Men’s mental health before, during and after a cancer diagnosis
Thanks to the enormous amount of work done by the Movember Foundation team since 2003, November has traditionally become the month dedicated to raising funds and awareness when it comes to male oriented cancers as well as suicide prevention. While mental health challenges and cancer diagnoses are challenges in their own right, there is also an understandable link between the two, in that a cancer diagnosis can have a profound impact on mental health. So, what are the stats, who is most vulnerable and who or what can help?
Statistics around men’s mental health and a cancer diagnosis
In a study of nearly 15,000 men and women, cancer was associated with elevated current anxiety levels in men as well as a lifetime diagnosis of depression, amongst other findings. Meanwhile, a study by the NIH in the USA found that among 8,651,569 cancer patients, 13,311 committed suicide, the majority of whom were male (83%).
The most common cancer in men is prostate cancer - it’s also one of the most common cancers in the UK overall. It’s followed by lung cancer and colorectal cancer. Meanwhile, adults aged 65 and over account for the majority (65.2%) of the total cancers in the UK and prostate cancer mainly affects men over 50.
However, anyone can get cancer at any age and incidents in people in their early twenties have been the age group with the greatest increase in incidence rates since the early 1990s. In particular, bowel cancer has been in the increase amongst younger people.
Who is most vulnerable?
First of all, it’s important to remember that a cancer diagnosis is difficult for everyone - both the patient themselves as well as their loved ones. It is a daunting experience, whatever age you are and whatever your prognosis. However, we all have different experiences, different support networks and different ways of handling it.
In the NIH study, it was found that those who were most vulnerable were older, unmarried men - although we could feasibly broaden that definition to include live-in companions or a strong family support network. However, the age factor is also likely explained, at least in part, by the greater prevalence of cancer cases amongst older men.
Importantly, the study commented on the management on mental health following a cancer diagnosis, also highlighting the ongoing improvements in cancer care and outcomes:
“Suicide is the culmination of unmanaged distress […] and risk factors for suicide among cancer patients are similar to those among the general population, including male sex and older age. As the survival rates of cancer patients continue to increase, it will become crucial to identify cancer patients at elevated risk of suicide.”
Of course, a person doesn’t have to be suicidal to be struggling with the mental impact of cancer. Suicide is the extreme end of a very broad spectrum of emotions. The Mental Health Foundation did a study that stated:
“One in three people with cancer will experience a mental health problem such as depression or anxiety disorders before, during or after treatment. A cancer diagnosis, its associated symptoms and treatment can have a significant emotional impact on people and their families, with fear, isolation, loss of self-esteem and loss of independence having an impact.”
Interestingly, the study found that often the most challenging time for mental health was towards the end of cancer treatment or once it had finished:
“Half of the service users we interviewed stated that they reached an emotional 'false summit' at the end of their treatment. This was due to the often-unexpected psychological distress created by cancer, stemming from the life changing experiences of cancer and cancer treatment, and also to the lack of available support for mental wellbeing. Once treatment stops, and people leave strictly managed clinical environments, survivors describe feeling as though they had 'fallen off a cliff edge'. The sudden loss of support often leaves people feeling isolated and abandoned at a time when support is needed the most.”
Who or what can help with mental health challenges surrounding cancer diagnosis and treatment?
While the Mental Health Foundation is right in that more could definitely be done to support individuals with their mental health during and after cancer treatment, there are resources, charities and organisations, many of them invaluable, local groups, that work hard to support individuals and their families. The NHS provides a list of mental health resources (not all of which are specifically cancer related), and Macmillan have a lot of comprehensive information to help offer guidance. We also work alongside a large number of small local charities that have been recommended by customers of ours who have experienced or are currently living with cancer.
The American Cancer Society recommends first simply being aware that difficult feelings are entirely normal surrounding a cancer diagnosis. That might sound obvious, but we all know it’s easier said than done when it comes to admitting we need help. They say:
“A cancer diagnosis can affect the emotional health of patients, families, and caregivers. Common feelings during this life-changing experience include anxiety, distress, and depression. Roles at home, school, and work can be affected. It's important to recognise these changes and get help when needed.”
While everyone’s experience is their own, we are big advocates of reminding people that they are not alone and there are other people who have had similar experiences. That is why support groups can be so valuable. For many, meeting people who identify with what they are going through makes it all just a little bit less isolating.
The value of self-care - seemingly little things can mean a lot
Meeting empathetic professionals outside the immediate clinical environment can also provide a sense of control, empowerment, acceptance or tools for helping to cope. From skincare to ease some of the painful or irritating side effects of cancer treatment, which can be demoralising and very much feel like salt in the wound. To nurses who are able to provide practical or emotional guidance, or simply someone who understands without you having to explain all the little details. It all has its place.
Lots of people, however, do prefer to speak to someone one-on-one, in which case speaking to your doctor about seeing a counsellor, or (if the means are available), speaking to a private consultant, may be an option.
It’s also important to remember the value of self-care at this time, and recognising that it’s ok to look after yourself - mind, body and soul. When faced with a course of chemotherapy, the idea of treating yourself to a new home fragrance or moisturiser might seem absurd, but having the little things that make you feel cared for, safe, ease aches and irritation and create enjoyable rituals each day can do wonderful things for providing a moment’s peace.
We all handle mental health differently, and although things are changing, there is a stereotype where men are less vocal about their worries, which can lead to greater vulnerability. The crucial thing, as the saying goes, is to remember it’s ok not to be ok, and there are lots of us available who want to support you and your loved ones on your cancer journey.
References
https://www.sciencedirect.com/science/article/abs/pii/S0022399918309929 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331593/
https://prostatecanceruk.org/prostate-information/are-you-at-risk
https://www.cancerresearchuk.org/health-professional/cancer-statistics/incidence/age#heading-One
https://www.mentalhealth.org.uk/news/cancer-patients-left-cope-mental-health-problems-alone
https://www.nhs.uk/conditions/stress-anxiety-depression/mental-health-helplines/
