Cancer Therapy

It seems like it would be a no-brainer that every cancer patient have some kind of mental health treatment along with whatever other cancer treatments they receive. Surgeries, radiation and chemotherapies are so common that the vast majority of cancer patients get at least one of them. Mental health services are considered optional.

I’ve had to fight for cancer therapy and have found it hard to get. The only therapists of any kind that I have found who have specific knowledge of cancer are the social workers connected to the the practices of oncologists. They tend to be case workers, have specific knowledge and can be extremely helpful, but are not psychologists. I haven’t found a psychologist with a specialty practice in cancer patients.

I weep every time I get into the details of my cancer story. Every time I go to see the oncologist, I weep. It disconcerts the doctors and nurses. My specific cancer treatment involves androgen deprivation, so that might account for my weepiness, or at least some of it. Nevertheless and despite knowing what the treatment is doing to my body, I am an obvious emotional problem in the oncology office.

Back in Memphis my oncologist would offer me anti-depressants pretty much every visit. I finally told him through many tears that I trust his judgement with regards to my cancer treatment but that I would prefer to see a psychiatrist if he thinks I should be medicated. He wasn’t pleased. Generally, I don’t think of myself as depressed. I think that I am profoundly sad about a profoundly upsetting situation. Seems normal.

Back when I had the energy, I really wanted and thought I could benefit from weekly cancer therapy. I was only able to get monthly check-ins. These were helpful, but I could have used more. After the cancer therapy dwindled, I was able to get some regular therapy through work, but again it was once and month and while helpful generally, didn’t have a cancer-specific component.

Now my energy levels are in the dumpster, which is evidently a known and anticipated side effect of the androgen deprivation therapy, I still have the weepiness and I still don’t have accessible therapy. When I got to Arizona and found an oncologist, I asked about cancer therapy. I was given a list of places to call. But the doctors appointments, blood tests, shots and scans are all scheduled efficiently and directly. For some reason, I have to handle the mental health component on my own.

Which is a problem.

I can get to appointments. But the same steps I take to schedule other cancer treatments do not work to secure comparable mental health services. I don’t get it. Why not?

It’s upsetting. This morning I made a call and got three important appointments made for upcoming tests. It was super easy. They called me. I called back. The insurance issues are taken care of up front. Approvals secured by the oncologist’s office before the tests are scheduled. Then I make a call to the social worker to try again to get mental health services. She’s helpful, but there’s nothing in place. Nothing pre-approved by my insurance. It’s treated as a separate situation. There is no list of psychologists or psychiatrists who have practices built around cancer patients. Further, I’m told that generally the therapists available through insurance are younger, less experienced and generally less reliable than private practice therapists. The suggestion is to pay cash to a private therapist for better and more consistent treatment.

My reaction to these things is to weep. It’s overly complicated and all up to me. It’s overwhelming. And today as I was getting the overwhelming picture I realized that I had received all of this information before, several months ago. The calls I made then came to nothing. And it starts to feel inevitable that again, I won’t find the help I’m asking for.