Post treatment depression

Merry Christmas zzonner! The holidays come and go with the same joy as precancer when you can finally put the diagnosis and treatment side effects on a back burner. It takes a while. My first surgery was over 11 years ago at Mayo Clinic Rochester. Followup chemo/radiation closer to home at U of Michigan ( tough for an Ohio State grad ) started a month after surgery. The end of treatment left me feeling like I was teetering on the edge of an abyss, with nothing there to catch me. Suddenly we weren't actively fighting cancer any more, but just waiting for it to show itself again. Luckily I knew about an immune augmentation clinic in the Bahamas that had a darn good record in prolonging lives of people with cancer. I started that shortly after the end of radiation and once again I felt I was doing everything I could to prevent a recurrence. Diet and lifestyle changes and simply working on my own attitude of gratitude have all helped. I'm quite the optimist so that helps, and this has gotten me through 4 metastases and 3 more surgeries. At 70, you're never sure if the slowing down is due to age or your chronic illness and treatment but you listen to your body and keep kicking the can down the road. I know others have sought therapy to get through the post treatment period, but I just did some reading. Favorite books which helped me regain my positive attitude: How Not to Be My Patient by Ed Creagan MD, a former palliative care physician at Mayo with many great suggestions for life changes, Radical Remissions by Kelly Turner, and her other book Radical Hope. For me, reading about others who have gone the cancer route and continue to live a good life helps my attitude a lot. The gratitude exercise of waking each morning and thinking of 4 things you are grateful for then again as you go to bed what 4 things happened that day to be thankful for. Just enjoying a quiet cup of coffee in a peaceful setting can be one of them. Congratulations on having NED right now! That is certainly worth celebrating. It takes time and some work on your part to get to your new normal where you can mostly enjoy life and place that cancer diagnosis in a dusty corner until your next scan blows the dust off again. THINK POSITIVE and never give up hope. .....Susan

Just pop in whenever you'd like... we do them twice weekly as follows:

Wednesdays, 6pm Eastern
Sundays, 9am Eastern

ID - 455 028 4795
Passcode - tuiBE5

No official format, we just go around the room, concentrating on the newbies, or those in need. We keep it light, have fun, but get down to business when needed. We're made up of 5 to 7 unofficial counselors like myself. Some are stage 4's, given months to live many many years ago. Some are stage 1, straight to surgery folks, and between all of us, we've done every chemo, radiation, surgery, and immunotherapy, known to man. And we have patients and caregivers drop in from all over the world... so we've also seen how things are done elsewhere, in many NHS countries. We know insurance, SSDI, and all the many tests, procedures, side effects we all go thru. After doing these calls since May 2021, I realize that we know far more than most of our doctors. Mainly because we're not specialists like our oncologists, radiation oncologists, thoracic surgeons, GI doctors, pathologists, radiologists, etc. We know and have gathered so much from ALL of these doctors along the way... and we see things from our patient's perspective. And yet we are careful... we understand we are not doctors... but we only tell the truth. We're not here to simply comfort others, give them faith or hope (although this almost always happens). It serves no one to bs others... just solid counseling. We talk openly and descriptively... nothing out of bounds.

Be well...

Gary

I would love to join in zoom. I am 45 years old. Had a cryo ablation about 4 years ago. I believe doctor over treated my my condition which fell me into great difficulties in my everyday living. Sometimes I feel it is not worth to live.

@zzonner
I'm sorry to hear you are struggling with post treatment depression or other mood disorders.
Unfortunately, this is a fairly common occurrence in 18-25% of cancer patients according to the recent literature on the topic. Distressingly, it is a topic that is rarely discussed in depth by oncologists or other members of the care team as many feel that while it may be a legitimate issue for some patients, it's not in their clinical wheelhouse. As such many don't feel comfortable about addressing the issue or making clinical recommendations other than a trial of various antidepressants.
The sources of cancer treatment related depression and other mood disorders are multifactorial in nature. First, there is the mental fog (a.k.a chemobrain) that almost every patient experiences. It is generally attributable to the release of lysed cellular contents which induces the released of inflammatory cyotikines. These in turn, active what is known as the NLRP3 inflammasome. This may may induce neuroinflammation and associated symptoms of mood changes and depression.
Also, there are a number of chemotherapy regimens, such as FOLFOX, that incorporate folinic acid, 5 fluro deoxyuridine (5FU) and oxyplatin in varying amounts. Each of these agents has been shown to be associated with increased rates of depression in significant subsets of patients treated for varying intervals with varied regimens in various clinical studies.
More recent studies have demonstrated that 5 FU in particular induces significant changes in the normal gut microbiome.
If you have been following the public or clinical literature in regard to the alterations in the gut microbiome and it's effects on the gut-brain axis, and the subsequent development of depression and anxiety. As clinicians have become more aware of the deleterious effects of cancer treatments in inducing changes in patients’ gut microbiomes and the link to their mental status, they have begun to tailor their approach to therapeutic interventions. ⁷This may include the recommendation of a probiotic supplement to replenish the healthy bacterial species that may have been diminished by their various chemo and immunotherapies.
I’ve experienced some relief and improvement with my chemo- induced brain fog, moodiness and depression with a daily probiotic regimen while on FOLFOX and FOLFIRI chemotherapy. My regimen was prepared in consultation with a nutritionist on my care team.
Another key in my fight with the blues is regular exercise. I try to walk, use my under the desk elliptical machine with variable resistance, light weights and resistance bands for at least 90 min 3-4 times a week.
I know it’s been a tough slog to get where you are in your battle with this disease. Savor the small victories and while difficult, you must maintain a positive mental attitude. You must resolve to own your disease and not let it own you.

Happy New Year. Things are good. As if we didn't have enough on our plate now, my wife and I caught Covid. It's been about a week and I think we are seeing the other side of it, but still a bit fluish and fatigued. I am really ready for 2024 and getting some plans put together for the year. In spite of Covid, my mental state is greatly improved and focusing on a few home project to keep me busy. Thanks for checking in.

I had an esophogectomy in 2020 on my birthday, 9/1. (The cancer was found during a visit to diagnose headaches, totally unrelated.) Prior to that I had 5 weeks of Chemo and Proton Beam Radiation. We did not know the stage until after the surgery. It was stage 3. The surgery was followed by 1 year of immunotherapy with opdivo. All CT scans since then have been clean.

I found that exercise and activity help me to forget that I ever had cancer, although I return in early Feb. of 24 for scans and a stretch. (The reminder.). I am 70 years young and in better shape than I was before the diagnosis. I go to the gym twice a week and walk the dog 3 or 4 times per week, mostly up hill. I was able to complete a nice ski trip last year and have already skied this year. In short, make sure you know where you will spend eternity and then live what is left of life to the fullest. There is no reason to worry about things you can't control.