22nd January 2020

Protecting your mental health is vital when you have lung cancer

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If you’ve been diagnosed with lung cancer, the focus will naturally be on your immediate physical needs and wellbeing. But what about your mental health?

Sadly, clinical depression is a common problem among people living with lung cancer.

Figures from a recent study from Ohio State University (OSU) indicate that it can affect between 16% and 29% of people with lung cancer whereas the average incidence for all cancers combined is around 15%.

Often, symptoms of shame and guilt relating to the prejudice and misperceptions that can surround lung cancer, especially in those who have smoked, add a sense of loneliness and isolation to an already difficult struggle.

People with lung cancer may feel less support than those affected by other cancers. Some lung cancer patients also find the physical impact of their symptoms and treatments can affect their mental wellbeing.

Demand for mental health support and treatment has greatly increased in recent times and even people in urgent need of help may face a lengthy wait, sometimes for several months.

Our chief executive, Paula Chadwick, believes this situation must change.

She said, “Being diagnosed with lung cancer is a major challenge so it’s not surprising that it can have a severely negative effect on a person’s mental health. We know that the NHS is struggling to keep pace with demand, but we believe these delays are unacceptable.

“People living with lung cancer know all too well just how precious time can be. If they need support for their mental health, they should be able to access it quickly. We urge the government to address this as an urgent priority.”

Anyone affected by lung cancer, particularly those diagnosed with late-stage lung cancer, should ensure they can recognise the more common symptoms of clinical depression, which include:

  • – Persistent feelings of sadness
  • – Feelings of helplessness, worthlessness, or hopelessness
  • – Loss of interest in activities you usually enjoy
  • – Decreased energy
  • – Poor concentration
  • – Difficulty falling asleep or sleeping too much
  • – Loss of appetite
  • – Thoughts of death or suicide

Of the 186 patients included in the OSU study who had been recently diagnosed with late-stage non-small-cell lung cancer (NSCLC), about 8% had severe depression, and another 28% had moderate depression.  

Many patients with severe depression reported finding it ‘hard to work, take care of domestic chores or get along with other people’. They also reported extreme levels of stress linked to their lung cancer and were the least confident that their treatment would help.

The OSU study concluded that patients should have their mental health needs assessed and steps should be taken promptly to address them in order to improve the wellbeing of the patient and the effectiveness of their treatments.

Meanwhile, another team of researchers from the universities of Cornell and Cincinnati investigated clear links between lung cancer and severe consequences of mental health problems, including suicide.

Their study stated that “It is important to identify high-risk patients in order to provide the proper psychological assessment, support and counselling. “

It also highlighted the importance of patients fully understanding their diagnosis and treatments and options open to them, which, along with better communication with their families and loved ones, could help reduce the suicide risks associated with depression.  

Here in the UK, mental health is now very much ‘on the public agenda’, greatly helped by famous people such as the Duke and Duchess of Sussex discussing their experiences and concerns.

Our charity has always been concerned with finding ways to improve the overall patient experience – making things better and easier for people living with lung cancer. For instance, we funded the first lung cancer nurse specialist; now this role is recognised as being a key part of a patient’s oncology team.

The value of lung cancer nurse specialists can’t be overstated, as clearly demonstrated when we were approached by lung cancer nurse specialist, Gilly Culshaw, to help support people affected by lung cancer on the Isle of Man.

“A lung cancer nurse specialist is a vital ally for anyone diagnosed with lung cancer. They know the impact a lung cancer diagnosis can have. They know their way around the healthcare system and understand the options available. They can take a step back from the emotions shared within a family. They are qualified, experienced and professional. They can be a guide and a confidant”.

Research has also shown patients with lung cancer live longer and fare better with treatment when cared for by a specialist nurse.

Patients who work with their lung cancer team to better understand their illness and treatment options also cope better with stress, anxiety and depression.

Mental health matters are often complex and may require an array of support and treatment. If you have concerns about your own mental health – or if you’re concerned about someone close to you – you can speak to one of the nurses on our free helpline.

Similarly, many people feel they can open up and share their concerns at one of our Patient Support Groups. We currently have 45 of these around the UK and we are keen to open more.  

These options may help guide people affected by lung cancer who are experiencing mental health issues towards routes to treatment. Your lung cancer team should also be able to offer support and guidance. The first step to feeling better is finding appropriate help.     

Patient story – Mandee Lucas

Mandee was diagnosed with Stage 3b lung cancer three years ago, becoming the fourth generation of her family to be affected by the disease.

Her pathway to diagnosis and treatment was far from straightforward. Her lung cancer was spotted by chance when she had an X-ray for entirely separate condition, and eventually she underwent surgery.  She has since had chemotherapy now undergoes regular tests and CT scans; currently, her medical status is ‘no evidence of disease’ (NED).

Mandee was deeply affected by the whole process and suffers with anxiety as the time for her scan approaches. She shared her story to support our #LikeMe campaign.

As she says:

“I still have bad days even though I’m NED. I think about it a lot. I expect it to come back at every scan. I expect bad news.

“I went through a period of depression, almost a PTSD (post-traumatic stress disorder) because I was so traumatised by what had happened and hadn’t really dealt with it.

“I didn’t know I was depressed. I had been back at work for almost a year and was really struggling. I have quite a high-pressured account manager role, and I was really, really struggling with the figures and the targets.

“Fortunately, I had an occupational health appointment through work, and they said ‘you are depressed’. I hadn’t dealt with my mum’s death because I went straight into my own diagnosis.

“I was very down. I was very negative. I’m usually a pretty happy – hate the word, but – bubbly person and I was not at all like that. I was buying things and thinking who I was going to leave it to in my will.

I had cognitive behavioural therapy (CBT) for four months. It didn’t start working until the 8th session when something just clicked, and I just feel great now. I’ve got some coping mechanisms and it’s really helped with everyday life. I feel like I’m myself again now”.

Mandee is now a patient advocate and a member of our Board of Trustees.