Silent Struggles: Mental Health in Cancer Patients and Caregivers

Cancer changes more than your body. It can shake your sense of control, rewrite your identity, and make everyday life feel like it’s happening in a different language than everyone else is speaking. 
 
We sit down with the Virginia Oncology Associates oncology social work team to talk plainly about mental health during the cancer journey for both patients and caregivers. We walk through the emotional reality of diagnosis, treatment, survivorship, and end-of-life care, including fear, shock, sadness, anger, anxiety, and the fear of recurrence that can linger long after treatment ends. We also name something we hear all the time: the pressure to “stay strong.” When people feel like they can’t share what they’re really feeling, they may withdraw, miss appointments, or struggle in silence while juggling financial stress, transportation, work, and family roles. 
 
Caregivers are a huge part of cancer care, and their mental health often gets overlooked. We talk about guilt, isolation, and the heavy burden of trying to hold everything together, plus the subtle signs of caregiver burnout like brain fog, mood changes, emotional numbness, and getting sick more often.  

We share practical ways to ask for help in small steps, use community resources, and reframe support as strength, not weakness, especially when stigma and access barriers are shaped by culture, age, race, and socioeconomic stress. 

Make sure to visit our show notes for mental health resources mentioned in this podcast. 

Resources: 

988: https://988lifeline.org/
NAMI: https://www.nami.org/
VOA: https://www.virginiacancer.com/cancer-resources/#support-groups-at-voa

Thank you for listening! If you're interested in hearing more from Virginia Oncology Associates, make sure to subscribe to Cancer Care Connections on Apple Podcasts, Spotify, or anywhere podcasts are available, or listen online at cancercareconnections.buzzsprout.com.

Cancer Care Connections is the official podcast of Virginia Oncology Associates. For more information, visit us at VirginiaCancer.com. or find us on Facebook or Instagram at Virginia Oncology Associates.

Transcript

Announcer 0:05

Welcome to Cancer Care Connections: The Social Work Side of Care, where we talk honestly about the parts of health that often go unspoken. Cancer changes more than your body. It can shake your sense of control, reshape your identity, and make everyday life feel more unfamiliar. In today's episode, we're joined by the whole VOA social work team to have a real conversation about mental health during the cancer journey for both patients and caregivers. From diagnosis to survivorship and beyond, we'll explore the emotional realities many people face, but don't always talk about: fear, anger, anxiety, and the quiet pressure to stay strong. If you've ever felt like you had to hold it together while struggling inside, this conversation is for you.

Felicia 0:49

May is Mental Health Awareness Month, and today we're talking about something that often doesn't get enough attention: mental health during the cancer journey. When cancer enters someone's life, it doesn't just affect the body, it affects emotions, relationships, routines, and how people see the future. Patients feel it, caregivers feel it, and often people try and carry it quietly. Today I'm joined by VOA's social work team, and we're here to discuss the importance of mental health during the cancer journey with the patient and the caregiver in mind. Please welcome Roshonda, Elisabeth, Nicole, Christy, and KeAuna. Thank you. Thank you for having us. We're excited to be here. Let's start with mental health during the cancer journey.

The Importance of Mental Health During the Cancer Journey

Felicia 1:31

When people think about cancer care, they often think of treatment plans and appointments, not mental health. So, Christy, can you explain why mental health is so important throughout the cancer journey?

Christy 1:41

Absolutely. So good morning. I think you kind of nailed it on the head in your intro. You know, you talked about how cancer care isn't just about the body, it includes the mind and the whole person. So I think that's something that's really important to realize and understand. You know, it really affects a patient's identity, their relationships, their emotional stability in general. You know, you have so many different emotions when you have that diagnosis. You know, when you're in that room, I've had patients tell me, you know, and they just get angry or fear, a lot of shock, disbelief, you know. So I really feel like having that mental health piece can help with that uncertainty and really help our patients to have a clear mind, to make those really important decisions, you know, about treatment and what kind of chemo or radiation, all of those things, not just in the beginning, but really throughout their whole journey, you know, just to have that supportive piece. You know, those tools like counseling and support groups. And I think those can really help with your open communication, even with your support team and and hopefully your care team and and all of those people who will kind of gather around you that you have that support.

Felicia 2:50

Thank you, Christy. KeAuna, now I turn to you.

KeAuna 2:53

What are your thoughts? Just to piggyback off of what Christy said during her opening statement, mental health during the journey of cancer care is critical because you can look at the patient not just as a cancer patient. You look at them, their emotional concerns and things that they don't speak on during their nursing segments with chemo treatment and different things like that. You get in their personal life and really see what goes on in their day-to-day lives outside of coming to treatment. What does it look like at home? What is affecting them at home and how they get to the place to come to treatment? And that's important because when you are at home, that journey to even come to those appointments, it may be different struggles for every patient to just get here and cope throughout that journey. So having that mental stability is very important during the journey of cancer care. And so just having that mental health support, it can help them regain that emotional stability throughout that time. Absolutely.

Felicia 3:59

Thank you. Back to Christy. From your perspective, how does a cancer diagnosis impact well-being throughout the cancer journey, whether it's through diagnosis, during treatment, into survivorship or near the end of life?

Christy 4:12

Sure, absolutely. So your your emotional well-being is really impacted throughout the entire journey, right? No matter if you're just being diagnosed or hopefully in remission and on with it. And you're really gonna go through that process like a cycle, right? You're not gonna just go from one to this to this. You're you're gonna keep ongoing, I think is the word I'm looking for. Yeah, up and down, roller coaster. I like that. Yeah. You know, so at diagnosis, like I kind of mentioned, you're gonna have that shock and fear, really having that numbness, the fear of death. And this can be really destabilizing because suddenly you're forced into those really important decisions and you're really out processing that overwhelming news of what does this mean? And then you have your treatment. So you start your treatment and you're gonna feel exhausted, or you don't know how you're gonna feel until you're really into it. So that uncertainty. And this is really where emotional well-being can be very affected. You can see your body image changing, your hair loss or weight loss, weight gain. This stage is also the opposite that I've seen, where patients are very empowered and they have that support, and I'm fighting the disease and I'm into this and I can do this. And then we also sometimes see the anxiety and depression emerge at this point or even intensify, especially if we don't have those supports or those caregivers. You know, if that is limited, we can see that piece of it. And then we have survivorship. So that piece I've noticed in our patients really gives relief, right? Of course. But you're always gonna have that little fear, I think, in the back of your mind, you know, reoccurrence. Is it going to come back? You know, you don't have that medical care, that stability anymore. You're not going to see the doctor, you know, consistently. So you don't have that care team anymore. So I think I've seen that in our patients who just come back every six months, or we keep in touch, or, you know, we we check in on our patients, of course. That's definitely a theme that I've noticed is that fear of reoccurrence in that stage. And then we have the advanced disease or unfortunately end-of-life care. So, you know, we talk about comfort and feeling supported and just really having those outlets and rally around our patients and hopefully they have that support, that mental health outlet. I do think that the biggest thing to take away is your emotional support for our patients is, you know, just as important as their medical care and their sure and their medical health.

Speaker 5 6:39

Sure.

Christy 6:40

Thank you, Christy.

Felicia 6:41

KeAuna, from your perspective, how does mental health influence the overall quality of life during cancer treatment?

KeAuna 6:47

Mental health influences the overall quality of life and treatment outcomes from there. It shapes how they interpret their journey of what their diagnosis is throughout that time. You can have two patients that have the same diagnosis, but they're going to interpret it differently, whether they have that mental stability. One patient can be actually doing well, doing treatment, but if they're not mentally well, they can interpret it as I have poor prognosis, I'm not doing well, I am feeling sad all the time, and they may not disclose of these things to their physicians or their care teams and different things like that. They also may be withdrawn from care. They may not talk to their family, they may go through different things in life. But you will also have those patients that interpret their prognosis as well, and they may not be doing well, but they just want to get through that treatment process. Um, so just depending on that emotional stability that they have, they will have different outcomes and how they feel about the day-to-day treatment outcome. Thank you for that perspective.

Felicia 7:55

Your welcome. Last question for KeAuna. What do you see happen when mental health needs go unaddressed during the treatment journey?

KeAuna 8:03

When mental health needs go unaddressed during the mental health journey, the patients tend to have the poor prognosis where you see the missing appointments, becoming withdrawn. They don't talk to their care team or communicate what's going on. They may have social determinants that are affecting their health, which is their outside influences of financial stress, transportation needs, and different needs that may be affecting how they are undergoing treatment during that time. They may feel overwhelmed with day-to-day living, trying to get the personal needs met outside of the chemo needs and the chemo schedule that may have just altered how they are now living or in their roles and their family. They may have been a caregiver to their family members or head of household. Now they have to be depended on and have a fixed income. So those are different things that affect how they look at the quality of life or how they're going to finish out treatment or the changes that have come about duing treatment. And a lot of things may go unnoticed if they unwilling to communicate those things to their care team or their family and different aspects that are going on outside of just getting treatment medically. A lot of mental and emotional things are going on that they may or may not discuss or disclose.

Speaker 5 9:27

Exactly. There's so many things happening behind the scenes that you may not know about. Absolutely. Thank you so much, KeAuna and Christy.

Felicia 9:33

Absolutely. Thank you.

Mental Health Challenges for Cancer Patients

Felicia 9:35

So let's shift to the patient experience for a bit. A cancer diagnosis can change how someone feels about their body, their independence, and even their identity. So, Roshonda, what mental health challenges do you see most often for patients as they move through a diagnosis into treatment and into survivorship?

Roshonda 9:54

Well, what I've seen is more like a diagnosis that is that initial shock, right? It's like, I have cancer. Also, possibly with the shock, they're asking themselves, how did I end up with cancer? So it's just really going through the processing of saying, now what do I do? Right. Because also with the shock is something that is not in their control. So it's a loss of control going on at this point in time. And then once that settles in, and now you start to get your appointments and different things from the physicians or, you know, your clinical team, now it's anxiety, right? It's like a lot of fear of uncertainty. You might have some emotions that you have not yet labeled. And what it looks like maybe be what we call is depression, could be sadness for them, is how they describe it, because they're thinking about of a time as saying, like, oh my God, it's loss is happening here, right? I'm losing myself. Um, I'm, you know, and losing myself looks like I lost control. I did everything right to this point. You might have, you know, just say nutrition-wise, diet, exercise, whatever you might feel you have done for your life, and now you have cancer. You have to process all this and then also start a treatment plan that you don't really have control over anymore, like know what is gonna be the actual outcome. So once all of that is going on, then it it might be some identity shifts. And what we call it sometimes is role reversal, right? So you have the caregiver, you're a caregiver for everybody. Now you're actually the patient. And then you have to rely on other people to help you. And how do I ask? What does that look like? So that's where kind of during treatment, that anxiety and depression stems from. Because now you're having to ask for support when you've always been the caregiver, or you also have been able to care for yourself on your own. So you didn't necessarily need that, you know, need help or need to ask for help. And then lastly, when I think of, when you think about survivorship, kind of to speak back to like what Christy and KeAuna was alluding to, it's more of that kind of fear, that underlining fear that they start to have that Christy was talking about of reoccurrence. That's always the question, right? And then when you think about fear of reoccurrence, you also want to think about they have to like reinvent their new self. Who am I now? So sometimes what I've done with patients in that aspect of it, because after survivorship, after treatment is done and you're in survivorship, what comes up is who am I? Right? So, and what I always tell patients is basically let's think about it in a new way, like let's think about it in this way. You're reinventing, you're basically reinventing yourself. You're normalizing who you are now. Who you were before might look differently in different aspects of your life, personal, professional. You might decided not to work, you might have decided personally you want to, you know, just focus more on family. But now who you are is how we're gonna move forward. So we kind of tie that all in together for survivorship. So that's where we're at. Different emotions. Yeah.

Felicia 12:53

Thank you for that perspective. Many patients feel pressure to stay positive sometimes throughout treatment, whether for their family, their kids, their friends, or even at work with their coworkers. So, Roshonda, what impact does that pressure have on a patient throughout their journey?

Roshonda 13:09

And the team, probably, we we see this happen, you know, we hear this word so often or this phrase so often is that "I have to stay strong". I have to stay strong for everyone, right? And how that kind of shows up for them is because a lot of times when we have our patients before us, they will say, I'm feeling this way, but I can't let my spouse or my children know, right? Haven't we all heard that before? Absolutely. I can't let my... I can't let them know how I'm feeling. So I think for patients, how it shows up is they feel like they have to stay strong for everyone. And maybe expressing that you have fear, like the anxiety, or that you're, you know, sad, they feel like they're not... that might be considered weakness, or they're not being hopeful about the outcome. So that's definitely something that kind of shows up for our patients on time to time.

Felicia 13:59

And anyone can feel free to jump in on this last question. But if a patient is listening right now and struggling emotionally, but hasn't said it out loud, what would you want them to hear today from our conversation?

Christy 14:13

I'll go. I really think I want them to hear, you know, you're not alone. You have your whole care team here for you. I tell my patients this. I think you guys do too, right? Every time, you're not alone, you have your care team. Even if you are, you know, the only sister left in your family, you know, and you feel like you don't have any support, you can always come to us, the social work team or your nurse, our nursing staff is wonderful. That's one of the biggest things that I really try to make my patients understand is you always have somebody in your corner. Even if that's just you coming in and just talking to me for 15 minutes and catching up on how the last week went since your last treatment. So I think that's really important for our patients to know. Exactly.

Felicia 14:56

They have their family at home and they have a new family and support. Absolutely. Great way to say that.

Christy 15:02

Say that. Thank you. Yeah.

KeAuna 15:03

And to piggyback what off of what Christy just said, I talk about the fear of losing that control, like Roshonda said, or the guilt of survivorship that a lot of our patients deal with and they don't discuss . Like they come back for checkups and different things like that, and they have a good prognosis. They have completed treatment and they have that guilt of survivorship that they don't talk about. And just being able to talk about it, because you may be able to help someone else during their journey, if you are, you know, being able to talk about it. That's why support groups are very important as well. Just being able to get it out and being able to help those in your community now. You are a part of a new community that other people may be struggling to go through that journey. So I think that's important. For sure.

Roshonda 15:55

What I usually say to patients, "you deserve support, but you can still have hard days". Absolutely. "It's okay to not be okay". Yeah. Right? You're human. So in that aspect of it, if you are having a bad day, you're experiencing anxiety, you're experiencing depression, it doesn't take away from the actual experience. It doesn't take away from you feeling like, okay, I have cancer. So we need to normalize that more, right? I have cancer, but you also are still human, right?

Speaker 5 16:29

It's that rollacoaster. Yeah, yeah. Well, thank you all for that insight. Absolutely.

Caregiver Stress And Burnout Signs

Felicia 16:36

I want to shift our focus to caregivers for a moment because caregivers are a huge part of the cancer journey. Absolutely. Caregivers are often the ones holding everything together, keeping track of appointments, medications, and their own emotions while trying not to fall apart themselves. So, how does caregiving affect mental health? Nicole and Elisabeth, I'd love to turn to you.

Nicole 16:57

That's a really good question, Felicia. Caregiving significantly impacts mental health. Caregivers are often running on both love and stress simultaneously, like at the same time. And so it can feel emotionally heavy and oftentimes lead to anxiety, depression, exhaustion, and eventually burnout.

Elisabeth 17:16

Yeah, and like Nicole was saying, just that combination of like that physical and an emotional stress that they're both tying, because they're literally like this in the middle. So a lot of caregivers have to put their own selves on hold. Yeah. Um, because the priority at that time is the patient, it's their family member. So they're managing appointments. I think somebody earlier said the roles essentially shift, right? Maybe they were the head of the household or the patient was the head of the household. Now that caregiver has to step in and make ends meet, drive them to appointments and make sure they're taking their medication. So it's just a lot to essentially tackle at one time. And still work sometimes too, right? Because you still have a job...They're doing it all. So, and then, like Nicole said, that then if they're leave that unaddressed, all that emotional , it's gonna just keep weighing on them. And this is gonna lead to that burnout for sure. Absolutely. Absolutely.

Roshonda 18:04

Yeah, and I will also like... what about the under... kind of the subconscious, what the caregivers thinking? I don't want that patient, I don't want my loved one to die on my watch. So they're carrying really that heavy burden of that. And a lot of times the caregivers don't have a place to actually talk through it because they also feel like if they say it out loud, it would be the reality. And then they would have to, then the patient would lose hope. Yeah. So what does that look like?

Elisabeth 18:31

Yeah, and then that kind of circles back into this moment of feeling isolated, right? Because now they're the caregiver, they have to take on all these responsibilities, and who do they turn to? They can't turn to the patient, right? You want to make them feel guilty or you can't turn to the patient. Because right, that's that guilt, and all those emotions come up. So it's like they're in this silo by themselves of who can I reach out to? Yeah. So yeah.

Felicia 18:53

Thank you. And Elisabeth, another question for you with your experience working in oncology, which emotional burdens do you see most that caregivers carry?

Elisabeth 19:02

For sure. Um, I would say for one, the guilt, right? Piggyback on what we all said, a lot of guilt is there. They're guilty if they need a break, guilty if their work schedule conflicts with treatment appointment times. So now it's like, we gotta make, I gotta make my own money to make sure I can help out. But then I feel guilty if I say, I can't, mom, I can't do it. Sister, I can't take you to your appointment today. You're gonna have to figure it out on your own. It's a lot of guilt. So it's like, what happens in that moment, right? Helplessness and loss of control. Essentially, this is something that nobody wants, right? Or nobody thinks to like say, I'm going to have cancer or a diagnosis. So that's out of their control. It's a loss of control, essentially. They can't control that their loved one is going through this diagnosis or this journey. And then I would just say, just like an emotional suppression side, they need to stay strong. So they're just carrying all of that on. They're suppressing their own emotions and they can't express their fear, the sadness, the anger, all of these things are showing up, but what outlet do they have?

Felicia 20:03

Exactly. Some caregivers might not want to show that emotion in front of their loved one. Absolutely. Yeah. According to an article on cancer.gov, actually 50% of caregivers report high emotional stress, and 43% say that they need help when showing emotional and physical strain because they never get it. Elisabeth, why do you think caregivers often ignore that stress or minimize their own mental health needs?

Elisabeth 20:30

Yeah. Expectation. They gotta just pretty much, essentially in their head, suck it up and these things gotta get done, right? So I'm gonna be the one to make sure that I am taking some and doing all these things. The patient is the main priority. So anything else outside of that, we're just gonna have to figure it out. I'm gonna have to maneuver and figure it out myself, essentially. They don't want to burden others, right? The patient is dealing with so much. So why adding on my needs or maybe my even my mental health at that time essentially will feel like a burden, right? So why would I need to be seeking support and going to all these things when the patient is the priority right now? And then a lot of times it goes down to lack of knowledge, you know. Knowledge is power. And if you don't have the knowledge and the resources that are out there or the things like that, then you're just kind of just, it is what it is. We'll get through it. So um just they don't know the signs of what burnout looks like. Yeah, I'm having a sad day, but like Roshonda said, they identify it maybe as sadness, but it essentially is can be depression, right? These are so many signs, and we identify with depression and things like that that just go unaddressed. So we don't look at it that way. So just not knowing what burnout looks like, not knowing what depression looks like earlier. So essentially that knowledge piece. And then to go into not knowing what resources are available. There's so much stuff, y'all, for caregiver support; support groups, educational seminars, things that you can, the patient and the caregiver can be on. Online seminars and learning together. So it's tackling both of them simultaneously. So yeah, it's just a lot of resources out there. So, like I said, just knowledge is power, just educating on what resources are out there.

Felicia 22:12

We often hear caregivers say things like, it's not about me, suppress their emotions, like you said, or I'll deal with it later.

Christy 22:18

Right.

Felicia 22:19

So, Nicole, I'm gonna turn to you. What are some common signs that a caregiver might be burning out even if they don't realize it?

Nicole 22:26

Yeah. So it's good to have a self-check, like check in with yourself. If you're feeling super stretched thin, feeling stretched out, that might be a good sign that it's time to get some support for yourself. Earlier, Elisabeth said they really don't know sometimes the caregiver doesn't understand or know what burnout looks like. So burnout can look like extreme exhaustion, mood changes, brain fog, getting sick more often. Sometimes we see the caregivers start to decline even faster than the patient. We often see that, right, guys? So that's just maybe being emotionally checked out. Sometimes you're like you're here, but you're really not here. We they come to the appointments and the caregivers sort of out in space or they seem preoccupied. Maybe they've already checked out just from being so exhausted. Many caregivers don't even realize that this is happening. The focus is so much on supporting the patients, and the signs can be surprisingly subtle. So it doesn't happen all at once. Asking for help, it doesn't mean that you failed. It just means you're human, as you talked about, even for the patient. The caregivers need to understand that they're also human as well. And so sometimes we need to reframe this. It's not like you're giving up, you're just helping take care of yourself as well. So you can help them out, essentially. Yeah, help yourself, help yourself to help others . Yeah.

Felicia 23:45

And Nicole, what are some ways that caregivers can ask for help without feeling that guilt?

Nicole 23:52

That's a good question. I think one way to reduce the guilt is by asking for help in increments. So you don't feel like you're given everything. So maybe that might look like tomorrow, would you mind running to the pharmacy for my loved one and picking up a prescription from 10 to 12? That relieves one task from off of your plate without you feeling like I'm just completely giving up. So I would say start with that small increments asking for help just one thing at a time.

Felicia 24:18

Yeah. I like that advice. Does anyone have any other tips that they wanted to share?

Elisabeth 24:24

I would say utilizing the resources that are out there. There's so many things like transportation for one. That's a huge thing. I talked about having to go to work, but then also having your loved one have show up for treatment. Maybe utilizing one of our transportation services out in a community to help for a week so you can make sure you get to work on time for that week and then maybe do on and off. So just kind of pre-planning the things out, come up with your own little system and then utilizing the resources to kind of fill in those gaps as needed.

Nicole 24:52

Yeah. Just caregiving for yourself is not separate from caregiving for the patient. It's a part of it. It should be a part of the journey. Taking care of yourself as well. Yeah.

Speaker 5 25:02

Well, thank you so much, Nicole and Elisabeth. Absolutely. Thank you. Thank you.

Stigma, Culture, And Access Barriers

Felicia 25:07

So mental health has been a huge subject nowadays, and we're talking mental health more and more, but the stigma is still very real, especially around cancer. So, Christy, can you explain how factors like race, cultural background, age, or socioeconomic status can influence that stigma?

Christy 25:25

Absolutely. So mental health stigma is really shaped by who we are and the world we live in. Right. So everybody's world looks different. Mine looks different than yours. You know, everybody's looks different. So we've got race and those cultural backgrounds that can influence whether emotional struggles are seen as a weakness. You know, something needs to be hidden, or shameful. Then you have the communities that have historical trauma. I've seen the mistrust in the medical system, the medical field. A lot of cultures, you know, just have had unfortunately horrible experiences and just have that mistrust. And then you go into age. We have older adults where, like you say, we weren't really speaking of mental health and really addressing those issues. So it's suppressed, not talked about. But then you have the younger adults who are definitely more open about it. But I think they are definitely trying to make it seem like they are okay. Right? We have social media, and all you see is those pretty pictures on social media of everything is good when really they're just saying they're okay and on the inside, they're struggling. But there's that pressure to just always be okay. And then you have the socioeconomics that you spoke about. We have people who are maybe facing those financial struggles or financial stress, and they just feel like that's just how it is. They just need to deal with it. And and those resources aren't available to them. It's a luxury. They don't deserve to receive help. So, really reducing that stigma means addressing that culture, that excess, the distrust, you know, not just awareness of mental health, but really just trying to address those aspects of it. Thank you, Christy.

Felicia 27:13

Elisabeth, I'm gonna turn to you. Yeah. How do you think social workers and community leaders can help reframe that mental health care is a strength and not a weakness?

Elisabeth 27:23

Absolutely. I guess we all can honestly say, just normalizing it. Yes. More of what we're doing today, having these uncomfortable conversations and just talking about it, sharing different experiences, like different cultures, like Christy said. It's going to have different upbringings and what we hold to us as weaknesses, or maybe it's frowned upon to go out and get the help. So just having these conversations, education, education, education, just educating everybody on what's out there, what the resources look like. And even from like a practice standpoint, one thing that we did, we started mental health first aid training here for our staff. It's a training to pretty much promote and to be able to identify those early signs of mental health and what that looks like. So that if not for yourself, but also for your coworkers, your loved ones. Because it doesn't just stop in the workplace, it goes to your personal lives. And so really just education, conversations, and just even outside of the month of mental health awareness, making it a part of our daily lives and checking in on people. It's quick to just pick up the phone and just check in. Wow, I haven't talked to such and such in a long time. Let me pick up the phone and see how they're doing. That goes a long way. Just showing up for the people that matter the most in your lives and maybe a stranger too. Being okay with just, hey, how you doing? Are you okay? Do you need any help? So I just make it within my personal life to just be that person, just be ing that bright light, because you really just never know what people are going. Like Christy said, behind closed doors, it can be a whole different situation. So just having those conversations and being that person. You don't see others doing it. I want you to be that person.

Nicole 28:58

And as a social worker, I would just want to scream from the mountaintops. Accepting support is not weakness. It's really not. It's sustainability. Right. It's sustainability.

Elisabeth 29:07

Yeah. It's okay to not be okay. And just saying that, labeling it for sure.

KeAuna 29:12

Yeah. The biggest question is what does mental health look like? It doesn't have a face. So everybody sitting at this table could have a different mental health diagnosis or symptom, and you could just never know. You just deal with it how you deal with it, unless you talk about it. For sure. And you could get that support and get that help. So just us being social workers, we may have our own mental health that we may deal with. But when you're working with patients or someone in a community, just in general, you walk into the store and you know, everybody, it doesn't have a face. So everybody may be dealing with their own mental health symptoms or things that they're going through that they may not talk about. So what does it really look like? It doesn't have a face to it. So that's the most important thing. Just care about that mental health for everybody instead of just, okay, this is an underlying thing that we just discuss with, you know, just your family or your, you know, your loved ones. It's just a secret. It doesn't have to be a secret if you are, you know, letting someone know I'm not okay.

Speaker 8 30:13

Yeah.

Roshonda 30:14

So in saying that, like just from the social work perspective and thinking about a community, it's it's more so like we all come from different walks of life, right? And we all have an experience, a different experience around mental health, right? But one of the things also is we all have a story. It's the story behind why we're experiencing the actual symptoms of mental health and and what does that look like? And us as the social work team and dealing with people with cancer, we have been able to kind of paint that picture for the individual who feels so weak in the most vulnerable time of their life. And we've came in and they've seen us and given us the most intimate details from the patient, from the caregiver. And with that, we are able to advocate for them. And that looks like with the community leaders to make sure that they have a support needed. Absolutely.

Felicia 31:05

Thank you all for those insights.

Practical Support Plus 988 And NAMI

Felicia 31:09

Before we wrap up today, I want to make sure that people leave with something tangible after this conversation for patients, caregivers, or even friends that want to support a loved one with cancer. So, Roshonda, do you have any simple, realistic ways to take care of your mental health?

Roshonda 31:24

Well, first I will say that the social work team here at VOA, we're embedded. We're part of your team. Um, so definitely reaching out to your clinical team and asking, you know, them to refer you to social work. Or you can call and ask to speak to a social worker, we'll make sure that you're connected to someone and that you can get on our schedule. Um, and then lastly, I would say short, day-to-day, if you don't feel like you have anybody to talk to, journaling, writing things down. When you write things down, it's more so like you put it on paper, and now you are what we call is released, right? You can take a short walk. Walking is great, right? Just taking a brief five-minute walk. We do this here at work sometimes because also, you know, just uh what we deal with on a day-to-day. Just taking a brief walk, feeling that fresh air does a lot of wonders. From what all the team had mentioned earlier, support groups, there's a lot of support groups available, depending on what type of support group you need. There's disease specific, there's some that are age-specific, but we are here if you need to look online or if you just need to access them. We do have like our own comprehensive kind of support group listing. And then also I would just say just the community resources, being aware of the community resources. But again, I know it can be overwhelming for anybody, right? A patient, a caregiver, just even our clinical providers. So just reaching out to your social work team, asking your clinical provider to make a referral is more simplistic. Um, just because navigating the system can be complex. And we have noticed that sometimes patients they feel like that's a barrier that basically exacerbates their mental health. So I would just say the simplest answer would be ask your doctor to speak to a social worker.

Felicia 33:05

Acknowledging that every person's timeline is different in their journey, where are some places a patient or a caregiver can turn to when they're ready for support?

Elisabeth 33:14

I do. Um, a good one. This is simple and straight to the point. It's 988. It's a mental health resource. You can speak with a live like counselor agent. They do crisis intervention right in the moment. They also provide like different support group networks and things like that. Another one is NAMI, N-A-M-I. That is another mental health alliance. So, yeah, just knowing what is out there, and you can browse their websites, but you can, like Roshonda said, just give us a call and we can get you guys connected to those specific ones.

Felicia 33:44

Thank you. To close out this conversation today, if we could change one message that people hear today about mental health and cancer, what should it be? Anyone is welcome to change.

Nicole 33:54

I would say that mental health is an important factor of everybody's cancer journey. Cancer care is more than just treating the disease, but it's about supporting the whole person. Absolutely.

Roshonda 34:04

And I would say self-care is not selfish, it's necessary.

Speaker 5 34:09

Necessary, I'm just gonna say necessary.

Felicia 34:11

Yes, absolutely. I love that. I love all the things that we talked about today and shining a light on mental health, especially in the cancer journey. So thank you all so much for this conversation today. And for the work you do every single day community. Thank you for having us here.

Announcer 34:31

Thank you for joining us today for Cancer Care Connections, the social work side of care. If today's conversation resonated with you, you are not alone. Whether you're a patient, a caregiver, or someone supporting a loved one, your experience and your mental health matter. If you need support, we encourage you to reach out to your care team, to community resources, or to someone you trust. Asking for help isn't a weakness. It's part of how we get through this. Be sure to subscribe, share this episode with someone who might need it, and join us next time as we continue these important conversations. Don't forget to subscribe to our podcast via Apple Podcasts, Spotify, or anywhere podcasts are available. Or listen online at CancerCareConnections.buzzsprout.com. Cancer Care Connections is the official podcast of Virginia Oncology Associates. For more information, visit us at VirginiaCancer.com or find us on Facebook or Instagram at Virginia Oncology Associates.