Cancer patients need support for depression, say health experts
A lack of emotional support for recovering cancer patients is leaving many suffering in silence as leading charities demand improvements to care.
Psychiatrists in the UAE have said many patients experience disrupted sleep, anger, stress, fear and sometimes post-traumatic stress disorder (PTSD) following a cancer diagnosis.
Research by UK-based Breast Cancer Care has shown that more than a quarter of patients it surveyed (26 per cent) said dealing with chemotherapy or radiotherapy was not as hard as coping with life after being discharged from hospital.
One in 10 felt positive and ready to move on when treatment was over, but more than half (53 per cent) struggled with anxiety once hospital treatment had ended.
Rahma, the cancer patient care society, said although the UAE is making great strides in awareness programmes, patients are often forgotten once a diagnosis is made.
“Psychological support is so important for patients and they shouldn’t feel they have to leave the UAE to access affordable treatment,” said Nora Al Suwaidi, Rahma’s director general.
“Cancer wards are morbid and there can be a lack of compassion towards patients.
“At Rahma, we want to help encourage more community support and volunteerism to help patients through what is a very difficult time.”
Mrs Al Suwaidi is helping develop a partnership with ProVita International Medical Centre in Abu Dhabi to improve palliative care for patients, as well as hospices in the UAE.
Rahma is one of the few non-profit organisations committed to helping cancer patients in the UAE but is facing challenging financial times and requires government sustainability grants to continue its work.
The World Health Organisation said 40 million people a year worldwide need palliative care but 86 per cent will not receive it.
Support for terminally ill patients is changing. Last year, Federal Decree No 4 on Medical Responsibility was approved, meaning doctors are no longer compelled to resuscitate dying patients.
“The hospice culture elsewhere has not developed yet in the UAE,” Mrs Al Suwaidi said.
“Nurses caring for cancer patients also need support and this is often overlooked as they suffer from compassion fatigue. It can be draining for them.
“I’ve seen many cancer patients in ICU units and it is hard for medical professionals to deal with. Hours are long and the pay isn’t great, so they also need support.
“We are trying to change the culture towards cancer in the UAE, but it will take time. As a young nation, we have an obligation to improve things for the future.”
Research published in the medical journal The Lancet said that cancer patients who were clinically depressed did not get the psychological therapy they needed, partly due to a focus on physical symptoms at the expense of good mental health care.
Of 21,000 cancer patients, they found 6 per cent to 13 per cent of people had clinical depression, compared with 2 per cent of the general population at any time.
Depression is most common in people with lung cancer, affecting 13 per cent of patients, followed by gynaecological, breast and colorectal cancer and then genitourinary cancer, for which 6 per cent of patients were diagnosed as depressed.
According to the World Health Organisation, the rate of depression has increased by more than 18 per cent since 2005.
The Priory’s Wellbeing Centre in Dubai offers support for stress, anxiety, depression and PTSD.
Dr Walid Abdul-Hamid, a consultant psychiatrist at The Priory, said doctors there are seeing an increasing number of people whose depression followed cancer treatment.
“A cancer diagnosis can leave patients feeling like they have no control over their own bodies and this often results in a real mix of feelings from anger, fear and despair, to uncertainty, loneliness and hopelessness,” he said.
“These feelings can prevail even after treatment has finished as the road ahead is suddenly so different.
“The impact a cancer diagnosis has on everyday life cannot be underestimated.”
Cancer survival is improving and has doubled over the last 40 years. For a number of cancers, including breast and skin cancer, more than eight out of 10 people will survive.
Research has led to better treatments, new drugs, more accurate tests, earlier diagnosis and screening programmes – giving patients a better chance of survival.
“A patient’s suffering extends far beyond the physical implications,” said Dr Abdul-Hamid. “It can lead to worries and fears about a recurrence, the impact on family and loved ones and mortality. Being able to simply ‘move on’ can be harder to do than you might think.”
“Confidence and self-esteem is often at an all-time low. Nobody should have to face a cancer diagnosis alone.”
Depression is most common in people with lung cancer, followed by gynaecological, breast and colorectal cancer
Dr Walid Abdul-Hamid, a psychiatrist, says nobody should have to face a cancer diagnosis alone