Cancer can be a devastating diagnosis but the psychological turmoil must also be treated.
"Because cancer is a stigma and mental health issues are stigmatized, the combination is just deadly and we don't talk about it enough," explains Cynthia Hayes, who's a cancer survivor and now a patient advocate.
Hayes says a person's mental health is almost instantly impacted after receiving a cancer diagnosis.
"Cancer is a psychological diagnosis too. It drives our emotions in ways that we cannot imagine beforehand, and so it is perfectly normal to feel depressed, and it's perfectly normal to be anxious, to be angry, to be confused," she said.
And when you have cancer, there are real physical changes happening inside the body which involve cytokines that allow the immune system to communicate throughout the body.
But they get out of balance as you go through treatment.
So even though you think you should be positive and hopeful, you physically can't be.
"Our bodies are telling us something else. They're telling us 'Climb back into bed. You are sick. You need to get better.' And that's part of what makes the psychological experience so challenging is the external environment is telling us one thing and the internal environment is telling us something entirely different," explained Hayes.
And as for the caregiver?
Hayes says it's important to listen and be supportive without judgment.
"The challenge is to help the patient feel what their feeling and really recognize what their feeling and then as the caregiver say 'I understand why you're feeling that way and I'm here for you,'" she advised.
And for the cancer patient, Hayes warns not to withhold your fears and worries from your loved ones, as it creates distance and can destroy intimate relationships.
"I always encourage the patients I work with to share, share, share, share! Just tell people what you're thinking and feeling because they can't understand it," she said.
There are nearly two million people in the United States who receive a cancer diagnosis every year. So if you're struggling psychologically, many cancer support groups are now online.
Hayes is also the author of The Big Ordeal: Understanding and Managing the Psychological Turmoil of Cancer.