Side Effect: Mood Changes

• Mood changes in patients with cancer refer to a person’s emotional state. These feelings can fluctuate from feeling happy and thankful to sad, anxious, irritable, or nervous.
• A change in mood is normal after a cancer diagnosis.
• Mood changes can range from minor and temporary to a more persistent or severe state.
• A patient with cancer can experience one or all emotions when diagnosed, throughout treatment, and after completion of therapy.
• Mood changes in patients with cancer are common, with up to 40% experiencing a variation in mood.
  • This can in turn affect a person’s ability to perform their normal daily functions and as a result, decrease satisfaction with certain parts of life that are normally enjoyable.

• As mentioned above, patients with cancer can experience mood changes in a variety of ways and at different times in their cancer journey.
• It can be difficult to pinpoint the exact feelings patients will experience, as it depends upon the individual and their circumstances.
• Some common feelings associated with mood changes in patients with cancer include:
  • sadness
  • anxiety
  • hopelessness
  • being overwhelmed.
• Mood changes can be caused by the diagnosis of cancer and side effects of cancer treatment (pain, fatigue, nausea, etc).
  • Psychological factors can play a role as well which can lead to anxiousness, depression, or a fear of cancer recurrence once treatment is complete.
  • Additionally, patients may experience a change in their weight, sleep, appetite, and energy levels, which can all affect mood.

• Any patient with cancer can experience mood changes, and most probably do.
• This can also have a significant impact on their loved ones. Family members, caregivers, and children may feel helpless or stressed seeing their loved one going through this journey or struggling with mood changes.
  • Loved ones may also experience anxiety, depression, and other emotional disturbances because of a patient with cancer’s illness and mood.
  • Everyone involved in the patient with cancer’s journey can be affected, and therefore experience changes in mood.

• Mood changes are most common during the initial stages of diagnosis and beginning of treatment. However, since side effects can last throughout treatment, mood changes can last throughout the duration of therapy.
  • Starting a new treatment is often the most common time to experience side effects of therapy, which sometimes include nausea, vomiting, fatigue, diarrhea, constipation, or pain.
• As mentioned before, mood changes can occur at any stage of the patient with cancer’s journey, including before, during, and after treatment as well as in remission, when cancer can no longer be detected.

Although difficult, there are several strategies that may be helpful in preventing mood changes in patients with cancer. Strategies include psychosocial support, education, and medications. Below are examples of people or activities patients can engage in before, during, or after treatment to assist.

• A good support system:
  • Include your family, friends, coworkers, and doctors in discussion about how you are feeling
• Manage physical symptoms:
  • Speak up! Ask your doctor or clinic staff about taking medications to lessen side effects, such as nausea, diarrhea, constipation, and pain
• Activities to promote relaxation/stress reduction – consider meditation, and breathing exercises

Social support, cognitive-behavioral therapy, relaxation techniques, and mindfulness-based stress reduction are all ways to possibly prevent mood changes or reduce the intensity.

• Treatment of mood changes involves a multi-disciplinary approach including combinations of psychotherapy and medications.
  • Antidepressants alleviate symptoms while psychotherapy assists in emotional support for patients with cancer and their loved ones.
• A newer approach involves a virtual reality during treatment, which can diminish symptoms like nausea and vomiting.
• Treatment often involves a combination because psychotherapy and medication therapy has been more successful versus either strategy alone. Below is a list of some strategies commonly used to treat mood changes in patients with cancer:

Medications – antidepressants

Examples:

• Sertraline (Zoloft®)
• Fluoxetine (Prozac®)
• Escitalopram (Lexapro®)
• Paroxetine (Paxil®)
• Citalopram (Celexa®)
• Venlafaxine (Effexor®)

Psychotherapy

• Counseling, support groups
• Guided imagery
• Virtual reality