CANCER AND PSYCHOLOGY
Written by Sharon Turner, Psychologist with information extracted from Cancer Council Victoria
Most people will experience strong emotions after a cancer diagnosis, not only when they first hear that it’s cancer, but also at various times during and after treatment. Cancer is a serious disease, the treatment may take a long time and can be demanding, and there are many periods of waiting and uncertainty. There is no right way to feel – experiencing a range of emotions is normal. The intense feelings may be constant, or they may come and go. You may find that some pass with time, while others last longer. At times, it may feel like you’re on an emotional roller-coaster. Everyone is different, and you need to deal with the diagnosis in your own way. As you navigate this challenging time, it may be reassuring to know that your reactions are natural, there are different ways to manage the emotional impact, and support is available.
Many people find that they cope better than expected with some aspects of the cancer experience but are surprised by how difficult other aspects turn out to be.
When you are diagnosed with cancer, it is often difficult to take in the news immediately – you might hear the words, but not be able to absorb them or believe them. Many people feel overwhelmed at first.
The weeks after diagnosis may be stressful. You may feel like everything is happening too fast – or too slowly. People often feel confused and anxious about treatments and side effects. You may wonder if you will be the same person as before and how your life will change.
Cancer treatments can be physically demanding and disrupt all your usual routines. You may also need to deal with practical issues such as travelling to treatment, paying for tests and treatment, getting time off work, and family responsibilities.
Treatment side effects:
The physical and emotional impacts of cancer are linked. Side effects of treatment can make it harder to cope emotionally, while emotional distress may make the physical side effects worse. The good news is many side effects can now be well managed if you tell your treatment team.
Many people are puzzled to find that their mood doesn’t improve as soon as treatment finishes. This can be a time of adjustment as you reassess priorities and come to terms with any long-term impacts of treatment. It is common to feel concerned about the cancer coming back, especially when you have follow-up tests.
It can be devastating to be told that the cancer is advanced at first diagnosis, or that it has returned after the initial treatment. If this is the case for you, you and your carers may find it helpful to see a professional counsellor or call Cancer Council 13 11 20.
Your coping toolbox:
Most of us have various ways of coping with difficult situations, which we have learned over time. These could include:
- Seeking more information
- Trying to fix the problem
- Having a laugh to feel better
- Trying to be strong and “soldiering on”
- Distracting ourselves from unhelpful thoughts and feelings
- Talking things through to try to make sense of what is happening.
How you cope depends on the type of situation you are facing, past experiences, your personality, upbringing and role models. It is important to think about what has worked for you in the past and to consider that after a cancer diagnosis you might need more than your usual ways of coping. There is no best or right way of coping but having a few strategies may help you feel more in control. Some coping strategies are less helpful, for example, many people go back and forth between denial and acceptance as they come to terms with a cancer diagnosis. When denial is ongoing, it can become hard to make decisions about treatment, or it could mean you avoid treatment or follow-up appointments. Some people use alcohol and drugs to cope with stressful situations. These may appear to provide relief in the short term but can cause emotional and physical harm and could affect how well the cancer treatment works. If you think you might be in denial or starting to rely on alcohol or drugs to cope, it is important to talk to your cancer care team about getting professional support. With the right help, it is possible to learn new ways of coping.
Tools for coping:
A coping toolbox is a set of strategies or “tools” you can use to help you cope with a cancer diagnosis and treatment. Each person’s toolbox will look different, but it’s useful to consider a range of strategies. Some of these are ways to solve particular problems; others aim to enhance your general wellbeing during this stressful time.
Find out what to expect: Information about the diagnosis and treatments can help you make decisions and plan ahead, and may make you feel more secure.
Eat and drink well:
Eating healthy food and drinking plenty of water will help your body cope with physical and emotional stress, but this can be challenging when you are feeling unwell. Talk to a dietitian and see Nutrition and Cancer for tips.
Research has shown that regular physical activity can help with feelings of anger, stress, anxiety and depression. It can also help manage fatigue and improve sleep. Even a short daily walk offers benefits. See Exercise for People Living with Cancer.
Share your concerns with a family member or friend, or with your general practitioner (GP), nurse, social worker or psychologist. Other options include calling Cancer Council 13 11 20, visiting the Online Community, or joining a support group. Accepting help with practical tasks such as shopping or housework may also make it easier to cope.
Through discussions with a counsellor, social worker or psychologist, you can identify problems and explore ways of resolving unhelpful thoughts and feelings that affect your health and day-to-day life. Counselling allows you to express your emotions in a safe and supportive environment, and to learn new coping skills. It can provide an opportunity to talk about thoughts and feelings that you might not feel comfortable sharing with family and friends.
Managing your thoughts:
People affected by cancer may find themselves going over and over the same distressing thoughts about the past, present or future. Ignoring such thoughts or trying to distract yourself may work at first, but they often return once you are no longer distracted – for example, during the night or early in the morning.
Identify where the thoughts come from:
Ask yourself if your thoughts are the result of an underlying belief, such as “The world should be a fair and just place”, “If I can’t do everything I used to do, I am useless” or “I am a burden to my family and friends”. Or perhaps you have a tendency to give personal meaning to everything that is happening, even to events that are beyond your control. For example, if you arrive at the treatment centre and can’t find a parking spot, you might think, “nothing ever goes right for me. I don’t know why I’m bothering with the treatment I know it won’t work”.
Consider your own advice:
Think of someone you love and imagine what you would say to them if they felt the same way.
Check your thoughts:
Ask yourself if you are jumping to conclusions or exaggerating the negatives. If so, is there something you can do to change the situation or improve it?
Write down your thoughts:
This helps slow down your thinking and makes it easier to focus. It may also help you work out if a thought is based on facts, realistic or helpful.
Recognise the little positives:
Some days it might be hard to find something positive. This is understandable, but if you feel like that every day, check whether you are ignoring any little achievements or happy events. Some people make a habit of writing down three good things that have happened to them each day. These don’t have to be major life events – they could just be an encouraging smile from a radiographer or a nice chat with a receptionist on a tough day.
Practise letting your thoughts come and go:
Thoughts are fleeting. Some we notice and many we don’t. Try to let your thoughts come and go without getting caught up in them. Cancer Council’s free meditation recording may help you practise this.
Be kind to yourself:
Use encouraging thoughts to talk yourself through difficulties, rather than undermining yourself. This does not come naturally to everyone, but counsellors and psychologists can teach you some techniques.
Seek professional help:
Social workers, psychologists and other health professionals are trained to help people manage how they’re feeling. Check what support is available at your treatment centre or ask your GP for a referral or contact the Cancer Council https://www.cancervic.org.au/downloads/resources/booklets/Emotions-andCancer.pdf.
Some people find online self-help programs or smartphone apps useful for tracking how they’re feeling. Visit Mood Gym or Mind Spot, or see the list of health and wellbeing apps at www.healthdirect.gov.au.