A kidney cancer diagnosis is daunting, but its impact on your mental health can be equally profound. If you are a patient, carer, or cancer survivor, it is important to know you are not alone and that there are ways to cope and seek help. This article explains the direct link between kidney cancer (KC) and mental health (MH), outlining common psychological effects, risk factors, coping mechanisms, and available support. We also aim to guide you through the emotional journey that often comes with a KC diagnosis.
MH challenges related to KC are often overlooked, but addressing them is just as important as treating the physical diseases. KC significantly impacts patient livelihood, and MH, with many patients experiencing anxiety, depression, and emotional distress due to the fear of recurrence. These psychological issues can deeply affect treatment adherence and quality of life, making it essential to understand and manage the emotional toll alongside the physical disease.
KC, also known as renal cancer, occurs in the kidneys and is the 10th most common cancer found globally. The kidneys are a pair of organs located in the back of the abdominal cavity. Their role is to filter the blood and remove waste and excess fluid from the body by producing urine. This type of cancer originates in the cells of the kidneys, typically starting from the lining of the small tubes within the kidney. The most common type is renal cell carcinoma, occurring in approximately 80% of individuals. Other types include renal sarcomas and Wilms tumours, often occurring in children under 5.1
Early stages of KC often have no symptoms, but as the disease progresses, symptoms can include blood in the urine, pain in the back or sides, a lump in the abdomen, unexplained weight loss, and fatigue. KC is a life-altering condition that affects how people think, feel and behave.
Once diagnosed, patients may experience a psychological shock, which can evolve into continual emotional struggles during treatment and recovery. Emotional distress typically stems from one's uncertainty of the future, pain or treatment effects, feelings of isolation, or changes in personal relationships. Whilst some patients begin to face MH during diagnosis, others may encounter it after treatment ends, impacting their quality of life as KC survivors.2
As emotional distress amplifies during the cancer journey, some patients may develop significant MH conditions that aren't typical stress responses. Below are the most commonly occurring MH challenges amongst KC patients.
Depression is characterised as persistent low moods with feelings of sadness and loss of interest, affecting how you think, behave, and feel. It is one of the most prevalent MH disorders among cancer patients, especially in KC, due to the uncertainty of prognosis and side effects of systemic treatments. Patients can experience low mood, loss of interest in activities, fatigue, feelings of hopelessness, and changes in appetite or sleep patterns. If left unaddressed, depression can interfere with treatment adherence and recovery.1
Anxiety is a common MH condition causing you to feel a feeling of dread, fear and uneasiness over anticipated events. In KC, chronic worry and fear are common concerning disease progression, treatment outcomes or the possibility of relapse. Anxiety symptoms include: muscle tension, restlessness, panic attacks, and irritability. Persistent anxiety can reduce patients’ quality of life and impair decision-making regarding treatment, as studies have shown that anxiety is commonly seen in patients undergoing immunotherapy or a nephrectomy, which is the surgical removal of the kidney.3,4
Sleeping disorders, like insomnia or obstructive sleep apnoea, have been linked to KC, particularly in renal cell carcinoma. Sleep apnoea is characterised by a temporary inability to breathe or reduced breathing during sleep, causing fatigue. Insomnia often occurs in KC patients due to a combination of stress, pain, frequent need to urinate, and medication side effects. The effect of poor sleeping habits further worsens moods and contributes to anxiety and depression, but can also cause physical healing to slow down and impair one's cognition and physical health due to the lack of rest.5,6
Psychological distress, namely depression and anxiety, significantly influences how a patient engages with their care. An example is that individuals who struggle with MH are more likely to miss scheduled appointments or neglect their medical schedules. Communicating with your healthcare providers may also be a struggle, which leads to misunderstandings and a lack of clarity about treatment plans. Furthermore, a lack of motivation can result in patients discontinuing their treatment early, whilst emotional turmoil weakens their body’s ability to recover. Addressing MH through targeted interventions, such as counselling and stress reduction techniques, has been shown to enhance treatment adherence, improve recovery rates, and improve survival rates and quality of life.1,2
Understanding and noticing the signs of MH decline is essential, whether in yourself or someone close to you. Often, signs may include one or more of the following: persistent sadness, frequent crying, and noticeable loss of interest in previously enjoyable activities. Other warning signs can be persistent restlessness, panic attacks or overwhelming fatigue without a medical cause. Withdrawal of emotion from friends and family, as well as expressing hopelessness and, in more extreme cases, self-harm, must never be ignored. Identifying these red flags early on and seeking help can make a significant difference in mental and physical health during cancer treatments.7
Knowing when to reach out for professional support is as important as recognising warning signs and early symptoms. If MH symptoms persist and interfere with daily life and life starts to become overwhelming, it may be time to consult an MH professional. Inability to sleep, eat, or effectively function, as well as thoughts of self-harm or hopelessness, should not go unnoticed and require immediate attention.6,7
Oncologists typically work with psychiatrists, therapists, and cancer social workers, who are professionals trained to support the MH needs of cancer patients. Their guidance can provide tools to not only cope during treatment but also to thrive after treatment.8
Integrating MH care into KC treatment can improve patients' overall outcomes. Patients can adopt several strategies to support their emotional health.
Cognitive behavioural therapy is a type of strategy which uses talking to help individuals manage MH conditions, like depression and anxiety, by addressing emotional concerns like stress or worries. It is widely used to help reframe negative thought patterns and create healthier coping mechanisms. It’s been proven to reduce symptoms of anxiety and depression in KC patients.9
Mindfulness techniques, such as meditation, deep breathing exercises and progressive muscle relaxation, can also help manage stress and promote calmness. It works by releasing the body from a fight or flight state to a calmer, less tense state, where your body feels more regulated. These techniques reduce the heart rate and lower and calm the body when feeling anxious. Overall, these techniques help, in the long term, with managing anxiety and managing moods.10
Creative outlets, like art or journaling, can create a therapeutic environment to express emotions and boost self-esteem, as they offer a break from everyday challenges and allow for relaxation and mindfulness. Additionally, light physical activity, such as walking or yoga, has been linked to improved moods and quality of life amongst cancer survivors, enhancing the quality of life as well as reducing the side effects of cancer treatments.11
Below are a few links to access support from organisations offering online forums, professional counselling, and support.
This article explores the links between mental health and kidney cancer, drawing focus to how a diagnosis of cancer in patients can impact their mental health, leading to conditions such as depression, anxiety, and sleep disorders. These psychological effects can impact treatment outcomes, recovery, quality of life, and well-being. It highlights the importance of recognising early symptoms of deteriorating mental health and ways to overcome them by using holistic methods, namely light activity, creative outlets, mindfulness techniques, and talking therapy. Overall, integrating mental health care into kidney cancer treatment can improve the quality of life of the patients as well as long-term recovery.
