on books have also been linked to cancer-linked cognitive impairment (Institute of Medicine).

Cognitive impairment is not just a problem to children suffering from cancer. Even young adults in high school and colleges experience this negative mental effect of cancer. Some researchers have deduced that cancer treatment (chemotherapy) reduces cognitive functioning leading to various negative learning outcomes (Institute of Medicine). For instance, in one particular study that investigated women being treated with chemotherapy to eliminate breast cancer, researchers noted that constant exposure to the treatment reduced cognitive abilities affecting areas functions such as short-term memory, long-term memory, speed of processing information, spatial abilities, and language skills (Institute of Medicine). The same kind of cognitive impairment has also been observed among other adults suffering from colorectal, lymphoma and other types of cancer, even though the degree of impairment varies with the type of cancer and the form of treatment being used to address it (Institute of Medicine).

Children and young people experiencing cognitive impairment or other negative mental effects of cancer such as hopelessness, depression and anxiety, often find it extremely difficult to learn and master behavioral and social skills important for day-to-day activities and learning. They find it difficult to achieve social, financial, emotional, and physical independence from their families/ caregivers (Castellino et al.). The negative mental effects of cancer plus the time-consuming treatment procedures can also affect a cancer patient’s ability to participate and acquire these social and developmental skills which are also necessary for successful learning in school (Castellino et al.). The problem is particularly serious among children who face lengthy periods of hospital stays when they should be playing and developing physical, social, emotional and mental skills necessary for maturing into a fully-functional adult (Castellino et al.).

Adolescent cancer patients can also experience a disruption of their education journey, as they struggle to get the treatment they require. Having to go to hospital every now and the can affect their social relationships and interfere with their successful functioning; consequences that will make it difficult for them to cope in school or to mature into fully-functioning adults (Castellino et al.). Several studies have also confirmed that adolescents find it difficult to plan for their education and for their careers. Cancer patients and survivors who push themselves through school and successfully graduate also experience difficulties in getting jobs as some employers discriminate against them (Castellino et al.).

Solution to the Problem

Various forms of cancer have devastating mental effects on Children and adults. From depression to hopelessness, anxiety, and cognitive impairment, the mental impact of cancer on school-going patients is huge. To deal with this problem, raising awareness about these effects through support groups is the way to go.

Multiple organizations have reported that information about the effects of cancer and the side effects of various methods of treatment is often requested by patients (Institute of Medicine). Most cancer patients are also of the opinion that information about what exactly they are suffering from and what that means is extremely important to them (Institute of Medicine). It is obvious that most patients think they need this kind of information. However, studies have consistently reported that the majority of cancer patients are dissatisfied with the education and information they receive from cancer hospitals and other oncology units (Institute of Medicine). Most cancer patients are also dissatisfied with how healthcare professionals provide the little information they provide. Even though studies have revealed this problem, not many studies have focused on finding the kind of information cancer patients need and how they want it delivered. The few that have, have come to the conclusion that most patients need information that is personalized and covers the diagnosis, treatment/ management and prognosis (Docherty).

Mental effects such as anxiety and hopelessness reduce the satisfaction levels of most patients. Other cancer and treatment-related side effects such as tiredness and pain also further dampen the mood of most cancer patients. From this information, there is clearly a need to better manage the information needs of patients.

The solution to reducing and mitigating the mental impact of cancer on school-going patients is by coming up with better awareness through a cancer support group (Docherty). Multiple services have shown the usefulness of social support groups to people struggling with substance abuse and other forms of disorders and illnesses including cancer. By making cancer patients fully aware of what their diagnosis means and what they should expect, support group leaders can help to lessen the negative mental impact of cancer on school-going children (Docherty).

For example, if all newly diagnosed cancer patients were to be immediately signed up to cancer support groups, they could be told that most patients often experience depression, anxiety and hopelessness and that these negative psychological states can be overcome with changing their mental attitude. To motivate cancer patients to start thinking more positively, those who have been able to recover from depression could share their stories, specifically about what they did to overcome their negative mental states (Docherty). By providing the right education, information and support, cancer patients can be helped to overcome anxiety, depression, and hopelessness. They could also be helped to regain some of their cognitive abilities (Docherty).

Researchers have pointed out that peer support groups often help people to share their personal experiences and that this sharing often helps participants (in this case the newly diagnosed cancer patients) to have the belief that they will overcome the challenge before them (Institute of Medicine). This belief is the key to patients successfully overcoming depression, anxiety, hopelessness and regaining their cognitive abilities. Cancer patients with this kind of belief have also recorded better and more positive health outcomes compared to other cancer patients without it (Institute of Medicine). This shows that support groups can have the positive effect and significantly mitigate the mental effects of cancer on patients, especially the school-going ones.

Specific Steps

Every hospital with an oncology unit or a cancer treatment should come up with a support group for cancer patients. The support groups should be headed by a social worker or a nurse with the necessary training and knowledge as to the kind of information to give to new group members. The group should meet twice a week. Every group session should be about informing the participants about their illness and giving them an opportunity to share their experiences and learn from others the different ways of coping with the challenges that cancer throws at you (Docherty). New members should especially be given a chance to share their experiences and ask any questions they may have. In the very first session, they should be told that they will likely face depression, anxiety and hopeless and be reassured that this is normal and that there are people who have overcome these negative mental states (Docherty). Informational material including pamphlets should also be published with more information for new group members. By raising the awareness levels of newly diagnosed cancer patients and giving them a platform to learn more and share their experiences, support groups can really help to mitigate the negative mental effects of cancer (Docherty).

Budget

Support groups are really cost effective because they do not need expensive technologies or medicines. However, the group leader be it a social worker or a nurse will need to be paid. With two meetings a week and each meeting going for not more than 3 hours, the total charge per social worker will definitely be in the region of 300 USD per week. A meeting room can be found on the hospital grounds so this will not be an additional expense. However, publishing informational materials will cost money and so will the refreshments that will be served during or after meetings. So basically about 500 USD will be needed to run a decent cancer support group. This is the cost per week. Per month the group will need about 2000 USD to run effectively. More groups can be formed if the members of the first group exceed 15 which will probably mean additional expenses. However, the initial cost of 2000 USD per month is affordable to meet the group’s objective of mitigating the negative mental effects of cancer.

The net effect of cancer support groups will be to help young cancer patients to manage their illnesses and to recover faster from the associated negative mental effects. This will help them to shorten their reintegration into school systems so that they can continue their education journey.

Conclusion

Cancer is one of the most devastating diseases in the United States and in other countries around the world. It has serious physical, mental and emotional effects. If not diagnosed early enough and addressed, it could lead to death. Millions of Americans are diagnosed with cancer every year. And although it was believed before that cancer only affects the elderly, more and more young people are being diagnosed with various forms of cancer. The impact of cancer on the mental health of these young, school-going persons is serious and more damaging. These people have their entire lives ahead of them and being diagnosed with cancer often triggers feelings of anxiety, hopelessness, and depression. Cancer and the cancer treatment procedure referred to as chemotherapy have also been linked to cognitive impairment reducing patients’ short-term memory, spatial awareness, arithmetic abilities, and the ability to read and write. This paper proposes cancer support groups as a solution to mitigating these negative mental effects. It shows that many cancer patients are often dissatisfied with the level of education and support they get from health care providers. By providing cancer patients with the right kind of information, education and support they need through support groups, it is the paper’s position that negative mental effects including depression, anxiety, and hopelessness will be tackled better enabling young cancer patients to quickly go back to school. Specific steps are given and a budget of 2000 USD per month is given. The adoption of this solution will go a long way in helping children and young people get back to school to complete their education.

Works Cited

"Adjustment To Cancer: Anxiety And Distress (PDQ®)". Pubmed Health, 2017, https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0032514/. Accessed 7 Apr 2018.

"Coping With Your Feelings During Advanced Cancer". National Cancer Institute, https://www.cancer.gov/about-cancer/advanced-cancer/feelings. Accessed 7 Apr 2018.

"Depression". National Cancer Institute, https://www.cancer.gov/about-cancer/coping/feelings/depression-hp-pdq. Accessed 7 Apr 2018.

Castellino, S. M. et al. "Developing Interventions For Cancer-Related Cognitive Dysfunction In Childhood Cancer Survivors". JNCI Journal Of The National Cancer Institute, vol 106, no. 8, 2014, pp. dju186-dju186. Oxford University Press (OUP), doi:10.1093/jnci/dju186. Accessed 7 Apr 2018.

Docherty, Andrea. "Experience, Functions And Benefits Of A Cancer Support Group". Patient Education And Counseling, vol 55, no. 1, 2004, pp. 87-93. Science Direct, doi:10.1016/j.pec.2003.08.002. Accessed 7 Apr 2018.

Gil, Sharon, and Ora Gilbar. "Hopelessness Among Cancer Patients". Journal Of Psychosocial Oncology, vol 19, no. 1, 2001, pp. 21-33. Taylor And Francis Online, doi:10.1300/j077v19n01_02. Accessed 7 Apr 2018.

Hermelink, Kerstin. "Cognitive Dysfunction In Cancer Patients Likely Not All Due To Chemotherapy". JNCI: Journal Of The National Cancer Institute, vol 109, no. 10, 2017. Oxford University Press (OUP), doi:10.1093/jnci/djx108. Accessed 7 Apr 2018.

Institute of Medicine. Cancer Care For The Whole Patient: Meeting Psychosocial Health Needs. National Academies Press, 2008, https://www.ncbi.nlm.nih.gov/books/NBK4011/. Accessed 7 Apr 2018.

Jean-Pierre, Pascal. "Management Of Cancer-Related Cognitive Dysfunction—Conceptualization Challenges And Implications For Clinical Research And Practice". Pubmed Central (PMC), 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4397910/. Accessed 7 Apr 2018.

Massie, M. J. "Prevalence Of Depression In Patients With Cancer". Journal Of The National Cancer Institute Monographs, vol 2004, no. 32, 2004, pp. 57-71. Oxford University Press (OUP), doi:10.1093/jncimonographs/lgh014. Accessed 7 Apr 2018.

Miller, Kimberly D. et al. "Cancer Treatment And Survivorship Statistics, 2016". CA: A Cancer Journal For Clinicians, vol 66, no. 4, 2016, pp. 271-289. Wiley Online Library, doi:10.3322/caac.21349. Accessed 7 Apr 2018.

Mystakidou, Kyriaki et al. "Depression, Hopelessness, And Sleep In Cancer Patients' Desire For Death". The International Journal Of Psychiatry In Medicine, vol 37, no. 2, 2007, pp. 201-211. SAGE Publications, doi:10.2190/0509-7332-388n-566w. Accessed 7 Apr 2018.

Parsons, Helen M. et al. "Impact Of Cancer On Work And Education Among Adolescent And Young Adult Cancer Survivors". Journal Of Clinical Oncology, vol 30, no. 19, 2012, pp. 2393-2400. National Library Of Medicine, doi:10.1200/jco.2011.39.6333. Accessed 7 Apr 2018.

Purushotham, A. et al. "Cancer And Mental Health—A Clinical And Research Unmet Need". Annals Of Oncology, vol 24, no. 9, 2013, pp. 2274-2278. Oxford University Press (OUP), doi:10.1093/annonc/mdt214. Accessed 7 Apr 2018.

Rodin, Gary et al. "Pathways To Distress: The Multiple Determinants Of Depression, Hopelessness, And The Desire For Hastened Death In Metastatic Cancer Patients". Social Science & Medicine, vol 68, no. 3, 2009, pp. 562-569. Elsevier BV, doi:10.1016/j.socscimed.2008.10.037. Accessed 7 Apr 2018.