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Changes in mood

Dr. Christine Maheu, RN, PhD

Dr. Christine Maheu is an Associate Professor in the Ingram School of Nursing, Faculty of Medicine, McGill University. Dr. Maheu is also an Affiliate Scientist at the University Health Network and the University of Toronto. At McGill University, she teaches research methods, supervises graduate students (masters, doctoral, post-doctoral), mentors practicing nurses and students in research, and conducts research in English and French. She has held research awards with the Canadian Institutes of Health Research, the Canadian Cancer Society, and the Canadian Partnership Against Cancer. These awards funded her research in psychosocial oncology, which focuses on developing and testing psychosocial interventions or measurements tools for various cancer populations. Additionally, in partnership with Ipsos Canada and funded by the Canadian Partnership Against Cancer, she is co-leading a nationwide survey of the needs of cancer patients for transition care from the end of their treatment to three years after their diagnosis. Dr. Maheu received awards for excellence in nursing research (2013, 2015, 2016) from Ovarian Cancer Canada, the Canadian Association of Nurses in Oncology, and the Quebec Association of Nurses in Oncology.

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Ms. Rosemary Cashman

Ms. Rosemary Cashman is a nurse practitioner at the BC Cancer Agency and an Adjunct Professor in the Faculty of Nursing at the University of British Columbia. Her professional experience includes the care of lymphoma, lung cancer and brain cancer patients. She co-chairs the Patient and Family Advisory Council, which guides the brain tumour care program at the BC Cancer Agency. She has authored book chapters and articles related to the care of brain tumour patients and their families. Ms. Cashman was involved in developing and implementing a rapid-access radiotherapy clinic for the palliative treatment of lung cancer and she continues to work in this clinic.

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Kyla Johnson, Occupational Therapist, Segal Cancer Centre, Jewish General Hospital

Ms. Kyla Johnson, M.Sc.A., originally from Edmonton, Alberta, Kyla Johnson works as an Occupational Therapist at the Segal Cancer Center of the Jewish General Hospital. She holds a Master of Science in Occupational Therapy from McGill University. Her goal as a rehabilitation professional in Oncology is to enable people with cancer to be able to do what they want and need to do, in all stages of their cancer experience. Kyla helps develop strategies and accommodations to facilitate a return to meaningful life roles, including work. She is specialized in cancer-related cognitive dysfunction and runs a weekly group teaching strategies to improve daily cognitive functioning. Kyla also leads a volunteer yoga class for young adults with cancer. She lives in Montreal, Quebec.

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Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C, BC Cancer

Ms. Maureen Parkinson is the province-wide vocational rehabilitation counsellor at the BC Cancer Agency. She has also been vocational rehabilitation counsellor at a public rehabilitation hospital and vocational rehabilitation consultant to insurance companies and the court system. She has instructed and facilitated Service-Canada-funded programs on job searching and career exploration. Ms. Parkinson has a Masters in Counselling Psychology, is a Canadian Certified Rehabilitation Counsellor, and completed the Certified Return to Work Coordinator Program through the National Institute for Disability Management and Research. She has developed return-to-work and job-search seminars for cancer patients and created the guidebook “Cancer and Returning to Work: A Practical Guide for Cancer Patients” as well as on-line articles about returning to work and school. She also co-authored a paper commissioned by the Canadian Association of Psychosocial Oncology, “Cancer and Work: A Canadian Perspective”.

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A cancer diagnosis can have a profound effect on feelings, roles and relationships, finances, and mental and physical health. Cancer can be a truly life-altering experience that leads people to see their priorities in new ways. This new way of seeing life can bring about positive changes but can also be disruptive and painful. It is common for people with cancer to feel distressed, anxious and sad.

The strain of coping with cancer diagnosis and treatment may be compounded by other life stressors, such as family dynamics, financial issues and professional challenges. Unmanaged stress can have a negative effect on health, including:

  • increased blood pressure
  • more rapid heart rate
  • decreased digestion
  • increased muscle tension
  • higher levels of stress hormones like adrenaline, that can lead to impaired immune function.

Vocational implications

For cancer survivors, returning to work may bring mixed emotions – relief that life is back to “normal,” fear and anxiety about how colleagues will relate to them or uncertainty about how they will manage their responsibilities or their feelings at work.

What patients can do

Discuss with your patient how they feel about going back to work and help them make decisions that are right for them. Encourage them to speak to their healthcare team if they notice mood changes. Consider medications for depression or anxiety.

Some strategies for changes in mood are:

  • Learn stress management techniques.
  • Learn to say no.
  • Delegate tasks.
  • Use breathing and relaxation techniques.
  • Use visualization and guided imagery techniques.
  • Exercise.
  • Find diversions.
  • Use a sense of humour when possible.
  • Connect with nature.

Other resources:

Job accommodations

There are several ways that jobs can be modified to minimize impact on mood:

Modify work tasks:

  • Identify non-essential job tasks and situations that may cause strong emotional or stress reactions.
  • Discuss with the supervisor whether these tasks can be re-assigned or shared with co-workers.
  • Identify supports at work that decrease stress.
  • Discuss ways of providing these supports (e.g., giving written instead of verbal instructions, extending deadlines, more frequent breaks, working from home).

Modify the work environment:

  • Request a quiet, private location where the employee can retreat if feeling overwhelmed.
  • Create a quiet work environment when possible.
  • Wear headphones to listen to soothing music.
  • Declutter the workspace.
  • Move the workstation to face a wall instead of a busy hallway to decrease visual distractions.
  • Optimize the lighting in the workplace (neither too dark nor too bright).