In 2019, Amy Hart was diagnosed with colorectal cancer at age 34. After treatment that included surgery to remove her colon, Hart is now free of the disease, but still very much dealing with the mental health challenges that come with it.

“I think once you hear the words, ‘You have cancer’ — no matter what your diagnosis is, no matter what stage or what type of cancer — it’s earth-shattering,” Hart said. “It puts your own mortality straight in your face and at 34 years old with two young kids, I struggled with that idea.”

Most cancer survivors deal with some type of mental health issue, said Becky Selig, MSW, director of patient education and research at the patient-empowerment and advocacy organization Fight Colorectal Cancer — but women may be hit particularly hard.

“Think about all of the demands that fall on women,” Selig said. “Many cancer patients are also struggling with the other day-to-day challenges that come with — you know — being a woman and a mom and trying to balance so many factors in life. All of that can be really compounding on itself.”

Hart and other colorectal cancer survivors may face a variety of mental health challenges, including anxiety, depression and low self-esteem. Understanding the impact colorectal cancer can have on your mental health may help you figure out ways to cope.

Surviving colon cancer but still at risk

For many people with colorectal cancer, surviving is just the beginning. One study of nearly 9,000 colorectal cancer survivors found they were more likely to receive a mental health disorder diagnosis than non-survivors — even five years or more after being diagnosed. And colorectal cancer survivors who were diagnosed with a mental health disorder were at increased risk of dying compared to those who weren’t.

Anxiety and depression are particularly common, affecting nearly 4 in 10 colorectal cancer survivors. One major source of anxiety for Hart and other colorectal cancer survivors? Fear that their cancer will come back. “Once you hear you have cancer, you always feel like you could hear it again,” Hart said.

Survivors often use the term “scanxiety” to describe the anxiety they feel before they get routine scans to check for cancer. “Even if you get clean scans for 10 years, the week leading up to a scan is gonna be hard,” Hart said.

Loving your body, changes and all

It’s no secret that many of us struggle to love our bodies. Throw in major physical changes caused by colorectal cancer, and self-acceptance may seem impossible.

“We’ve heard a lot of survivors talk about the body issues and shame around some of the changes that they experienced, both through surgery and treatment,” Selig said.

Low self-esteem was already an issue for Hart long before her colorectal cancer diagnosis. “I was struggling as a woman, as a person, pretty much my whole adult life with accepting myself and loving myself,” she said.

After her diagnosis, Hart was forced to face the ways colorectal cancer changed her body. The surgery to remove her colon left her with an ostomy, a pouch worn outside the body that collects waste through an opening called a stoma.

“Right before I went into surgery, I was just convinced my life was over,” Hart said. “And I was really afraid of how I would respond when I woke up.”

But while she knew the ostomy would have a huge impact on her body image, Hart didn’t anticipate how much it would change the way she looked at herself — and that ultimately she would love herself more.

After a lot of work (with the help of a support team that includes a therapist), Hart has become much more accepting of her body, ostomy and all.

“It did take some time going downward before I could start my journey upward with my self-image. But on the other side of having an ostomy bag and going through some of the most impactful moments in my life, I feel more confident in myself,” Hart said. “I’m still learning to accept myself, and I have hard days. But I’m just so much nicer to myself now.”

Finding ways to cope with the mental health effects of colon cancer

For some women, using a pretty or decorated ostomy bag cover can be a helpful way to cope, allowing them to express personality and improve their body image. You can find a wide selection of bag covers online — from bedazzled to bawdy.

To cope with the mental health challenges that come with surviving colorectal cancer, Selig said it’s important to be honest about what you need. “Many people struggle with letting people help,” she said. “Allowing yourself to ask for help and to be okay accepting help can be huge.”

Selig also suggests talking to a therapist or fellow survivor who understands your experience and can reassure you that everything you’re feeling is completely normal. “Those anxieties and fears? You’re not alone in that,” Selig said.

Hart’s journey as a colorectal cancer survivor has inspired her to share her experience on social media in the hope that she can help others who are struggling.

“I want so badly for people to know that normal life is on the other side of all this, coupled with all the changes,” she said. “Life is still just as beautiful, painful, annoying, mundane — all of these things — as it ever was.”