Mental Health counselling to reduce stress and anxiety in reproductive cancer!
The emotional effects of the stress and anxiety caused by cancer treatments, especially for women suffering from reproductive cancers,
are often not adequately addressed by healthcare providers. Up to 58% of individuals with cancer have issues with depression, compared to
7.6% of the general population.
Forty-five per cent of women with gynaecological cancers experience Post Traumatic Stress Disorder (anxiety, sleep issues, worry and concern, hyperfocus on symptoms, fear, among others) and compounded by the blame they place on themselves for their use of birth control or smoking early in life.
According to the National Cancer Institute, nearly 41% of survivors of breast cancer – also considered reproductive cancer because many
with the BRCA gene also develop ovarian or uterine cancers – have a sub-clinical presentation of PTSD; while they may not meet all the
criteria for a full diagnosis, they still suffer from the intense fear and helplessness associated with PTSD.
Despite these alarming statistics, most women do not receive mental health counselling as part of their cancer treatment program. Although
many do get emotional support from their spouses, families and other cancer survivors, the guidance of a trained mental health professional
would provide a very different perspective.
A mental health counsellor or therapist can and often does provide invaluable support, and emotional and nonjudgmental space as well as
healthy skills and strategies to manage symptoms.
Stress and anxiety related to reproductive cancer treatment often lead women to skip treatments and blood draws. This leads them to be
perceived as difficult by their doctors, but their non-compliance is really an avoidance behavior to cope with the stress associated with the treatment. And although they know they shouldn’t skip their treatments, avoidance and fear keep many women from doing just
And if an oncologist recognizes this problem in one of his or her patients, the protocol is to send the patient to her primary care physician
for anti-anxiety or anti-depressive medications. This only adds another doctor’s appointment the patient does not want to attend, and more
medication she does not want to take. Once again, this makes women feel even more shame and increased avoidance.
“I see a significant need for counsellors to be trained in how to work with people with cancer, especially women with reproductive cancers
because they have very unique needs,” says Linda Waters, a Licensed Professional Clinical Counselor Supervisor. “People with cancer are
living a lot longer, and they must deal with physical and mental health issues throughout their lives.”
Waters is pursuing her doctorate in counsellor education at the University of Toledo. As part of her research, she is studying the impact
of female reproductive cancers on mental health.
Here are seven specific reasons women with female reproductive cancers develop mental health issues that could be positively addressed
by a professional mental health counsellor.
1. Loss of Fertility and Sex Drive
Young women with reproductive cancers who still want to have children can often be put into early menopause by cancer treatments, which also greatly reduce sex drive, both of which can cause great angst in relationships. To boot, reproductive cancer survivors are often
not eligible for hormone replacement therapies to alleviate the symptoms of early menopause. “For many women, hormone
replacement drugs are not indicated for estrogen-positive cancers,” Waters explains. “Even an estrogen cream that would help with
lubrication could fuel cancer recurrence.”
2. Body-Image Issues
As a result of treatment for female reproductive cancers, women can have scarring from mastectomies and other surgeries, internal scarring from radioactive seeds, intense burns or changes in skin texture and appearance from radiation or drugs, and swelling of limbs due to the removal of lymph nodes that necessitates the wearing of compression bandages. Mental health counselling can help women learn to love and accept their new bodies and view their scars as signs of strength.
3. Loss of Role
Many women are not used to being the centre of attention in their family unit. They are the caregiver, not the focus of caregiving. Women often withhold their emotional experience with cancer because they don’t want their spouses to worry about them. This can
add another layer of avoidance and that exacerbates stress and anxiety.