How Cancer Affects Your Mental Health In Ways You May Not Expect

The beginning of August can signal the final days of summer, college move-in preparations, and squeezing in a final family vacation. But on August 1, 2023, it signaled something altogether different for Mary Beth Brault. Her life shifted. It was the day that she was diagnosed with PH+ B-cell acute lymphoblastic leukemia.

For the then-55-year-old, it was “a long, complex name for an aggressive blood cancer that hit like a freight train,” she says. “It shattered everything and rocked the foundation of our world. At the beginning of July, I was working, traveling, and going to concerts with my kids. By July 31, I could barely walk into the emergency room. Overnight, my whole life changed. But the worst moment—far and away—was telling my children. That broke me.”

According to the National Cancer Institute, approximately two million people will be diagnosed with cancer in 2025. Most people know that the disease takes a physical toll on the body, including fatigue, pain, nausea, and vomiting. But they may not factor in the mental and emotional toll of the disease.

“Being diagnosed with cancer can bring on a wide range of strong emotions in the period after diagnosis. Immediate reactions can vary – but many people feel shocked or numb, finding it hard to believe or fully process the news,” explains Michael A. Hoyt, PhD, professor and chair of Population Health & Disease Prevention of UC Irvine’s Joe C. Wen School of Population & Public Health.

From anger to anxiety, guilt to determination, a cancer diagnosis takes a toll on the person with the disease, as well as their family and friends.

Initial Reactions and Emotions

Brian Koffman, MDCM, is the co-founder, chief medical officer, and EVP of CLL Society Inc., an organization that addresses the needs of leukemia and lymphoma patients. His connection is intensely personal.

“I was diagnosed with chronic lymphocytic leukemia (CLL) in 2005,” he says. “My cancer diagnosis was a complete shock and raised disbelief. I was feeling well and was surprised when the leukemia was discovered on routine blood work,” he notes. “It was a gut punch.”

“Cancer is a thief, upending your sense of safety in your own body and your plans and hopes for the future. Depending on the type of treatment you need, you may have to give up the routine and activities you built your life around. It can feel like you’ve lost control over your life as you pivot your attention to battling cancer and coping with the uncertainty it brings,” says Hannah Holmes, PhD, clinical health psychologist at Holmes Psychology.

Forging an unknown path can also lead to unexpected emotions. These include:

• Stress and anxiety. “Fear and anxiety are also very common — people often worry about what will happen next, how they’ll get through treatment, and what it means for their future,” says
  Dr. Hoyt.
• Depression and sadness. One in four cancer patients struggle with depression. Unfortunately,
  only 5% of those struggling see a mental health professional, according to the National
  Cancer Institute.
• Anger and denial. “Some people feel angry — at the situation, the healthcare system, or just at the unfairness of it all. Others may go into denial, telling themselves it can’t be true, as a way to cope with the overwhelming news,” Dr. Hoyt notes.
• Guilt. People can experience guilt if they feel like the cancer is their fault, or they feel bad about burdening their family and friends.

Dealing With Misconceptions

You may also find yourself dealing with common misconceptions others have about walking through the cancer journey, such as:

• You shouldn’t be secluded. “The biggest misconception in my case was isolation—and why it’s necessary,” states Brault. “Once chemo started and my immune system was gone, I was essentially on lockdown. So was my husband. One random virus could [have] killed me.”
• Cancer patients need additional advice. “Another common issue: unsolicited advice. ‘Drink green juice.’ ‘Avoid sugar.’ ‘Try this herb.’ Let’s be honest — by the time you’re diagnosed, the ship has sailed. And I hate to state the obvious, but the chemo they are dumping into my body is exponentially more toxic than any cookie. People mean well, but it’s exhausting,” Brault says.
• All cancers behave the same way. “[It’s] a common misconception that a particular cancer diagnosis is predictable in its behavior and prognosis. There are always ‘outliers’ who beat the odds and live far beyond their ‘predicted’ life expectancy,” says Dr. Koffman.

Finding Hope and Joy

While research doesn’t necessarily show there is a correlation between a positive attitude and cancer treatment outcomes, for some, it can make a difference in the journey.

“What I love about the focus on hope involves taking a step back and asking ourselves what hope really is… and the way I have considered hope in my own work is to think of hope as a possessing the belief, skills, and actions to identify and pursue the things you value most in life,” says Dr. Hoyt.

Hope can help shift focus – from the difficulty and pain of cancer to things in life that bring joy or pleasure. And research does show that positive thinking builds resiliency and combats the stress’ inflammatory process. And joy can be found in regular, everyday activities, or things that give you a new sense of purpose.

Coping Mechanisms and Support Systems

Whether it’s a group of people walking through the same journey, friends, or a spouse, a support system is a critical part of your mental and emotional health when dealing with cancer. In addition to having people who care about you and help you, it’s beneficial to have other methods of coping.

Ideas include:

• Seeking out professional counseling. A mental health professional who is trained to help you navigate the emotions that come with a cancer diagnosis can offer critical support.
• Journaling. Getting your feelings out on paper can be a cathartic experience.
• Establish boundaries. “Saying no to energy-drainers and the people that never gave support [helps to protect] my peace,” Brault notes.
• Take part in hobbies you enjoy.
• Be patient with yourself. Learn to rest when you need it.
• Check out cancer support groups: Finding like-minded people is a great way to relate through lived experience, get guidance, and have a place to talk with others who understand the process.
• Prioritize rest. it is more important than ever to take care of yourself.
• Find ways to reduce stress. Techniques that involve nervous system regulation and mindfulness may be helpful.
• Practice vulnerability. Learn to express emotions with people who know how to listen without attempting to ‘fix’ you. Bottling up emotions can increase feelings of stress, anxiety, and depression.

People think they know what they will do when challenges strike. But often, you don’t truly know until you are experiencing it. Give yourself grace as you walk through your cancer journey, and care for yourself physically, emotionally, and mentally.