Motherhood and Metastatic Cancer: Depression and Anxiety Are Common

Mothers with advanced cancer are at a greater risk of psychological distress and lower health-related quality of life than the general population, according to findings of a recent study published in Cancer.

Researchers from the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center examined how parenting concerns might relate to quality of life in 224 women who had stage 4 solid tumor cancer and at least one child under the age of 18.

“Among women with metastatic cancer, their health-related quality of life is powerfully interlinked with their parenting concerns about the impact of their illness on their minor children,” Eliza Park, M.D., assistant professor in the UNC School of Medicine Department of Psychiatry and Department of Medicine, said in an interview with CURE.

For evaluation, the women conducted an online survey that measured depression and anxiety symptom severity; functional status; parenting concerns; demographics; communication; and parenting characteristics.

The researchers determined that women who were mothers had higher depression and anxiety scores. In addition, emotional well-being scores were lower compared with all adults with cancer.

“For patients with advanced cancer, the cumulative impact of physical changes, treatment decisions, financial burden and fear of dying can all take an enormous toll on patients and their families,” Park said. “Many individuals develop symptoms of depression and anxiety, which in turn make it harder to cope with all the challenges of living with stage 4 disease. To best support patients living with advanced cancer, careful attention to their psychosocial needs is critical to their ability to cope with the ups and downs of cancer.”

Interestingly, emotional well-being was significantly linked with whether the mother had talked with her children about her disease and how it could affect them financially, noted the researchers. Parenting concerns made up 39 percent of the difference in the quality of life scores.

Park explained that there are ways to effectively treat depression and anxiety, such as counseling, spiritual support, physical activity and medication. “For parents with advanced cancer, our study suggests that specifically addressing parenting concerns is critical to help lowering depression and anxiety symptoms,” she said.

Women should know that most oncology providers will address these concerns with a patient and their family. “Distress screening is now mandated at National Comprehensive Cancer Centers,” Park said. “The easy part is assessment. The harder part is deciding how to address their emotional and psychological well-being once problems have been identified.”

At UNC-Chapel Hill, Park and colleagues are working to develop interventions that can better support patients with stage 4 disease. She hopes that the interviews and surveys that have been conducted over the past three years with patients and their families will help provide some insight.

“We are using the collective wisdom from the patients and family members who generously participated in our studies to develop interventions to reduce their parenting concerns and improve their emotional well-being,” Park said.