CANCER: THE SILENT KILLER OF THE BODY AND MIND

By Xuan Ru Liew

“Even the darkest night will end, and the sun will rise”, somewhere, in some time, I have heard this quote being said. One might be sceptical of this quote as I was before, but there is a living proof of this saying to prove us wrong. And that would be this man, Danny Raven Tan, a 50 years old local Singaporean painter who has quit his job to not only pursue his artistic dreams but to take care of his mother who is diagnosed with dementia.

Moreover, he is a pancreatic cancer fighter and survivor of 8 years.

 

The Battler of Cancer

“I have 6 tubes stuck in my body when I woke up.” Danny recounted his experience of his first diagnostic of pancreatic cancer in a talk he was giving in the East campus of the United World College of South East Asia. I didn’t know what was happening, he said

In his talk, he had revealed that he did not let both of his parents know about his condition, narrating the one time when he had to drag an empty luggage bag to the lift with the excuse of going away to another country for work, when in actuality, he was going away for his chemotherapy.

Later on in the talk, one of my classmates had asked whether he had, in the end, told his parents of his situation. Shaking his head furiously, he retorted, “Why not? They will only worry!” Despite not telling his parents, he has stated that his strength of living had come from his wish of not wanting his parents to worry.

When his father had passed on due to respiratory failure, Danny fell into depression. It was like an “emotional rollercoaster”, according to him. On the December of the same year, he had even decided to stop his chemotherapy.

Doctors had shown concern for him, telling him that his decision might cause his death. But in response, he answered, “I’m already half dead.” What’s the point? Who wants to live like that?

 

He’s not alone

There are many like Danny Raven Tan who is going through the same mixture of cancer and depression.

With the total of 14.5 million people living beyond their cancer diagnostic in 2014 in the United States, about 15 to 20 percent of them have depression. In comparison with the general population of the U.S, the number is about 2 to 3 times higher, according to the United States National Cancer Institute.A depressed cancer patient looking out of a window

To further support this finding, research done at the University Hospital Cancer Center in Newark, New Jersey, had 400 cancer patients that were treated in between 2013 and 2016 with the age ranging from 20 to 86 assessed for depression. The study had shown that around 40 percent of the patients do have depression, with 3 of every 4 never diagnosed nor treated for it.

So why isn’t aren’t they diagnosed in the first place?

The reason why depression goes under the radar for cancer patients is, unfortunately, many. One of them is that health professionals may mistake it as shock and sadness from receiving such news on their health condition. Because of the belief that if the roles were to be reversed, they too, would feel the same way, depression is considered as a normal response and would not be diagnosed.

Another presumption is that all people with cancer are depressed. This belief causes people to see little of the signs of depression and the impact the mental condition will have on the patients’ quality of life. This promotes the underdiagnosis and undertreatment of depression in cancer patients.

An additional reason for why depression is undiagnosed is due to the difficulty of differentiating the physical symptoms of depression from being caused by the illness or its treatment. Examples of such problems arising are the loss of appetite due to chemotherapy, fatigue could be caused by cancer, lack of sleep due to the unrelieved pain. Despite the 2 reasons above having some factors, this is primarily the reason why there are underdiagnosis and undertreatment of depression in cancer patients.

 

Depression can be treated*

Despite the difficulty in distinguishing depression from the side effects of cancer, it can be prevented, with diagnosis and treatment being the key.Photo credit Matthias Zomer

“These efforts are particularly important for patients in urban centres, those who are female and those who are unable to work because of their disease,” Jason Domogauer, an M.D./Ph.D. student at Rutgers University New Jersey Medical School, referred to his previous finding in the survey conducted.

 

Family and friends support is also crucial and is found that patients with more social support tend to feel less anxious or depressed and is reported to have a better quality of life.

 

As a family member or friend, you could gently invite the patient to talk about their fears and concerns, though keeping in mind that if the patient is not ready to talk, you do not force them to. When listening, do not judge the patient’s feelings or your own, but it is okay to point out and disagree with the self-defeating thoughts. To distract the patients, you could engage them in the activities that they enjoy. If the patient starts to take antidepressants, encourage them to continue treatment until symptoms improve (which may take 2 to 4 weeks).

When Danny felt depressed, he decided to get a tattoo in order to believe that the scar on his body would go away due to it being a constant reminder of his nightmare. But his friends told him that instead of hiding it away, he should proudly show it while giving Danny a photoshoot to document his battling body. This helped lift him up from the shadows of depression and allow him to pursue his dreams of being an artist.

Although providing support to the patient is valued, it is even vital for you to take care of your health, keeping in mind that caregivers too, can become depressed. This is important as the mood and atmosphere you bring in can affect the patient. So take time to care for yourself maybe even by spending time with friends or doing things you enjoy. You could perhaps also consider getting support through groups or one-on-one counselling.

On the other hand, as patients with cancer, you should not feel as though you have to control these feelings on your own. It is urgent for you to reach out and get help for your life and your health. You could talk about feelings and fears that you or family members have. It’s OK to feel sad, angry, and frustrated, but don’t take it out on those close to you. You could consider seeking help through counselling and support groups too. When given medicine, take all medicines as prescribed and do not suddenly stop taking them. Antidepressants take at least 2 to 4 weeks to work, so give it time.

It is normal to grieve the changes that cancer has brought. The future what was once so sure has now become uncertain. In fact, some dreams and plans may be lost forever. But stay strong and ask for the help you need to cope with these feelings.

As Danny Raven Tan has said, in life, we will face many challenges, “(but) God sends his best soldiers to fight the toughest war”

 

* These are assistance that is verified by The American Cancer Society medical and editorial content team that you can give to the patients.