The Swallows Australian Edition Magazine

Psychosocial Aspects
of Head and Neck
Cancer
- Jane Turner
Head and neck cancer is an “equal
opportunity cancer” – it doesn’t discriminate in
terms of age, relationships, work or caring
roles. Over the past 25 years I have been
involved in the care of many people with head
and neck cancer, and this story is about Jeff
(not his real name), a 43-year old man who
was working as an IT consultant before his
diagnosis. Jeff coped with the diagnosis by
going into overdrive about information. He got
second opinions, increased his exercise, and
kept a blog documenting his experience.
When he was admitted to hospital because of
pain and problems with his intake he glossed
over the problems and discharged himself
after a few days because he felt he was “on top
of it”.
After discharge from hospital, things started to
get really tough for Jeff. He found going to
work exhausting, and he couldn’t concentrate
the way he used to. He worried about his job
and the impact on his family if he took time off.
He tried to put on a brave face so that his wife
Karen wouldn’t worry. She did worry. She tried
to prepare meals he would enjoy, and felt
frustrated when he didn’t want to eat. The
harder she tried to help him, the more Jeff
seemed to withdraw. During a routine follow-up
appointment, his oncologist said that he
thought Jeff looked stressed, and Karen burst
into tears, saying “We need help”.
When I saw Jeff, I thought he was depressed.
He thought he wasn’t trying hard enough. But
depression is common for people treated for
head and neck cancer. Depression is low
mood and not being able to “snap out of it”,
not being able to enjoy things, and having low
energy and interest in things. A common part
is withdrawing and feelings of being a burden
on others. Depression happens when people
Jane Turner,
Professor,
Discipline of
Psychiatry
Faculty of
Medicine, The
University of
Queensland.
have cancer because of a combination of
factors – grief about the cancer, pain, weight
loss, treatments, not being able to work (at
least temporarily) and concerns about the
future to name just a few!
Depression doesn’t mean that the person
hasn’t tried hard enough.
In fact, trying hard was actually causing
problems for Jeff. When he came to see me,
he talked about his expectations of himself and
always having to be in control. No wonder he
felt dreadful after his admission – not in
control, and having unrealistic expectations of
how he should cope with really challenging
treatment. Because he couldn’t live up to his
ideals of how he should be coping he felt
guilty. Jeff wanted to protect Karen from how
awful he felt, so avoided talking with her to
“protect” her.
No two people are affected in the same way by
head and neck cancer. We all bring our unique
strengths and frailties. Jeff had coped all his
life by being independent and working hard,
and it was great until he got cancer – but then
he couldn’t control everything.
Over time Jeff came to see that sharing his
feelings was not a sign of weakness – it meant
that people who loved him could support him
and share the experience. Jeff talked with
other people treated for head and neck cancer
and started to be kinder to himself. Jeff is no
longer depressed. He is enjoying life, and feels
closer to Karen.
Jeff’s advice, to talk about feelings, to admit to
feeling down if that is an issue, and to get help
if you need it.
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