Ovarian Cancer And Mental Health

Overview 

Ovarian cancer is a gynaecological disorder that affects many women.¹ It stands as the sixth most common cancer among women in the UK and eighth globally, based on data from 2022. Despite new treatments being developed to improve survival rates, the mental and emotional challenges that come with the disease are often underestimated.² Living with ovarian cancer can be overwhelming due to the intense physical symptoms and heavy emotional toll. Many women experience uncertainty regarding their health status, fear of cancer recurrence, and anxiety about what lies ahead.² Furthermore, many patients with ovarian cancer experience depression and anxiety.² The psychological impact that living with cancer has can affect how well individuals manage their treatment plans, their social life and overall quality of life. Unfortunately, these mental health struggles are not always recognised or addressed early enough. Understanding how women cope with the physical and emotional impacts of ovarian cancer is important.³ Patients who have engaged in methods such as counselling, support groups, or mindfulness techniques have reported feeling more in control of their condition.³ Support from friends, family, and healthcare providers can also play a crucial role in emotional coping. The current article explores the link between ovarian cancer and mental health, addressing the emotional challenges, social implications, and coping strategies for those affected by the diagnosis.

Understanding ovarian cancer

Ovarian cancer begins in the cells of the ovaries, most often in the outer epithelial layer.⁴ There are five key types of epithelial ovarian cancer, with high-grade serous carcinoma being the most common. Other types include:⁵

• Clear cell carcinoma
• Endometrioid carcinoma
• Mucinous carcinoma
• Low-grade serous carcinoma 

The risk factors that may increase the likelihood of developing ovarian cancer include: ⁴

• Older age
• Family history of ovarian or breast cancer
• Genetic mutations (e.g., BRCA1, BRCA2)
• Previous cancer diagnoses
• Late menopause 

Common symptoms include:⁶

• Abdominal pain or discomfort
• Constant bloating
• Fatigue
• Loss of appetite

Often called a “silent disease,” ovarian cancer is usually diagnosed late because its signs are subtle and there is a lack of effective screening tools.⁷ The average age of diagnosis in developed countries is 63.⁴ Common treatments for ovarian cancer include surgery, chemotherapy, and sometimes radiotherapy.7 Treatment usually starts with extensive surgery and combination chemotherapy. Many patients tend to respond well to treatment at first; however, around 80% experience recurrence, leading to repeated chemotherapy cycles over several years.³ Unfortunately, chemotherapy can lead to side effects such as fatigue, joint pain and nerve damage.⁷ Long-term treatments are linked to emotional distress, such as fear of recurrence, pain, and physical exhaustion.⁸ Coping strategies and psychological support can be key in helping patients manage both the physical and emotional effects of the disease.³

Psychological impact of ovarian cancer

Being diagnosed with ovarian cancer can take a serious toll on one’s mental health. Women with ovarian cancer have been found to be at a higher risk of developing mental health conditions compared to the general population.⁹ The two most common psychological conditions experienced are depression and anxiety. Anxiety can present as constant fear, worry, and nervousness.² This ongoing stress can interfere with sleep, concentration, and the ability to enjoy day-to-day life. Depression, on the other hand, can present as deep feelings of sadness, hopelessness, and detachment. Many women report a lack of energy, a loss of interest in activities they once enjoyed, and difficulty keeping up with friendships during or after treatment.² The emotional weight of living with ovarian cancer, dealing with treatment’s side effects, and the fear of cancer recurrence can all contribute to reduced mental well-being. Recognising these psychological effects and getting help early, such as counselling, peer groups, or mindfulness practices, can make a significant difference in improving quality of life during and after treatment.¹⁰ 

Social and emotional challenges

Ovarian cancer does not just impact the individual but also those around them. How women feel and connect with others plays a major role in their overall well-being, influencing how well they cope during and after treatment.¹¹ Feelings of isolation, low self-esteem, and financial stress are commonly reported. Many women experience a shrinking social circle during treatment, often as a result of fatigue, physical changes, or friends and family not knowing how to help.¹² This can lead to a deep sense of loneliness and disconnection. A major emotional challenge is also the feeling of being a burden to loved ones. Women with ovarian cancer often report guilt or sadness about relying on others for help with day-to-day tasks or emotional support.¹² This perception can further reduce self-worth and increase emotional distress. Studies show that loneliness can significantly worsen psychological distress over time, leading to increased anxiety, depression, and a reduced quality of life.¹² Social support from family, friends or healthcare professionals can play an important role in improving emotional outcomes. Environments that encourage open communication and relevant resources that promote mental health care can help women feel less alone and more empowered in their cancer journey.¹¹

Coping strategies and mental health support

Coping strategies are the psychological and behavioural tools individuals use to manage stress, especially during challenging life events like a cancer diagnosis. These strategies are often either problem-focused coping, aiming to tackle the source of stress, or emotion-focused coping, helping to manage emotional responses. In reality, most people use a mix of both approaches, and strategies often overlap depending on the situation.³ A diagnosis of ovarian cancer can trigger a range of emotional and social concerns about treatment, recovery, relationships, and quality of life. Positive coping strategies include acceptance and seeking support. However, negative coping strategies, such as denial or self-blame, can result in higher distress and lower quality of life.¹³ Therapeutic interventions such as Acceptance and Commitment Therapy (ACT) can help individuals build emotional resilience by emphasising acceptance of difficult thoughts, feelings and symptoms rather than avoiding them.¹⁴ Other supportive practices such as peer support groups, mindfulness meditation, and exercise can also help to reduce stress, improve mood, and help patients feel more in control.

The role of healthcare providers

Healthcare providers play a vital role in supporting the mental health of women with ovarian cancer. Although medical treatment focuses on the physical aspects of the disease, emotional well-being is just as important yet often overlooked. Integrating mental health care into routine cancer treatment could lead to improved outcomes and quality of life. This means educating patients about the emotional challenges they may face, normalising mental health struggles, and addressing common misconceptions, e.g., the idea that feeling depressed or anxious is a sign of weakness. Open conversations about mental health help to reduce stigma and encourage patients to seek support when needed. Since coping strategies directly impact a patient’s well-being, cancer care groups should work with individuals to identify healthy ways to cope, such as counselling, peer support, or therapeutic practices.¹³ Additionally, healthcare policymakers should put greater focus on the development of mental health resources specifically tailored for women with ovarian cancer. More studies should be conducted to explore which treatments and interventions are most effective at reducing the mental health burden faced by this group.² By taking a more holistic approach, healthcare providers can greatly improve both the emotional and physical journey of ovarian cancer patients.

Summary

Ovarian cancer not only impacts physical health but is also a source of profound emotional and psychological distress for many women. As women live longer with the disease, the emotional toll, including anxiety, depression, and the fear of recurrence, has become a critical issue. Coping with the mental health challenges of ovarian cancer requires more than just physical treatment, but also interventions that tackle the emotional and social impacts as well. Many patients also struggle with loneliness, feelings of being a burden, and reduced social support, which can exacerbate psychological distress. Therefore, early interventions, such as counselling, mindfulness, and support groups, should be offered which can help to improve a patient’s overall emotional well-being. Healthcare professionals play a vital role in helping patients develop healthy coping strategies and ensuring that emotional well-being is prioritised. Policymakers should work to promote more mental health resources and research into effective interventions. By addressing both the physical and emotional needs of ovarian cancer patients, we aim to greatly enhance the quality of life of patients throughout treatment and recovery.