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Cancer and
Mental Health
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC

CEUs available at:

~ Explore the contribution of stress, anxiety, depression to cancer
~ Explore the contribution of cancer to stress, anxiety, depression
~ Identify PACER Strategies to prevent mood issues

~ Stress is one of the most preventable causes of cancer.
~ Chronic stress (physical or psychosocial)  HPA-Axis dysregulation  Inflammation, sleep disruption, alterations in gut microbiota, increases in hypertension, glutamate induced neurotoxic environment, immune suppression, tendency to gravitate toward high glycemic comfort foods and away from foods high in antioxidants.
Mental Health and Cancer
~ In seven studies, severe life events, anxiety, depression, insufficient social support perception, or avoiding coping strategy were significantly associated with cancer risk
~ In a 2019 meta-analysis, which included 281,290 participants work stress was found to be an important risk factor for colorectal, lung, and esophagus cancers
~ Chronic physical or psychosocial stress suppresses the immune system and is associated with increased inflammation
Mental Health Causes of Cancer
~ Oxidative Stress
~ Free radicals are unstable molecules that are naturally produced in the body as a byproduct of breaking down nutrients for bodily processes or from exposure to toxic substances (residual waste)
~ Endogenous free radicals are generated from immune cell activation, inflammation, mental stress, excessive exercise, ischemia, infection, cancer, aging.
~ Exogenous free radicals result from air and water pollution, cigarette smoke, alcohol, heavy metals, certain drugs, industrial solvents, cooking (smoked meat, used oil, trans-fats), radiation, etc.
Mental Health Causes of Cancer
~ Oxidative stress cont…
~ When free radicals are produced faster than they can be neutralized by antioxidants and cleared it causes oxidative stress.
~ Dysregulation of the HPA-Axis results in elevated oxidative stress that leads to neuroinflammation and subsequent anxiety and depressive symptoms.
~ Oxidative stress has been implicated in depression and high anxiety levels and cancer, arthritis, aging, autoimmune (inflammatory) disorders, cardiovascular and neurodegenerative diseases
~ Cancer initiation and promotion are associated with chromosomal defects and oncogene activation induced by free radicals
Cancer Impact on Mental Health
~ Approximately 40% of the survivors reported moderate to high anxiety scores and approximately 20% reported moderate to high depression scores
~ Anxiety: Worsening, recurrence, rejection
~ Non-grief related depression possibly related to inflammation or the effects of treatment
~ Grief related to functional losses
~ Post Traumatic Stress
~ The person or a close relative of a person was exposed to death, threatened death, actual or threatened serious injury
Cancer Impact on Mental Health
~ Cancer-related cognitive impairment (CRCI), which can include changes in memory, executive function, attention, and processing speed, occurs in up to 30% of patients prior to any treatment and in up to 75% of patients during treatment
~ Cancer treatment and chronic stress from cancer can be neurotoxic
~ Chemotherapy or radiation can cause hearing loss and tinnitus (also some antiemetics)
~ Cancer treatment can cause dehydration
~ Cancer survivors have increased inflammation on average 20 years after treatment which is associated with lower cognitive performance.
PACER Strategies for Mental Health
~ Physical
~ CBD (nonpsychoatcive) has been found to possess antioxidant and anti-inflammatory activity
~ Vitamin E deficiency in the mouse brain significantly increases the levels oxidative stress markers and anxiogenic behavior
~ Vitamin C
~ Vitamin A (Beta Carotene / oranges)
~ Lycopene (reds)
~ Selenium
~ Omega 3 fatty acids help reduce inflammation. (Omega-6s tend to promote inflammation). A healthy diet should consist of about 4 grams omega-6s for every 1g omega-3. American diets provide 24 grams of omega-6s for every gram of omega-3 which partly explains the rising rate of inflammatory disorders (4:1 vs 24:1)

PACER Strategies for Mental Health
~ Physical
~ Flavonoids are compounds present in most plants which have potent antioxidant activity (flavanols, isoflavones, anthocyanins etc.)
~ The main natural sources of flavonoids include green tea, grapes, apple, dark cocoa, ginkgo biloba, soybean, berries, onion, broccoli, garlic, cumin, turmeric, tomatoes
~ Biochemical causes of depression, anxiety and cognitive disorders are metabolic disorders of monoamine neurotransmitters (NE, 5-HT, and DA) and impairment of the HPA axis. Many flavonoids act on the monoamine system and have antioxidant, anti-inflammatory, and antidepressant properties
~ Low glycemic index diet
~ BMI management

PACER Strategies for Mental Health
~ Physical
~ Exercise: Walking, Tai Chi, QiGong,
~ Deep breathing to increase oxygenation and trigger downregulation of the HPA-Axis
~ Sleep (to reduce oxidative stress)
~ Hydration which directly impacts mood and cognition

PACER Strategies for Mental Health
~ Affective
~ Radical acceptance of feelings to prevent dirty discomfort
~ Happiness and laughter boost immunity
~ Awe and wonder reduce inflammation
~ Distress tolerance helps regulate the HPA-Axis
PACER Strategies for Mental Health
~ Cognitive
~ Cognitive reserve
~ Hardiness buffers against the stressful life event
~ Psychological flexibility helps reduce HPA-Axis activation and subsequent inflammation
~ Health literacy

PACER Strategies for Mental Health
~ Environmental
~ Nature therapy enhances natural killer cells and “arsenal” enzymes, cortisol reduction
~ Some research suggests exposure to natural tree oils helps lift depression, lowers blood pressure, and may also reduce anxiety
~ Aromatherapy for mood, pain, inflammation
~ Ergonomics and assistive devices (boost chairs, stair chairs, shower benches,
~ Logistical assistance (transportation, shopping, prepackaged medication etc.)
~ Hearing loss and tinnitus monitoring and management

PACER Strategies for Mental Health
~ Relational
~ Social support to prevent distress and aid in coping and prevention of cognitive decline (which means supports need to be mentally and physically healthy too)
~ Significant others
~ Support groups
~ Spiritual leaders
~ Self esteem
~ Communication skills to ask for what is needed and maintain boundaries
~ Respite care for caregivers