A Patient Power user asked, “[My husband is taking a combination of a BTK inhibitor, an anti-CD20 monoclonal antibody, and a BCL-2 inhibitor, and while the results have been amazing, it’s been making him feel horrible.] He’s experiencing GI symptoms: belching, diarrhea, and sometimes vomiting. He’s very discouraged. How can I help him with this? I’m trying to be supportive, but his negative emotions are sometimes hard to take. I think he would benefit from antidepressants, but I’m afraid to mention that to him, because he doesn’t think he’s depressed. How can I support my husband and help him to see the positive and not the negatives all the time?”

Expert Response

“That is a tough situation,” acknowledged Susan Hedlund, MSW, LCSW, an oncology social worker.

“I think it is important for the patient’s wife to try to find a way (as compassionately as she can), to be honest with him. She might try saying, ‘I’m thrilled that your results have been amazing, but you aren’t yourself. I know you are feeling badly, and it is understandably affecting your mood. I’d like for us to talk with your doctor about that.’ If the husband is willing, then they might be able to discuss with the provider either a referral to a mental health provider, or ideally a psychiatrist familiar with oncology, who could prescribe an antidepressant,” Hedlund said.

This reluctance to recognize one’s own struggle isn’t new. “Unfortunately, there is still a belief among some that we should just be able to ‘tough it out,’ yet upwards of 25% of cancer patients experience depression that can be well-treated with a combination of anti-depressants and counseling. It truly becomes a quality-of-life issue,” Hedlund said.

“Surviving is wonderful but surviving and thriving is better. Antidepressants and counseling are additional tools in the toolbox.”

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