By Dr Moira Fraser-Pearce
Being told you have cancer is the last thing anyone wants to hear. Hearing the word, the worry of what it means, waiting to find out what the prognosis might be, whether there is suitable treatment available, and what that might entail can be acutely distressing – and that is just the start. All of this comes before you’ve started thinking about what your diagnosis might mean for you and your family, your finances, your work, and everything else that matters to you.
Macmillan is proud to work side by side with the NHS to help people find a way through these often traumatic and confusing times, providing the practical advice and emotional support needed to help people make sense of it all.
Hearing the word, the worry of what it means, waiting to find out what the prognosis might be can be acutely distressing – and that is just the start
But sadly, this is not enough. For thousands of people diagnosed with cancer every year, the toll of a diagnosis can reach a point where increased psychological support is needed as part of their treatment, not as an afterthought.
Poor mental health has a negative impact on people’s ability to cope with cancer treatment. It leads to worse physical health outcomes and hinders recovery. And it’s not just at the point of diagnosis that this support matters. Coping with multiple appointments, the uncertainty of the future, and arduous treatment regimes also takes a toll. Many people who have finished cancer treatment are expected to pick up where they left off. But at the very time they’re expected to be celebrating, they often feel isolated and cast adrift, unsure of how to rebuild their lives.
Many people feel they can’t talk about their worries about the future because of the pressure to “stay positive” and “fight”, meaning they must cope with their worst fears alone. Often, meeting the emotional and mental health needs of people throughout their experience of cancer remains the unspoken frontier.
At the very time people who have finished cancer treatment are expected to be celebrating, they often feel isolated and cast adrift, unsure of how to rebuild their lives.
With NHS England’s recent commitment to both cancer and mental health, it seems logical to look at where these two areas intersect. How difficult can it be? And with the NHS England long term plan in the offing, surely that makes it a great time to move this forward.
It sounds straightforward. We have a measurable cancer population and several well-known ways in which we can support the mental health of people with long term physical conditions. So, is the answer simply to assess the needs of patients, put the right support in place and tell people how to access it?
As you may expect, nothing is that easy. There needs to be much more done to ensure people get the right support early on in treatment, so that their mental health doesn’t deteriorate – and this starts with an investment in trained professionals. There simply aren’t the staff available, despite efforts to increase the mental health workforce. And who should be responsible – the cancer system, the mental health system, or both? The risk is that it falls between the two, and neither fully grasps the problem or the solution.
Many people feel they can’t talk about their worries about the future because of the pressure to “stay positive” and “fight”, meaning they must cope with their worst fears alone.
Addressing the challenges in cancer, mental health and wider staffing is key to futureproofing the NHS. Investment in cancer services and in mental health are very welcome and desperately needed. This needs to be supported by clear workforce plans in the NHS England long term plan if we’re to achieve world class care in a health service that’s fit for the future.
This includes training more staff, retaining them once they are in place and making sure they understand the range of things cancer can mean – which can include long-term deterioration in health; living with pain and fatigue; money and relationship issues; and the prospect of death or long-term disability. We also need to put systems in place so that cancer care teams and mental health teams communicate effectively and know how to refer patients seamlessly, so that people don’t get lost in the system.
It’s a lot to do in a system that’s already bursting at the seams, held together by the hard work of all the amazing staff that make up our National Health Service.
Investment needs to be supported by clear workforce plans in the NHS England long term plan if we’re to achieve world class care
But if we are to invest billions into treating people’s cancer, then let’s do the job properly. Treating people’s cancer is vital, of course, but people are much more than their physical illness. If we don’t empower patients to live their lives in the way that they choose to, then we really are failing those who need our help most. Only when mental and physical health are treated holistically will we be able to meet the growing and changing needs of people with cancer.