Growing Concern over Mental Health of Cancer Patients

For cancer patients, since the global explosion of COVID-19 pandemic, growing concern over their mental health has become more expedient, especially since most can’t access health facilities for treatment or work to raise funds, thus spiraling them into depression, Ayodeji Ake reports

Eight years ago, Mrs. Nnena Obasi was struck by cancer which stripped her of her finances and some of the properties she laboured hard for. Due to her experience, cancer patients develop mental illness due to the outrageous cost of treatments. According to her, in most cases, the worry of generating money for cancer treatment has sent a lot to early grave. For survivors, a lot have developed one mental illness or the other through stigma.

“It all started in the year 2013. I felt a lump on my left breast. I didn’t know what it was until I visited the hospital and was referred to an oncologist and after the examinations it was confirmed it was cancer and that was how the journey started. I had my radiotherapy then I started the treatments.

“The stigma wasn’t easy especially when you have girl children and people getting to know their mother is a breast cancer survivor, men run away from them because they feel cancer is hereditary, which is not. Then, people were afraid of me and there were a lot of discriminating rumours. Some said it’s a spell, some spread the rumour that cancer is contagious and there were a lot of stories making rounds but today I am a living testimony.

“In Nigeria, we have a serious problem. Cancer patents are neglected and cancer treatment is still very expensive. I spent so much money, I sold so many of my properties to survive cancer but there are a lot of Nigerians out there who don’t have the opportunity. We need cancer centres in local governments so it can be easily accessed. Also drugs and treatment prices should be subsidised. When one looks around and discovers no financial support, there is no solution other than death. Support from the government will go a long way to assist cancer patients” she said.

Mental health became a growing concern especially during the COVID-19 lockdown. A lot of activities were stopped and gatherings were disrupted to curtail the deadly virus from spreading. Consequently, cancer survivors like Mrs. Obasi couldn’t access health facilities for treatment. A large number of survivors ran into depression.

“Before COVID-19, the cancer survivor group had line-up activities we engaged in: we visited the beach, the spa, the cinemas and other social activities but since the era of COVID-19, we couldn’t meet up with these activities again. A lot of people called that they were running into depression. I know of someone who was depressed and now down with stroke,” Obasi said.

Expert Opinion about Mental Health

Mental Health Advocate, Dr. Olamide Bello, in an exclusive with THISDAY, noted that although physical health is very important, mental health is also very crucial.

She further explained that mental health is attached to all health conditions, most especially depression and anxiety disorder.

She said: “We tend to focus on physical health and dealing with chronic conditions like hypertension, diabetes, cancer and other health issues. However, we tend to forget that mental health also plays a part in addressing the region as a realistic person and the fact that having these conditions puts you at risk of mental health disorders for instance particularly depression, anxiety disorders.

“It is important to take note that even though we address physical health in terms of treating those conditions we need to value our mental health and also our social wellbeing because WHO defines health as the state of physical emotional and social wellbeing and not just the absence of diseases and infirmities.

“Mental health deals with the fact that how we move, think, adapt, feel and how productive we are. Mental health is the state of wellbeing in which an individual realises their own capabilities and is able to handle stress, and be productive at work and in their community. We need to understand what our skills are and how we can build these skills to help our mental health” she said.

According to Bello, the transformation and alteration of the physique of cancer survivors may trigger mental disorder.

“It is a fact that breast cancer is a chronic condition and so having to deal with breast cancer is alone puts one at risk of a mental health disorder because it’s a life changing thing, it’s not a just a disease, it’s not just malaria, I mean if I go to the hospital if I have malaria now and I am given medications I am going to be fine.

“If I start treatment on time, I am going to be fine and be discharged but it’s a chronic thing, it’s not something that gets solved in a day or something that gets solved in a month, it affects your emotions because the fear of stigmatisation because I have breast cancer, or whether I am going to lose my breast because I have breast cancer?

“Men also have breast cancer, but women particularly, we are identified with how we see ourselves when we look into the mirror and this is someone that used to feel and see these aesthetics. Looking at the mirror and you telling me that I will have to cut off my breast because I have breast cancer, is a life changing thing.

“As much as possible, we need to have the talk and see that people are not feeling stigmatised because they don’t have breast or because they have breast cancer, I cannot look beautiful anymore or I don’t feel like myself anymore and I mean even the amount that I spent in managing the condition, you go for chemotherapy, you lose taste in what you use to enjoy, you go for radiotherapy, your hair starts falling out.

” I mean people feel beautiful when they make their hair but now your hair is falling out and things like that. So there is no way it’s not going to definitely affect anybody and that puts the person at risk of having a full blown mental health disorder,” she said.

Mental Health in COVID-19

In an encounter with the Founder, Care Organisation Public Enlightenment (COPE), a breast cancer non-profit organisation, Mrs. Ebun Anozie, she recounted experiences on impact of COVID-19 on cancer survivors as it relates to mental health.

“There is no doubt that the pandemic threw the entire world into a state of uncertainty because it was unexpected. In the first few weeks of the lockdown in Lagos, communicating primarily virtually was a challenge for our group members. A lot of them were always thrilled to attend our monthly meetings where we invite professionals to provide members of our support group with the necessary tools on how to live a healthy and fulfilled ‘new normal life’ after breast cancer diagnosis and treatment(s) with COVID-19 and the state lockdown, we could no longer meet in person.

“Furthermore, some of our members also found it difficult to visit their doctors for treatment for fear of becoming infected with COVID at a hospital, which was understandable considering the global statistics on certain categories of people with underlying medical conditions being susceptible to complications if infected with COVID-19. A lot of our members also missed communicating frequently with their support group partners who they rely on for emotional, social and spiritual support” she said.

Sharing her personal experience, Anozie narrated how she during COVID-19 indulged herself in some activities to avert destabilised mental health.

“Personally, I became lethargic. I became paranoid, I could not go out to exercise and became unnecessarily confused and anxious wanting to know the latest news on COVID-19. I found myself flipping from one news channel to the other listening to conflicting theories. I did my best to be brave because I needed to allay the fears of our group members.

“However, it was infuriating being in a frequent state of panic mode as well as gaining weight due to infrequent exercise. I am grateful for my daughter who encouraged me to de-stress by listening to my favourite jazz music and starting a small vegetable farm, which now puts a smile on my face each time I tend to the plants and consume fresh vegetables.

“With the respite that the vaccines have brought, and although no country is completely out of the woods, we felt it was important to find a way to organise a meeting to encourage our members while maintaining safety protocols.

“We specifically wanted to have a mental health professional speak to the group on how to cope with the mental health impact of the pandemic, even as the world begins to slowly open up again. We presented the idea to the group and they embraced the idea.

“I sought the support of Leadway Health and they graciously agreed and have been supporting us. Also, we distributed gifts which had been generously donated to our members by the ever supportive Founder, GingerSoulLifestyle, Mrs. Amina Gbajamila,” she said.

Preventive Measures

Speaking on preventive measures, Dr. Bello noted that keeping social relationships and healthy lifestyle modification by consuming vegetables, fruits and adequate water, stabilises mental health.

She said: “the key things really for tips on how to help is, in terms of lifestyle modification we can talk about eating well in terms of eating more fruits, eating more vegetables, drinking a lot of water, exercise also that is very key because those things help with building what we call endorphins, they are hormones that help with improving mood as much as possible.

“Things like fitness, finding things that you enjoy if it is taking minutes out of your time every day to do something you love doing even if it is listening to music, even if it is dancing, even if it is cooking, whenever it is and then all these other things, sometimes you might just need to express yourself.

“It might just be finding someone to talk to, expressing yourself, the person just listening and just that singular action of talking to somebody might help with managing your stress and there is what we call the four As of stress management where we talk about Avoiding, Altering, Adapting and Accepting. So those things, different situations require different things and it is an on-going daily challenge, it’s not something you can solve in a day, you have to keep doing it every day.

“I mentioned earlier that to build a habit you have to keep doing something for twenty one days and even after you do it for twenty one days when you have that habit, you have to keep doing it every day because it is an on-going daily challenge, you always have to go through stress, you always have to go through one thing or another.

“So you need to keep making sure that are you reassessing yourself on a daily basis, after today now did I do well in terms of managing my stress, tomorrow what am i going to do, am I doing it in a better day?, so you need to keep re-accessing and re-evaluating your journey because it is not something that get solved in a day”.