These pages are not intended to substitute for expert medical evaluation or treatment.

Instead, I am sharing with you what I learned as a cancer patient, about how to advocate for the best possible treatment of not only my cancer, but of all of the conditions, questions, and decisions associated with my cancer.

---

I already knew that depression was often associated with certain medical conditions because I experienced depression for the first time during the period of time when it was discovered that I had a silent heart attack.

Depression is also a common occurance in people with cancer.

I don't know how much there might be some physiological basis for depression in cancer and other serious diseases, but it is not difficult to see how the situation of having cancer can be a depressing factor.

Many people finally let go of the youthful illusion of invincibility (e.g. it will happen to someone else), when they first hear a diagnosis of cancer. That one will someday die is suddenly very real in one's daily thoughts after one has received a cancer diagnosis.

Let's face it, most of us today remember when a cancer diagnosis almost always indicated that death would follow. Even though medical science has made immense progress and can now treat most, and cure many, cancers, it's hard to shake that old feeling of helpless doom which used to be a justifiable response to a cancer diagnosis.

But, I found that there are things that can effectively address this depression.



• INFORMATION -- One of the fastest ways to overcome a feeling of helplessness is to find out what may help, and to take the mystery out of the disease.
  
  So, I wrote down every term and explanation that my physicians used, and got copies of all of my laboratory and radiological reports, and studied those with the help of some good books and Web sites from reputable sources. In my case, it was a self-directed crash course on testicular cancer.
  
  Understanding what was happening in my body was less frightening than just knowing the vague "cancer" word. It also helped me be able to ask the right questions at my medical appointments, and -- most important -- it helped me be able to make informed decisions throughout the course of my treatment. In other words, I wasn't helpless, because I had learned to understand my choices.
  
  
• ACKNOWLEDGE THE DEPRESSION -- Some people don't effectively address their own depression because they don't admit to themselves that they are depressed, even though the depression is interfering with their functioning in life. In my own case, I had to come to terms that I, as a psychologist, was experiencing serious depression.
  
  But, just as information took the mystery out of cancer in the point above, acknowledging that I was depressed took the mystery out of my problematic feelings and my reduced functioning in my daily life.
  
  Having acknowledged my own depression, I was then finally able to do something about it.
  
  
• USE HUMOR -- During the dismal period of time when the physicians thought that I had both testicular cancer and adrenal cancer, I remember saying to my work supervisor, "Well, I'm glad I didn't quit smoking. I'd be really angry if I had gone through the pain of nicotine withdrawal and then got cancer in these other places."
  
  Now, aside from the fact that my conclusion wasn't logical since lung cancer risk is a separate issue from risk of testicular or adrenal cancer, the sarcastic humor did help me feel better because it made me laugh.
  
  
• GET BUSY -- Even if cancer has lowered your energy level, you need to engage in activities that will stimulate your mind. Everyone feels better when they feel like they've accomplished something. Cancer doesn't change that.
  
  One person may finish the quilt being made for the grandchild. Another may join a support group -- to help both themselves and other people. Yet another person may immerse themselves in a hobby, such as genealogy.
  
  Whatever it is, find something that you feel good about doing, and then do it!
  
  
• ACT AS IF YOU FEEL HAPPIER THAN YOU DO -- This may sound simplistic, but just as a depressed mood slows down our behavior, slowed down behavior depresses our mood. So, part of the plan for feeling better involves acting as if you feel a little better than you do, so that your mood will follow your behavior.
  
  So, you're sad and feel like doing nothing for the third day in a row? It's time to take a shower, brush your hair, put on your favorite outfit, eat your favorite food, and call that friend who can always make you laugh.
  
  
• TREAT YOURSELF -- When we were children, my sisters and I knew that if we had to have shots at the doctor's office, that Dad would next take us to a drug store soda fountain for a chocolate or cherry coke. He made sure that we had something to look forward to, something to think about other than the needle stick.
  
  I think I made a similar reward plan for myself when I went through my daily radiation treatments. I took advantage of the location of the clinic -- very close to where my grandparents and cousins lived during my childhood -- to drive on roads that brought back happy memories, even though another route would have been a little faster.
  
  The oncology treatment center itself had some built in reinforcement one could pleasantly anticipate, such as offering free massages after some of the radiation sessions.
  
  You may need to come up with your own reinforcement plan, based on what gives you pleasure. But, do be sure to have a pleasure plan in place while you go through the cancer treatments.
  
  
• TALK ABOUT CANCER -- Some very well meaning friends and relatives will bend over backwards to avoid saying "cancer" in front of you, fearful that they will remind you of your plight and make you feel sad. ....... As if you could ever forget about it ???
  
  You may have to help your loved ones understand that it's okay to talk about cancer. You couldn't forget that you have cancer not matter how much you might want to, so they aren't going to make you sad. Instead, you need to know that there are some loved ones who are willing to hear your thoughts and feelings about cancer.
  
  
• TALK ABOUT OTHER THINGS -- On the other hand, sometimes you don't want to talk about cancer because there's more to life than cancer. You want to talk about mutual acquaintances, planned activities, or recipes for chicken soup. You are, after all, still alive, and you want to be treated as such.
  
  
• TEND TO YOUR BUSINESS -- Many people may not realize that soon after a person is hit with a cancer diagnosis, they are also hit with horrendous financial impacts. While it is wonderful that there are now excellent cancer detection and treatment technologies, they cost huge amounts. And, in today's healthcare market, even good insurance will only absorb part of this huge impact.
  
  Go to my page Cancer Debt at http://home.comcast.net/~Testicular/cancerdebt.html for some thoughts about dealing with the burden of debt that follows cancer treatment.
  
  Equally important, be sure to keep your employment status secure by promptly returning employee medical leave forms and by communicating regularly with your employer about your status.
  
  I had to miss work after my surgeries, but I was able to work throughout radiation treatment. In my case, I think that work helped to take my mind off of the radiation effects that I did have. But, I also let my employer know that many people can't keep up work during radiation, so that the company would be prepared in case I couldn't keep up the pace. I was fortunate, and didn't have to leave work again. But, whether working is even possible varies from person to person, depending on what specific effects the person has, and the severity of these. Just keep your employer well informed.
  
  
• FIND SOMETHING VALUABLE -- Having cancer is not a happy thing, so we simply aren't going to reach a point when we're happy about the cancer.
  
  But, there are countless things that we can feel good about, and we need to pay attention to those things if we want to feel better.
  
  For example, most cancer patients say that their lives are forever changed by the experience of having cancer. Many point out that for the first time in their lives they had to truly think about what is most important in life. Some of the daily details about which we used to catastophize are suddenly not so important, after all. Other things, such as important relationships with other people, are valued more dearly than ever before.
  
  Some people find value by trying to help others who are going through a similar circumstance. I have no doubt that my cancer Web pages serve that function for me. It is something good that can come out of a bad thing.
  
  
• ANTIDEPRESSANT MEDICATION -- An antidepressant medication may help.
  
  Men who have had testicular cancer, especially if they have a lowered testosterone level, may want to talk with their physician about Wellbutrin, since it often doesn't have the same adverse effect on sexual functioning as do some of the other antidepressant medications.
  
  In my case, it took a combinaton of Depa-Testosterone injections and Wellbutrin to bring my mood, and my functioning in many life areas, back to normal.
  

---

NOTE: Some of the symptoms of depression in cancer may be the same as symptoms of Cancer Fatigue Syndrome, which is common in people with cancer, or low testosterone level which afflicts some men who have had testicular cancer.

Don't rule out the possibility that you may have more than one, or even all, of these problems going on. I did.

But .... do be aware that you may well have to point this out to your physician.

Physicians, understandably, treat the most obvious physical manefestations of cancer. Their awareness of you also having cancer fatigue, depression, and/or low testosterone level may depend on you putting that issue in front of your physician and being sure that he or she understands how severely you are being affected.

If your physician doesn't take you seriously about how you're suffering with any of these associated problems, do find another physician, because there are treatments to help with these cancer-related problems.

---

Visit my main Testicular Cancer Web Page

at

http://home.comcast.net/~Testicular/

And, I'll be glad to communicate with anyone who has concerns about facing cancer fatigue, testicular cancer, testicular implants and/or testosterone level.