Can endocrine therapies for breast cancer cause psychiatric conditions such as anxiety and depression? Although there is no evidence to support this, many patients face strong negative emotions during the treatment period. We talked with Dr. Emanuela Mencaglia, psychologist at Humanitas, about how it is possible to find a balance between the benefits and side effects of this type of therapy from a psychological point of view.
When the disease affects the body as well as the mind
“There are no data in the literature to confirm that endocrine therapies influence mood – explained Dr. Mencaglia – this is because oncological disease in itself strongly influences the personal emotional sphere. It is therefore very difficult at a time as important as that of a diagnosis or intervention to distinguish whether the presence of anxiety and depression is related to drugs or the complexity of the situation that the patient lives. However, according to experts, the data available in the literature shows that factors linked to the patient’s personality, such as age, level of education and being in a couple or single, play a decisive role.
Early menopause among the side effects
“Endocrine therapies lead most young patients to an early menopause – continued the specialist – a condition that cannot be underestimated from an emotional point of view, and the age of early onset, in this sense, is a key element. A young patient who had no premenopausal symptoms and who, from one day to the next, enters the menopause, will have a lot of trouble in the early periods, not only from a physical point of view, but also from a mental point of view, because the menopause is commonly understood as synonymous with aging, coinciding with the loss of fertility. The difficult acceptance of this step well in advance therefore sees the need for dedicated psychological support. “Some women have good personal resources and are able to face this change autonomously, not without pain and not without being passed through the so-called “personal mourning” – added the doctor – other women instead need more comfort and to become ‘enlightened’ towards the way to understand how to proceed. Finally, even for women already in menopause the therapy is not easy; it’s like repeating a passage that has already happened.
Awareness, a precious help
Knowing what you are going through when you are undergoing endocrine therapy to defeat breast cancer can be very painful. On the other hand, knowledge and awareness help later. Having a clear picture of your situation seems to initially increase the symptoms of anxiety and depression. Informed patients are those who apparently have the most difficulty managing the information in their possession and the individual personality structure can help or not to overcome the impasse of being aware, although this remains fundamental to the awareness, which becomes necessary to deal with the disease, therapies and possible side effects. Even not being alone, having a husband or a partner seems to be favorable because this represents a strong psychological support, as well as practical. Being in a couple in conditions of illness represents a solid social and relational network capable of improving and simplifying the quality of life of patients.
Among the side effects there is also a decrease in libido
“An early menopause dramatically affects libido and consequently sexuality, a very delicate aspect for a woman’s life – concluded the specialist. During menopause there can be joint pain, making the movement more difficult and annoying: the presence of pain is a known factor that can worsen the symptoms of depression, because it affects the daily activities affecting the quality of life. Although this therapy brings with it several important discomforts, it is good to continue to follow the prescribed endocrine therapy, remembering to report any side effects to the doctor or oncologist of reference: sometimes they can offer just small tricks to feel better.
