Vicki Wilson was diagnosed with breast cancer just four years after her mother had passed away from the same disease. This was just the beginning of Vicki’s long history with cancer. Twenty years later, after extensive treatment and a supposed cure, the cancer returned in the same breast.

Suspicious that she may have the BRCA1 gene, she begged the doctors to “take the lot”, both her breasts and her ovaries. Then came what she still calls the worst day of her life; the day she was diagnosed with ovarian cancer. “My blood ran cold,” she says. “All I could think was that I was going to die. I’m actually going to die now. I have the killer disease.”

And sadly, this is the fate of many cancer patients. Faced with a cancer diagnosis or ongoing treatment, their mental health is inevitably at risk of decline. “During the course of your cancer or cancers, you’re coming to terms with the fact that death is now a reality,” says Vicki. “And that’s not something you think about until you receive a diagnosis like that.”

Associate Nurse at Ballarat Oncology and Haematology Services, Virginia Murphy, defines the journey of a cancer patient by three stages. After an initial diagnosis, the patient is left fearful and confused. “When we meet a patient for the first time, we have to be aware that this is likely to be the hardest day of their life,” Ms Murphy says. “They get ushered toward us from the doctor’s room looking like a scared lamb.” The middle phase occurs throughout their treatment, whether that be chemotherapy or another form of medication. “You can tell the patient is much more comfortable during this stage as they’re now aware of what’s happening to their body and how they’re going to physically feel during this process,” she says.

When a cancer patient reaches the end of their treatment, it is likely they’ll find themselves feeling anxious because they don’t know what comes next. “People tell me that they feel much safer while being treated,” says Ms Murphy. “Once you cut ties, it’s like jumping off a big cliff. Outside of these walls there’s nothing more we can do for the patient.” The clinic introduced a psychologist for use by patients receiving chemotherapy treatment, but they weren’t taking advantage of the opportunity, which Ms Murphy believes is a result of the stigma attached to mental health conditions.

And that’s the position Vicki found herself in, post-diagnosis. “There’s a sadness attached to cancer,” she says. “You build a shell that removes you from everyone else, and that’s what I’ve become.” Cancer patients are not asking for psychological help, despite a diagnosis inevitably having an impact of those sorts. “I put on a really brave face, but it’s not always like that”, Vicki says – and she has noticed a similar pattern of behaviour in other cancer-affected people.

But it’s not just the patients who aren’t consciously thinking about seeking help for their mental wellbeing, it’s their carers too. Researcher for Prevention and Wellbeing at Peter MacCallum Cancer Centre, Cassandra Smith, says they provide a carer’s circle for people looking after their loved ones who have cancer. However, the attendance levels are quite low. “Those people don’t see themselves as carers,” she says. “They see themselves as doing something that they’re just supposed to do, without consideration of their own wellbeing.”

Ms Smith says there is research to show that once a person receives a cancer diagnosis, worrying and being sad is a normal reaction. But worse she says, it also shows that oncologists and cancer doctors don’t have the time to focus on the mental health of their patients. “It’s an emerging topic in research as to how we should work with cancer patients who have mental health issues as a result of their cancer,” says Cassandra.

As discussions continue regarding the support available to cancer patients experiencing mental health issues, Vicki says it is important for patients to surround themselves with positive people, and look for the good in cancer treatment. She believes people are aware of their body and changes to it nowadays, so there are no excuses for delaying checkups or treatment. But Ms Murphy says that it’s the stigma attached to mental health that is turning cancer patients off seeking psychological help. “They don’t see themselves as mad, just sick,” she says.

“There are so many people out there floundering around with a diagnosis or post-diagnosis, and it’s a real worry.”

If you or someone you know is struggling with mental illness, call lifeline 13 11 44 or talk to someone online at lifeline.org.