Psychiatrist: Cancer patients do not anticipate the need

As a cancer patient, you may see many doctors and clinicians from a variety of medical specialties during the treatment process. The oncologist often leads the care team and helps determine the course of treatment. You may see surgeons or receive treatment from a radiation oncologist. Nurses, physician assistants, nurse practitioners and others can be key members of your care team. Then there is the psychiatrist. Although not the first doctor you might think of when diagnosing cancer, a psychiatrist can play an important role in treating stress, depression, and other cancer-related side effects that sometimes interfere with treatment and affect quality of life.

“Many people who have been diagnosed with cancer or who are dealing with cancer treatment develop emotional distress and anxiety,” says Dr. Noah Horowitz, MD, a psychiatrist at our hospital near Phoenix. “They feel depressed. They feel scared. They have trouble sleeping. There are many potential symptoms that interfere with what a psychiatrist does in practice to treat major conditions. Not that all of these people need a specialist like me, but some may do he-she “A more serious reaction or severe symptoms.”

Natural responses to life-altering events.

Starting a new job, laying off work, having a child, losing a loved one – these vicissitudes in life often lead to a flurry of strong emotions. Anxiety, depression, and stress are normal reactions to many life-altering events, whether festive or challenging. When diagnosed with cancer, those feelings can become overwhelming. “My argument is that many patients diagnosed with cancer can be considered post-traumatic stress disorder (PTSD) patients,” says Dr. “The initial diagnostic criteria for PTSD is to be in a situation that you think could kill or seriously injure you. People who hear they have cancer may think, ‘I might die.'”

If left unaddressed, stress and anxiety can have a profound effect on the human body at the cellular level and can have serious effects on the body’s ability to fight disease. In situations of physical or psychological stress, the glands of the body, such as pilots preparing for takeoff, begin to turn on systems that produce hormones that help the body cope. Adrenaline is released to help increase blood circulation, stimulate faster breathing, and prepare muscles for exertion. Dopamine sends messages to nerve cells in the body. Glucocorticoids are on standby to treat inflammation or help stimulate an immune response. Cortisol begins to increase the level of sugar in the blood in the body.

“These are really good reflexes when you’re trying to beat a tiger,” says Dr. Bornfriend. “Your heart rate increases, your muscles tense, your breathing quickens, and your vision becomes focused and sharp. But your body also takes energy away from certain things. When you’re under stress, depressed or anxious, your body responds by getting rid of things, stress hormones like cortisol and catecholamines. Like adrenaline and dopamine.Chronic stress can impair your immune response, and can make you more susceptible to the virus and your ability to absorb nutrients.

A 2003 study by Ohio State University researchers concluded that stress, both short-term and chronic, “can have direct negative effects on a variety of immune mechanisms; both animal and human studies have provided compelling evidence. And that these immune disorders are important Health.” A 2010 study published by the National Institutes of Health links stress to cancer growth. “Chronic stress results in the activation of specific signaling pathways in cancer cells and the tumor microenvironment, which leads to tumor growth and progression,” the study says.

worsening side effects

Stress and depression can also drain a patient of the energy and strength they often need to combat some of the stressful side effects of cancer treatments, says Dr. Bornfriend. Chemical treatments can cause nausea and decreased appetite, which can later lead to hair and weight loss. Fatigue may appear. The pain can be both physically and emotionally draining. “Not only do these things make you feel good, but your experience with them can become so powerful that they can interfere with what needs to be done to treat cancer,” he says. “If you are so depressed and ask, ‘What’s the point? “You may not be tired to eat. Or you can’t rest at night because you are too anxious. How will you rest? You need to be strong enough to treat you?”

Enter a psychiatrist, who can work with your care team to recommend medications, such as antidepressants and anxiolytics designed to help relieve stress and improve mood. A psychiatrist may also recommend supportive care therapies, such as massage therapy and acupuncture, to help relieve stress or certain side effects that contribute to stress.

Despite the many potential benefits involved, some patients are reluctant to see a psychiatrist because of the old and ingrained stigmas associated with psychiatric care. “The stigma never goes away,” says Dr. Horowitz. “People, for whatever reason, based on their pride or values, see this as a sign of weakness.” But psychological care isn’t just about helping people feel better. Psychiatrists may be seen for reasons other than depression or anxiety. They may recommend medications such as bupropion (Wellbutrin® or Zyband®) or varenicline (Chantix®) to help you quit smoking. They may be able to help patients with eating or sleeping disorders or manage pain. They can also help patients who suffer from delirium, a severe state of confusion or disorientation that sometimes occurs during a long hospital stay. Dr. Bornfriend says: Some patients who are reluctant to see a psychiatrist will say, ‘What are you saying, I’m crazy?’ People will say: Of course I’m depressed. I have cancer. I understand. I’m not saying that you have no right. I’m saying there are things we can do that can have a huge impact on the way you fight this disease.”