Anxiety and Depression
Anxiety
High levels of anxiety or worry is very common when you are facing GIST. Anxiety can be classified in one of two ways, either acute or chronic. Symptoms of acute anxiety include:
- a rapid heartbeat or palpitations
- chest pain
- shortness of breath or feeling of being suffocated
- severe sweating
- chills
- hot flashes
- dizziness
- nausea
- trembling
- abdominal pain
- feeling fearful
- high blood pressure
- diarrhea
Symptoms of chronic anxiety include:
- insomnia
- muscle tension
- extreme fatigue
- inability to concentrate or make decisions
- being irritable
- excessive worrying
- restlessness
There are many things that you can try to manage and reduce your anxiety level. Anxiety can be treated with or without using medications. Psychotherapy and social support have shown to be very effective in managing anxiety in cancer patients.
Going for massages or participating in other activities, such as meditation, yoga, art, and imagery techniques, should also help alleviate anxiety. You may wish to work with a psychiatrist or psychologist to receive individual, family, or group counseling to manage your anxiety. Medications can be prescribed by a licensed psychiatrist or psychologist to make you feel less anxious and more relaxed. Joining either an online or in-person support group with others who are also battling cancer has been proven to be highly effective at managing anxiety.
To reduce and manage anxiety caused by surgery and procedures try the following strategies:
- If you have to have a procedure or surgery to remove a tumor, it may help to make a pre-operative appointment with your surgeon to ask any questions you may have regarding the surgery or procedure. You may also want to see the operating room in advance so that you know where you will be during the procedure.
- Make sure to ask your surgeon what you can expect as a result of the surgery/procedure so that you can have an idea of what will follow.
Asking your oncologist and other physicians on your medical team what can be expected during treatment is also a good idea to reduce anxiety. If you have a general idea of what to expect, you may be less anxious about treatment and your condition. Don’t let your anxiety keep you down. Talk to your physician today about managing your anxiety.
Depression
Sometimes a more serious condition, depression, can occur. This may be related to the disease itself, but in a few cases it appears to be caused by Gleevec (it has also been noted with dasatanib). Dana-Farber Cancer Institute reported on a series of 7 patients with depression that seemed to be caused by Gleevec or dasatinib1. In reporting their findings, the Dana-Farber team noted,
"Depression is a common problem in oncology, with many possible causal factors, including disease progression, treatment-related toxicities, social issues, and fear about the possibility of death. Thus it is oftentimes difficult to ascertain a relationship between depression and drug exposure. However, a striking pattern emerges from this series of seven patients. All were coping well with their disease psychologically before imatinib/dasatinib therapy, yet developed profound depression during treatment, with many experiencing complete remission or improvement of symptoms after dose reduction or drug discontinuation. Three patients demonstrated significant suicidal ideation (thoughts about suicide)—a psychiatric emergency. Interestingly, two patients had relapse of depression after TKI rechallenge and one patient was randomly assigned to the treatment arm of a placebo-controlled trial."
They then concluded, "In our experience, TKI-associated psychiatric symptoms responded inconsistently to standard antidepressant treatment; dose reduction may benefit some patients, and in severe, treatment-refractory cases, discontinuation of the suspect TKI should be considered. Based on this experience, we recommend that patients treated with TKI, especially imatinib and dasatinib, should receive routine screening for depressive symptoms and suicidal ideation. Given the known elevated risk of suicide in cancer patients, suicidal ideation should be treated as a psychiatric emergency, with immediate referral to a psychiatrist for assessment. Although in our clinical experience we have only noted TKI-associated depression in patients treated with imatinib and dasatinib, it is not inconceivable that similar adverse effects may be seen with other TKIs, given that they share common mechanisms of activity and have overlapping molecular targets. Further research on the incidence and risk factors for depression in patients treated with TKI is needed."
Helpful sites
Depression and Anxiety
Symptoms & Solutions: Anxiety and Cancer
Anxiety Disorder
References
1. Small Molecule Tyrosine Kinase Inhibitor and Depression
Richard Quek, Jeffrey A. Morgan, Suzanne George, James E. Butrynski, Kathleen Polson
