Skin Cancer Can Impact Emotional Well-Being

The psychological effects of skin cancer can play out in a variety of ways in a patient’s life, according to an expert at the CURE® Educated Patient® Skin Cancer Summit.

Maureen Sanger, a psychologist at Tennessee Oncology who holds a post doctorate degree in psychology, spoke about how living with skin cancer impacts a patient’s emotional health and potential coping strategies to combat these effects.

“Before cancer, a person's life is often going along with some routine in order, kind of like a set of billiard balls neatly arranged on a rack,” said Sanger during her presentation. “But then cancer comes along, and it's like the cue ball that disrupts the order and sends the balls scattering.”

According to survey data Sanger cited, one of the biggest challenges that comes with skin cancer is living with uncertainty. Patients may wonder how treatment will work, how it will affect them, what side effects they’ll have and in what ways it might change their appearance.

“But the challenge of living with uncertainty doesn't end when treatment ends,” she added. “In fact, fear of cancer coming back is almost a universal worry and may spike at particular times such as when it's time for scans or imaging or an appointment with your oncologist or dermatologist for surveillance.”

Cancer may become a chronic stressor for patients, a constant presence with consequences that trickle into a patient’s physical, emotional and mental well-being.

“Some of the physical symptoms or signs of that dealing with that chronic stress can be body aches or chest tightness (and) sore muscles from tensing,” Sanger said. “Our emotional reactions might include anxiety, anger, tearfulness, edginess. Dealing with chronic stress can also affect our thinking and learning and memory skills.”

A patient experiencing these symptoms may be inclined to withdraw, isolate or lash out at others. Sanger explained that according to studies in patients with melanoma, 30% report significant psychological distress, which are most commonly anxiety and depression.

In addition to the internalized emotions, having skin cancer may affect how a patient interacts with the outside world. Some of the social effects Sanger described were changes in responsibilities at work and at home, difficulty performing normal tasks due to physical limitations or pain, negative changes in confidence (due to changes in appearance) that may cause an individual to avoid social situations and the inability to continue favorite activities that involve being in the sun.

Although a patient cannot change the fact that they have cancer, they can make choices about how they respond to and live with it, said Sanger. Some ways she shared for patients to achieve this include maintaining good health habits (a nutritious diet, physical activity and good sleep), expressing and acknowledging emotions through healthy mechanisms (talking or writing about them), accepting the unchangeable aspects, being fully engaged in the present, taking control of what you can (being an active and informed participant in the care process, engaging in preventative strategies, staying connected to loved ones, choosing a positive attitude) and helping others or accepting help.

Sanger also shared some important resources patients can utilize to receive support during their cancer journey. These included individual counseling, support groups, peer-to-peer programs, mindfulness-based stress reduction and various internet resources (skincancer.net, aimatmelanoma.org, cancercare.org).

“While life will never look exactly the same as it did before cancer, there can be a new order and routine to life that can be meaningful,” Sanger concluded.

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