Cancer & Mental Health
The Overlooked Intersection in Whole-Person Care
(Based on WHO, 2017, pp. 19–23)
Cancer is often treated as a physical disease. But the truth is that it also deeply affects the mind. Anxiety, depression, and emotional fatigue are part of the cancer journey, yet they often remain invisible in treatment plans.
According to the World Health Organization, about one in four people with cancer experience anxiety or depression. Only about one in five of those are formally recognized as having a mental health disorder and receive care. Without support, people face poorer quality of life, longer hospital stays, lower adherence to treatment, and higher suicide risk.
The Emotional Weight of a Diagnosis
Emotional distress is almost universal after a cancer diagnosis. In the first year following a breast cancer diagnosis, half of patients experience significant anxiety or depression. Over time, the number decreases, but about one in four continue to experience distress for years.
These emotions are not signs of weakness. They are natural responses to uncertainty, pain, and major life disruption. What’s troubling is that they often go untreated.
The Hidden Impact of Under-Treatment
Many people with cancer show signs of depression or anxiety that go unnoticed. Fatigue, appetite changes, and sleep issues can be symptoms of both cancer and depression, which makes diagnosis difficult. Sometimes clinicians assume sadness is “expected” and therefore not something to treat.
When emotional pain goes unaddressed, treatment outcomes suffer. Depression in cancer patients has been linked to lower compliance with chemotherapy, slower recovery, and longer hospitalization.
Screening and Early Support
Some countries have made important progress. Australia, for example, published national guidelines for screening, assessing, and managing depression and anxiety in adults with cancer. These recommend routine screening at key stages of care using simple tools like the Distress Thermometer, Edmonton Symptom Assessment System, or the Hospital Anxiety and Depression Scale.
When emotional distress is identified early, people can receive timely psychosocial support, which improves both quality of life and medical outcomes.
Cancer and Severe Mental Illness
The relationship between cancer and severe mental illness reveals another layer of inequality. Research shows that people with schizophrenia or bipolar disorder are not more likely to develop cancer, but they are more likely to die from it.
The reasons are systemic.
People with schizophrenia smoke at much higher rates, sometimes as high as 80%, which increases their risk for lung cancer.
They participate in cancer screening programs less often than the general population.
They are less likely to receive surgery, radiation, or chemotherapy when cancer is diagnosed.
They are more likely to present with advanced disease and metastases.
A study in Australia found that cancer mortality among psychiatric patients was 30% higher than in the general population. In London, survival rates were significantly lower for people with mental illness, depression, dementia, or substance use disorders, even after controlling for the stage of diagnosis.
What This Means for Care
The WHO concludes that every person receiving palliative care should also receive a psychological assessment and, when needed, evidence-based treatment for depression and anxiety.
This is the heart of integrated care: seeing the person as a whole. When oncology and behavioral health teams work together, people live longer, cope better, and have a higher quality of life throughout treatment.
The Systemic Imperative
Cancer care often mirrors the health system itself, highly specialized, yet fragmented. Emotional care and physical treatment happen in parallel rather than together. Real progress comes from bringing those systems into alignment.
Integrated care doesn’t just treat the disease. It restores connection, dignity, and hope.