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.
Dear Xuan,
Thank you for the privilege of reading your piece. It made me teary. I know many people who have battled cancer (and some who have lost) and the information and ideas you’ve conveyed are really important. Danny is indeed inspiring.
The focus of your story, depression in cancer patients and caregivers, is fresh. Good job finding a new angle on an old topic.
You lead in with Danny. He’s an interesting man and a good hook. Then you present some basic cancer information and begin your discussion on depression. Importantly, you maintain Danny as the main thread throughout, returning to his story in a body paragraph and at the end. This is called circular writing and it works. I think you also integrated quotes and data from other medical professionals and sources in a smooth way that did not take us too far from Danny. The piece flows well.
I think you also did well in choosing what information to include. Cancer, and I’m sure even the more narrow focus of depression in cancer, is a huge topic and I think you successfully presented a narrow but important set of facts. That’s a hard task.
A few things to look out for:
– Verb tenses. Occasionally your verb tenses are incorrect, “is” versus “are”, for example. When I’m editing, I often read a draft with a focus on one issue at a time. So you might read your essay through once just for small verb tense errors, once for clarity of facts, etc.
– Bold face. Your teacher would know better than me, but unless you’re publishing online and the bold faced words are links, you may not want to do this. It breaks up the flow. Rather, you might format the guidelines into a short list.
– The reader. Sometimes you address the caregiver, sometimes the patient. For the reader, this is a little jarring. I think you could smooth this out by addressing neither directly. Rather, take a step back. I’ll give you an example:
You say, “On the other hand, as patients with cancer you should not feel you have to handle this on your own.”
You might say, “On the other hand, cancer patients should not have to handle this all alone.”
This is a tricky concept and takes practice. I can talk to you more about it if you like.
Xuan, you do a lot with this piece and I’m very impressed. Your writing has a nice tone (also called voice). You’re able to present information in a story format, which is engaging and easy to take in. By focusing on Danny, you give the data a human face. You made it real. Keep writing.
This is some very insightful and clear advice, Xuan Ru. I hope that you can be proud of your feedback and take this forward to further develop your writing skills.
Thank you for such clear, thoughtful advice, Kate.