MICHEL MARTIN, HOST:
More Americans than ever are surviving cancer, but Iowa is one of the few states where cancer rates are increasing. Scientists are still figuring out why. As they do, a growing number of survivors there are in need of mental health care after treatment ends. Iowa Public Radio's Natalie Krebs has this report.
NATALIE KREBS, BYLINE: Back in 2015, Morgan Newman was busy building her life. She was working as a dental assistant in Des Moines and studying to become a social worker. Then she got an abnormal result on her Pap smear. She wasn't that concerned about it. She was only 24. She went back to the doctor so they could check her for abnormal tissue.
MORGAN NEWMAN: And ended up hemorrhaging on the table. And so they had to stop, and they referred me to a gynecologic oncologist at that point.
KREBS: Newman had cervical cancer. She was shocked. Newman needed six weeks of radiation and chemotherapy. For a while, her scans were clear. But three months later, doctors found suspicious nodules in her lungs. She had more chemo, and it was stronger than the first round. It wore her down physically, yes, but also mentally as she watched her friends hit significant milestones.
NEWMAN: My friends were getting married. They were having children, you know, progressing in their lives and their careers. And I just felt stuck.
KREBS: Studies show cancer survivors are more likely to experience anxiety and depression that can last years after they finish treatment. But one survey found only 1 in 5 had seen a mental health professional. Newman had been seeing a therapist, but after she got sick, she quit going. It was just too expensive on top of all her medical bills. And between school, work and treatment, she didn't have time. Eventually, Newman finished treatment. A year passed. She got a new job with better benefits. She could go back to therapy. Now, almost 10 years later, Newman remains cancer-free, but she still goes to therapy.
NEWMAN: The fear of the unknown really takes over and can physically impact your body as well as your mind of what if the cancer's back?
KREBS: Newman sees Julie Larson, a therapist in Des Moines who works with lots of cancer survivors. She says it's common for people to seek her out months or even years after finishing treatment.
JULIE LARSON: Physically, people's bodies have changed, and they are reconciling loss and grief. And those experiences are a little bit more silent, a little more invisible, and friends and family don't often fully understand or grasp that.
KREBS: But finding therapists who know cancer can be a challenge, especially in Iowa. Iowa is largely rural, and some of the counties that have the highest cancer rates also have the fewest mental health professionals. Dr. Patricia Ganz is an oncologist and a UCLA professor who studies cancer survivorship. She says given the shortage of resources, oncologists themselves need to step up. Mental health care should be a routine part of cancer treatment.
PATRICIA GANZ: We know how to give pills. We know how to give pain medicines, sleep medicines, but we're not real schooled in the antidepressants.
KREBS: Ganz says there is increasing awareness about mental health needs in cancer, but not all doctors conduct what is known as a distress screening.
GANZ: Of course, if you screen, that means you have to be able to provide services. That's not always available if you don't have access to a mental health professional.
KREBS: In Iowa, some cancer centers are trying to do more. The MercyOne hospital in Des Moines has started offering services like counseling, music therapy and mindfulness to cancer patients, even after they finish treatment. Dr. Richard Deming runs the clinic.
RICHARD DEMING: Every step along the way, whether it's through diagnosis or treatment or follow-up, we have to ask, what are the issues you're experiencing? Not just do you have cancer? Did we get rid of the cancer?
KREBS: Deming says during treatment, patients spend a lot of time with doctors and get asked a lot how they are doing. But once the clinical whirlwind ends, cancer survivors can suddenly feel abandoned and alone.
For NPR News, I'm Natalie Krebs in Des Moines.
MARTIN: That story comes from NPR's partnership with Iowa Public Radio and KFF Health News. Transcript provided by NPR, Copyright NPR.
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