“It deprived me of sleep,” says hematologist Mayer Souza, 67, after being diagnosed with prostate cancer. “I was so nervous and afraid.” “The death issue had been haunting me for weeks. It was very stressful.”
Although she realized that emotionally dealing with the news was not as simple as she imagined, Mayer did not seek professional help.
“My daughters kept pulling my ear for me to do something,” he says. “They even suggested seeing a specialist.”
In the SUS (Unified Health System), psychological treatment for cancer patients is free and forms part of comprehensive health care. However, many men are reluctant to seek help in this regard, according to experts.
“The first thing that most patients report is the fear of death,” says Katia Antunes, psycho-oncologist and member of the Scientific Committee of the Lado a Lado pela Vida Institute, with 18 years of experience in oncology centres. “Then comes the fear that they will not be able to bear the treatment, that they will suffer and not get a positive result. But they do not seek psychological services.”
Antunes states that resistance is linked to social pressures based on the masculinity stereotype, which says men cannot cry or show weakness, which encourages the denial of feelings such as anger and sadness, which are common after diagnosis.
This pattern keeps men away from psychiatric clinics, exacerbating emotional problems, such as anxiety and depression.
Furthermore, there are other factors that can worsen the situation, such as financial and logistical difficulties during treatment. Not everyone has the resources for high-quality cancer treatment. Costs can be high.
Furthermore, many need to leave work or travel to other cities during treatment, which includes staying in hotels, shelters or with relatives.
“All of this creates additional concerns and impacts mental health beyond the treatment itself,” Andrade says.
According to David Muniz, an oncologist at Serio Lebanon Hospital, in São Paulo, the treatments themselves can cause mood changes and affect mental health. For example, radiation therapy and surgery to remove the prostate can have consequences, such as urinary incontinence and erectile dysfunction, which may worsen the psychological condition.
“Therefore, it is essential that the patient maintains open and direct communication with the multidisciplinary health team, which includes doctors, psychologists, physiotherapists and psychiatrists. This specialized monitoring helps in managing the physical and emotional side effects of treatment.”
Regarding the use of medications to treat disorders such as anxiety and depression, the diagnosis and indication for medications should be made by psychiatrists, due to the need to evaluate interactions between psychiatric medications and oncology treatment.
From the point of view of experts, the support of family and friends is also necessary to face challenges in a lighter and safer way. And that’s what Mayer did.
“I ended up not seeking mental health care because I knew how I would react. I thought it would be over soon, so I stayed with my loved ones and did things I loved. I listened to music, watched movies, and read things that didn’t involve mental terror,” he says.
Although support from loved ones benefits treatment, patients often take out their anger on their families.
“How many times have I heard women and wives complain, saying that their husband is very angry, but they don’t acknowledge that he needs help,” Antonis says.
According to her, the family is like a “surprise box” in the context of cancer. Relatives may be affected more emotionally than the patient himself, or on the contrary, they may strengthen each other to support the patient.
“The dynamics are different. There are children who fight not to be taken care of or to survive. Some are spared due to lack of patience, while others are proactive. The patient notices these tensions and becomes more depressed,” says Antunes.
The psycho-oncologist states that women bear most of the responsibilities and experience a greater burden, while men tend to provide less support during illness, which may lead to separation.
In these cases, it is necessary to evaluate the impact of cancer on family dynamics from the beginning to determine the best treatment, which includes reorganizing the family emotionally, and ensuring the well-being of everyone involved.
Psychotherapy for cancer patients can be done individually or in groups, depending on the patients’ needs and preferences.
Individual psychotherapy is recommended for those who find it more difficult to expose themselves, providing a safe environment to express feelings and concerns.
Support groups, especially segregated by gender, are important for creating space for exchange, reducing taboos, and promoting emotional adjustment through sharing among people with similar experiences.
This report is part of the Vita project, which was developed with support from the Syrian-Lebanese Hospital