Life with metastatic colorectal cancer can be hard on both your body and your mind. "Metastatic" means the disease has spread to other places in your body, like your liver or lungs. Though there are exceptions, doctors usually can't cure metastatic colorectal cancer with current treatments. Still, many people can live years with it.
To keep your cancer under control, you may need strong therapies that cause side effects. Or you may have to change treatments if they stop working. You might feel sick, tired, or lose weight. These physical challenges can also affect how you feel emotionally.
Stress is common in people who live with a serious illness like cancer. An uncertain future can also leave you worried, sad, or angry. These are all normal feelings. The good news is there are ways to care for your mental health and well-being if you have metastatic colorectal cancer.
What You May Feel When Treatments Stop Working
When treatments for your cancer stop working, it can bring up a lot of different emotions. Sometimes, feelings you already had may become stronger.
"Patients with metastatic colon cancer should know that their mental health matters," says Amy Siston, PhD, CST, a licensed clinical psychologist who specializes in psychosocial oncology at University of Chicago Medicine.
"While loved ones may encourage patients to stay positive, it is unrealistic and exhausting to be positive all the time. Allowing space for all emotions can help patients feel understood and less alone," she adds.
Sadness or depression
When you have a serious illness, like cancer, it's common to feel very sad. In fact, your chances of depression are five times higher if you have cancer. Research suggests that 1 in 4 cancer patients are depressed.
You might grieve the life you once knew. It may be hard to find joy in daily tasks if you don't have energy or can't be independent. Also, relationships with loved ones can change and leave you feeling down.
Fear
Cancer can be scary. Many people with advanced cancer express fears about the future. "Fear of dying, fear of leaving loved ones behind, and deep concern about how their loved ones cope with grief and loss [are common]," explains Siston.
Stress and worry
People with cancer often stress over the life changes they go through. You may worry about how long you have to live, how you will get things done, or how you will pay your bills. Studies suggest about 40% of cancer patients report major distress.
Anger
It's normal to feel angry about your diagnosis. Your situation may feel unfair or out of your control. You may think or ask, "Why me?" Sometimes, people take their anger out on family, friends, or their health care team.
Loneliness
Life with cancer can be lonely. You might feel like no one understands what you're going through. Your friends and family may visit or call less often because they don't know what to say.
Guilt
Some people blame themselves for having cancer. They end up feeling guilty about lifestyle choices they made. Or they may feel bad that they upset their loved ones.
Acceptance or peace
Not everyone goes through only negative emotions. Some people are able to focus better on what they believe really matters, like time with their family and friends. You may feel peace after your diagnosis. Or you might have a renewed sense of meaning.
Maintaining Your Mental Health
If you have advanced colorectal cancer and struggle with mental health concerns, there are things that can help you cope.
Medications
Medications are sometimes needed to manage mental health conditions in people with cancer, especially if symptoms are severe.
"Antidepressants are good options for continuing low mood and loss of interest or pleasure," says Joanna Arch, PhD, a professor in the Department of Psychology and Neuroscience at the University of Colorado Boulder.
The antidepressant medicines citalopram (Celexa) and sertraline (Zoloft) are often used in cancer patients, Arch says. "[They] tend to be good choices due to lower drug interactions," she explains.
Psychotherapy
Psychotherapy, also known as "talk therapy," is a treatment where you talk to a trained professional about your thoughts and feelings. The goal is to help you manage them in a healthy way.
If you have cancer, research suggests psychotherapy can:
- Lessen stress
- Make you more resilient
- Improve your quality of life
"Ultimately, the most effective approach is a combination of psychotherapy and psychotropic medication management," says Siston.
Maintaining Your Well-Being
Certain lifestyle habits can improve your well-being if you have metastatic colorectal cancer.
Don't stop doing what you love
Try to find little ways to keep your life as normal as possible.
"Continuing to do what brings people joy and vitality and spending quality time with friends and loved ones can help to maintain mood and motivation in the face of advanced cancer," says Arch.
Relax
Relaxation exercises like meditation, deep breathing, gentle yoga, or guided imagery can help lessen stress when you feel worried.
One large review found that a specific set of yoga breathing exercises improves anxiety, stress, sleep, and quality of life in people with cancer.
Exercise
Research suggests physical activity can improve fatigue and quality of life in people with cancer, even in those with metastatic cancer.
"Exercise – particularly combined aerobic and resistance training and mind-body practices – has been shown to reduce cognitive side effects of chemotherapy, and thus, boost well-being," adds Arch.
If you don't feel well enough to hit the gym, a simple walk can help.
"Walking is easy to do, can be done indoors or outdoors, and may be enjoyed alone or with a friend," says Siston.
Sleep
Quality sleep can boost your immune system, which may help your body fight cancer better. Sleep also plays a part in your mental health. People with the sleep disorder insomnia are:
- 10 times more likely to have depression
- 17 times more likely to have anxiety
A solid sleep routine can help. You may also want to try these tips:
- Make sure your room is quiet, cool, and dark.
- Avoid electronic devices at least an hour before bed.
- Read, meditate, or listen to soft music if you can't fall asleep.
- Avoid large meals or caffeine right before bed.
Diet
A healthy diet can give you energy and may also improve your outlook. "A plant-rich diet emphasizing whole grains, vegetables, and fruit has been shown to improve progression-free time and overall survival," says Arch. Try to avoid processed or packaged foods as well as those that contain a lot of sugar.
Finding Support
It's important to surround yourself with people who provide encouragement and support. A support group is one way to connect with others who have the same cancer that you have.
"Decades of research have demonstrated the benefit of strong social support on improved quality of life, better emotional well-being, and improved survival rates among cancer patients," says Siston.
You can find support groups for colorectal cancer via resources like:
- The American Cancer Society
- Colon Cancer Coalition
- Colorectal Cancer Alliance
- Colontown
How to Talk to Your Family and Friends
"Talking to loved ones about prognosis can be one of the most difficult conversations patients face," says Siston.
Siston suggests you pick a time of day when everyone is well-rested and able to focus. She says information should be shared in an open and honest way. It should also be tailored to a person's specific age and understanding. And prepare for a wide range of reactions.
"Some loved ones may accept the prognosis. Others may become very upset, and some may avoid the reality of the situation and encourage the patient to continue fighting," Siston explains. "Discussing these different responses can help patients to navigate the conversation more comfortably."
It might help to tell your family and friends what type of support or help you need. For example, if you need a ride to your treatments, you can specifically ask them.
Though this conversation can be tough, it can also be a chance for you to express your emotions to others. You can talk about your worries and fears. You may even end up feeling better after you talk.
Takeaways
A serious medical condition, like metastatic colorectal cancer, can take a toll on your mental health. You might feel scared, lonely, or sad. Medication and therapy are options if your symptoms become severe. Lifestyle habits like exercise, sleep, and diet can also help you feel better. The most important thing is that you get the help and support you need.
Is it normal to feel depressed if I have cancer?
Yes, it's very normal to feel sad and down. But if these feelings affect your daily life, you should talk to your doctor.
Can I take medicines for my mental health symptoms if I have cancer?
Medications can help if your symptoms are severe or don't go away. Doctors often prescribe a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) because they're less likely to cause bad side effects. This class includes citalopram (Celexa) and sertraline (Zoloft).
Show Sources
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