New research shows that women with mental health problems are twice as likely to die from the disease… I survived breast cancer but was floored by depression and just six sessions of cognitive behavioral therapy saved my life

The words stopped me. Depression ‘significantly affects’ breast cancer survival, headlined a medical journal.

It was an article about research published last week showing that breast cancer patients with depression are up to twice as likely to die from the disease as women in good mental health.

As a former breast surgeon who has had breast cancer three times – I am currently undergoing treatment – ​​I noticed it straight away.

You see, I’ve also been floored by depression since my first cancer diagnosis in 2015, at the age of 40. And I’m not the only one.

Up to a quarter of people with cancer develop clinically significant depression – two to three times the rate in the general population.

Are we, the unfortunate ones, really doomed? The short answer is: I don’t think so.

When I saw the study, I immediately delved into the data. I discovered that, despite the worrying claims, the real picture is probably not so bleak.

To draw their conclusions, the Russian researchers analyzed a number of existing studies. Some of these date back to 1977 and the most recent date back to 2018, which is a long time ago in terms of breast cancer treatment.

Since then, a slew of new treatments have emerged to tackle the more difficult-to-treat forms of the disease, and many of them have been remarkably successful.

I’m currently working on it myself – palbociclib – which was described by the Institute of Cancer Research in London as one of ‘the most important breakthroughs’ in decades. My treatment seems to be working and I am optimistic.

But as a patient I cannot deny the truth. It’s no surprise to me that depression, left untreated, can shorten our lives. When we are depressed, we are less likely to eat well and exercise, drink and smoke less often, and take the medications we need.

All of these things increase the risk of recurrence. Both cancer and depression make it harder to work. We are struggling financially, which makes our mental health even worse. It can be a vicious circle.

But my message, believe it or not, is one of hope. If you are a breast cancer patient suffering from depression, I want you to know that getting the right treatment is transformative. There are specific psychological support services for people with cancer, and they saved my life.

As a cancer surgeon, I didn’t realize that depression, anxiety, and other mental health issues were common after a diagnosis.

It sounds ridiculous, but it’s true. You see, I was focused on the physical side effects – until I got cancer myself.

Chemotherapy was hard. Mornings spent in the shower, feeling sorry for myself, waiting for the pain and nausea to go away. Combine that with the sadness for everything I lost. My hair. My chest. My fertility. Possibly my job. What about my relationship?

When I finished treatment – ​​chemotherapy, surgery and radiotherapy – I was told that my doctor would not see me again for five years. I felt an overwhelming sense of panic and despair. Was that it? How would I deal with it?

For the next five years, I woke up every day thinking, “Is this the day my breast cancer comes back?”

I felt something minor, like a pain in my hip, and I went into a blind panic. My doctor sent me for testing, which only made my anxiety worse. The same went for my annual mammography screening. “What if it’s not okay?” I wondered. Would I fall to pieces if I had to experience it all again?

When my cancer first returned in 2018 – a lump of scar tissue near my armpit – I lost my job.

I was left with chronic pain and a stiff shoulder and my life as I knew it was over. I defined myself as a surgeon and suddenly had no idea who I was or how to fill my days. And how many days did I have left to fill?

It was then that my oncology nurse told me that guidance was available through Macmillan Cancer Support. I met a wonderful therapist named Diane who told me it was normal to feel depressed and anxious.

As a former breast surgeon who has had breast cancer three times – I am currently undergoing treatment – ​​I noticed it straight away

Over six sessions of cognitive behavioral therapy (CBT) – a form of psychotherapy – she helped me develop coping strategies and small things to focus on, like celebrating a “win” every day.

But more importantly, you just had someone to talk to. I didn’t want to burden my friends and family with my morbid thoughts; I wasn’t sure if they would understand or know what to say. But in Diane I found someone I could be honest with. I was able to admit that I wasn’t doing well and express all my irrational feelings and fears. And once I said them out loud, it was like a weight had been lifted off my shoulders.

When my mother passed away in December 2022, I fell into depression again. I contacted the local hospice, which offers eight free CBT sessions to anyone who needs it. It was so important to me to have that space to cry, scream and scream. I would never have had the courage to be so vulnerable with my family.

My therapist asked me to draw how I felt. As she pulled out the crayons, I thought, This is ridiculous. But soon I was staring at a black angry scribble and was able to explain how my sadness was holding me back.

She encouraged me to write silly poems and letters as a way to express my feelings, and I still reread them now when I’m confused.

When I was diagnosed with breast cancer for the second time in 2023, I had CBT sessions again. I am eternally grateful to everyone who funds it through donations to Macmillan.

Referrals for therapy on the NHS take months, if not years, and private sessions with a therapist who specializes in cancer patients can be even harder to find.

Depression and anxiety can occur weeks, months, or even years after a cancer diagnosis. Something you read could trigger this – a celebrity being diagnosed with cancer, for example – or a friend in a support group could die, and you’d be consumed with guilt: “Why am I still alive?”

Knowing what I know now, I believe that anyone diagnosed with cancer should be told that their mental health can be affected just as much as their physical health.

But depression doesn’t have to be the end of our lives; help is available.