Emotional support for cancer patients

Emotional pain and distress are caused by cancer and its treatment.1

  1. How do people respond emotionally to cancer?
  2. How to make sense of a cancer diagnosis
  3. How do you survive cancer emotionally?
  4. Who can help when you have cancer?

How do people respond emotionally to cancer?

Cancer has interrupted your life, your way of living and may change you as a person perhaps forever. More than likely you will be need of emotional support. All aspects of your social, physical and emotional wellbeing1 will be threatened and your core beliefs will be challenged.

The totality of the impact is a big concept to appreciate as the multiple losses you experience mount up. There will be an increasing need for emotional support as you witness changes to your health, body image and your role at home, at work and within your social circle.

A period of grief may initially follow the diagnosis2 as you yearn for your old life whilst trying to accept the change that this illness has brought upon your body, mind and spirit. In fact, the notable work of Weisman and Worden in the 1976 publication International Journal of Psychiatry in Medicine states that the first one hundred days following a cancer diagnosis were identified to be the period of adjustment time when a patient is most vulnerable and prone to emotional distress.

Despite all the advances in treatment, this is often the time when people with cancer think most about concerns of life and death and express worries over their physical symptoms.3

In response to this disruption, the full spectrum of emotions will be provoked, and it is common to experience not only the negative emotions of;

  • fear
  • sadness
  • anger
  • guilt
  • fear
  • embarrassment
  • shame4

but also the positive emotions of hope and gratitude.5

The way you respond to these emotions will depend upon a number of factors above and beyond your type of cancer, stage or grade, even beyond your prognosis.

The psychological impact cancer will have on the individual will depend on many competing factors;

  • your personality
  • your belief system
  • your expectations of health6
  • how much you have to lose
  • your role within your family
  • your support network
  • your personal coping abilities
  • your baseline mental wellbeing
  • your lifestyle
  • your own age
  • the age of your children.

All of these aspects of your life will have an effect upon the overall intensity of the situation and the resulting emotional pressure you experience.

Support

How to react emotionally to cancer?

There is dignity to be found in a complete range of reactions and in the innate coping abilities of; acceptance, denial or resolve to fight. Yours is the right to respond exactly how you do, it is your natural reaction and how you react is entirely appropriate. However, how you come to mentally frame the situation will affect the levels of emotional suffering you will experience as your emotions are the body’s reactions to the way you are thinking.7

People react to adversity differs, and their response may not be predictable even to themselves. In fact when under intense emotional strain they may not even be consciously aware of their own emotional response or even what emotional support they may need.

The trial of being able to regulate emotional distress in order to be able to cope better with the experience is significant, yet an important challenge to attempt to overcome. Seeking emotional support will be a necessity. This journey could be a long run; with better treatments and better outcomes, many people are living longer in the survivorship stage. This means that there could be many ups and downs to endure along the way and difficult times to get through, which all will provoke periods of intense emotions.

Depending on your mindset, interpretations of events can be clouded, catastrophised, embellished or taken out of proportion which has the potential to lead untold damage psychologically. Unbridled emotional distress will mean that your quality of life will suffer, along with your relationships and your ability to make clear decisions will also be negatively impacted.8

For those with a serious illness, facing any fears you have is key in reducing emotional distress.9 Having the ability to step back from the situation and see clearly what you are going through will help you see how well you are coping. Being able to tap into this heightened awareness will help you understand what emotional support you need to help you get through this period of psychosocial crisis.10

Physically you may experience bodily reactions which are beyond your control and impossible to stop. This is a scary time as you feel lost to the moment, isolated in your internal pain.

Your body’s immediate way of releasing tension and stress is to cry and for those around you it can be their expression of deep love, empathy and concern. You may find yourself acting and behaving irrationally or even finding that you get locked upon a specific focus or goal which helps you cope during the chaos.

It is likely that you will experience the full emotional range from fits of anger, to outbursts of inappropriate laughter. These processes are mechanisms your body goes through in reaction to the acute stress it is under as you mentally ride the emotional rollercoaster.

Chest pains, skin rashes, a bitter taste in your mouth, a feeling of sickness in your mouth and headaches are all common physical reactions to highly emotional and stressful times.11

How to make sense of a cancer diagnosis

As humans, our minds try to make sense of what is happening and try to understand.  We seemingly have an inbuilt need to rationalise everything, place logic upon the world around us and try to find meaning behind events which occur in our lives. We try to assign meaning and exert control over every part of life, including illness and even death.

These attempts to make sense throw up many emotional, psychological and cognitive challenges.12 The need to break down the vastness of the problem so that it is easier to process and compartmentalise makes us question; how did this happen? Why did I get cancer? What could or should you have done differently? Did I deserve this?

To think that what has happened is ‘God’s way’, the natural order or simply to put it all down to fate, means that we can devolve any personal responsibility of having to find the meaning or reason why we got sick. This leaves us more satisfied than trying to find the unsatisfying real reasons we develop cancer such as; poor lifestyle choices, bad genes, our toxic environment, viruses, old age or sheer bad luck.

It is simply impossible for anyone be able to exactly say what combination of such cumulative factors over time led to you developing cancer.

Cancer, the disease itself, seems illogical and its nature defies rational; why would your body go into self-destruct? This is tough to deal with because when a situation does not make sense, adjusting in a positive way becomes difficult.13 By trying to understand only leaves room for self-blame and rumination which are entirely pointless and destructive.

A cancer diagnosis, especially one with a poor prognosis may seem completely unfair and the truth is, it is. No one has asked for this to happen to them or deserves it.

Cancer is often painless, symptomless until it has spread and become a very real threat. Frustratingly, this silent presence in your body will only rear its ugly head when it is established enough for obvious, undeniable symptoms appear.

It is normal that people lead such busy lives in this modern world, it can be easy to put yourself last, to put off going to the doctor or to even be aware of your body enough to notice vague symptoms appearing over time.

Stop hating yourself, stop beating yourself up or trying to justify and point blame at yourself for getting this cruel disease because you think that you must have done something wrong. This is nonsense. Yes, there are things you can do to reduce your chances of developing this disease, but life isn’t always easy and living the perfect lifestyle isn’t always attainable or even possible throughout life because simply living and surviving in this modern world gets in the way.

Also, the reality is that any cell can go rogue at any time, so there could simply be an element of chance and sheer unluckiness in the whole thing.

The likelihood of developing cancer will ultimately depend upon your own individual genetic response to the cancer promoters you are exposed to over a lifetime in your internal and external environment. Firstly, your genetic and epigenetic response is beyond your control and even if you had made poor lifestyle choices over time or hadn’t been self-aware enough to catch this disease early enough, what good is it to punish yourself even further?

Be kind to yourself, you need a bit of kindness right now.

How do you survive cancer emotionally?

Cancer provokes a complex emotional reaction which is difficult to survive on your own. Seek emotional support from your inner circle and medical team.

The importance placed upon the recognition and management of emotional distress in modern oncology is now much more significant and is described by Bultz and Carlson as the ‘Sixth vital sign’ in an article published in 2016 in the Journal of Clinical Oncology.14

Not only is a cancer diagnosis devastating in its own right, it also abruptly takes you out of your normal daily routine and isolates you away from your usual supportive social network of work and your social life. You then find yourself entering into a whole new world of medical terminology, decision-making, drug protocols which provoke intense emotions and family crisis.

These changes happening all at once can be extremely overwhelming, but the harsh reality is that the more you resist dealing with these emotions, the more pain and suffering you will feel.

Seek the support from psychosocial interventions through your medical team such as individual cancer counselling and group support. This means that you can take an active role in your recovery and benefit from the positive outcomes which result from professional help.

In fact, for many, the ability to manage the severe emotional distress of a cancer diagnosis is associated with;

  • a better quality of life
  • less depression and anxiety
  • increased self-esteem
  • a stronger immune system
  • enhanced survival times15
  • better treatment compliance
  • a decreased risk of progression and death.16

Who can help when you have cancer?

You will need different types of emotional support at different times to help you navigate this daunting and troubled journey. There should be no point in your experience when you are in doubt as to where to turn and to whom to turn to for the emotional, practical and the informational support you will need.17

Who can help when you have cancer?

In the immediate instant of diagnosis your oncologist will be there for the consultation and will provide emotional support in the instant. However it will be the specialist cancer nurses at the hospital who will help you deal with the initial shock and who are there to give you the appropriate information on your individual cancer. Don’t forget that you to ring these nurses for counselling and support through any crisis moment; if you need someone to clarify and explain any aspect of your treatment plan, to listen to your worries and fears and direct you to any further relevant support.

The wider cancer care medical team is made up of;

  • pharmacists
  • dietitians
  • physiotherapists
  • counsellors
  • palliative care nurses
  • occupational therapists
  • your primary care physician/ GP.

They are all there to support every aspect of your experience and do not hesitate to ask to speak to them directly if and when you need their emotional support.

You then need to surround yourself with your community, whatever shape that consists of and by doing this you will experience the charitable nature of society.18 One of the main positives the world of cancer has to offer is its supportive community, made up of the many who have walked this road before you.

There is a huge network of local cancer charities which offer a wide range of support services. Many provide not just counselling but also practical support such as cleaning, ironing, cooked meals, help with childcare, financial planning and also offer complementary treatments such as reflexology and massage, free of charge.

They often have a helpline should you be in a crisis moment of emotional turmoil and find yourself needing emotional support. To be able to speak to someone directly in that instant who understands what you are going through and can give you sound advice.

The cancer community online can also offer invaluable support for anyone struggling to cope with a cancer diagnosis. To off-load and talk to people who can appreciate your situation, people who are journeying alongside you, who can share great advice and support can be a source of such comfort.

Then you will have your own supportive community to rely upon of family, friends, colleagues, acquaintances, people whom you meet through this experience and from the wider communities you belong to, including religious groups.

Family support

Upon diagnosis you will be initially inundated by offers of kindness, love and emotional support.

Even if you feel initially suffocated by the shower of support, you will find that having this network of positive, strong and caring people is a crucial part to fighting this disease. This is mainly because your environment will have an impact upon how mentally robust you are and resilient you are to the risk of depression and anxiety.19

By embracing the prayers and well-wishes and emotional support of those around you, you will open yourself up to reaping benefits such as; an enhanced sense of overall wellbeing, a strengthened immune system20 resulting in overall improved coping abilities.

When the dust settles, you will know who your true friends are and will rely closely upon the vital social network of your inner circle.

Having built your relationships in good times, this is when you get to benefit from some aspects of deep value that friendships can offer you; the boost to your resilience you will experience and the protection you will feel when times get tough. Accept this emotional support as the act of love it is.

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Recommend to others facing cancer, on support forums, social media, in person or by email. Thank you.

References

  1. Sippel, L. M., R. H. Pietrzak, D. S. Charney, L. C. Mayes, and S. M. Southwick (2015) ‘ How does social support enhance resilience in the trauma-exposed individual? ‘, Ecology and Society , 20(4), pp. 10. [Online]. Available at: https://www.ecologyandsociety.org/vol20/iss4/art10/ (Accessed: 9th September 2019).
  2. Die Trill, M., 2012. Psychological aspects of depression in cancer patients: an update. Annals of Oncology, [Online]. Volume 23, x302–x305. Available at: https://academic.oup.com/annonc/article/23/suppl_10/x302/208732 [Accessed 14 December 2018].
  3. Weisman AD & Worden JW. (1976-1977) ‘The existential plight in cancer: significance of the first 100 days.’, International Journal of Psychiatry in Medicine, 7(1):1-15(1), pp. 1-15 [Online]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/1052080 (Accessed: 17th May 2019).
  4. Stanczyk, M. M., 2011. Music therapy in supportive cancer care. Reports of Practical Oncology and Radiotherapy, [Online]. 16(5), 170–172. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3863265/ [Accessed 14 December 2018].
  5. Conley, C. C., 2016. Emotions and Emotion Regulation in Breast Cancer Survivorship. Healthcare (Basel), [Online]. 4(3), 56. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5041057/ [Accessed 14 December 2018].
  6. Brand, P. Dr., 1993. The Gift Nobody Wants. 1st ed. United States of America: Harper Collins.
  7. Sweet, C., 2010. Change Your Life with CBT. 1st ed. Great Britain: Prentice Hall Life.
  8. Southwick, S. M. & Charney, D. S., 2018. Resilience. 2nd ed. United Kingdom: Cambridge University Press.
  9. Spiegel, M.D., D. and Classen, C., Ph.D. 2000. Group Therapy for cancer Patients. 1st ed. United States of America: Basic Books.
  10. Tolle, E., 2006. A New Earth. 1st ed. United States of America: Penguin Books.
  11. Harrison, E., 2018. Teach Yourself to Meditate. 2nd ed. Great Britain: Piatkus.
  12. Jim, H.S. et al. (2006) ‘Strategies Used in Coping With a Cancer Diagnosis Predict Meaning in Life for Survivors’, Health Psychology, 25(6), pp. 753–761. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2151209/ (Accessed: 9th September 2019).
  13. Cole, F., MacDonald, H., Carus, C., Howden-Leach, H. (2010) Overcoming Chronic Pain, 2nd edn., London, UK: Robinson.
  14. Bultz BD, Carlson LE. (2005) ‘Emotional distress: the sixth vital sign in cancer care.’, Journal of Clinical Oncology, 23((26)), pp. 6440-1. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16155033 (Accessed: 19th June 2019).
  15. Mohan Rao et al., R., 2017. Role of Yoga in Cancer Patients: Expectations, Benefits, and Risks: A Review. Indian Journal of Palliative Care, [Online]. 23(3), 225–230. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5545945/ [Accessed 14 December 2018].
  16. Conley, C. C., 2016. Emotions and Emotion Regulation in Breast Cancer Survivorship. Healthcare (Basel), [Online]. 4(3), 56. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5041057/ [Accessed 14 December 2018].
  17. Snyder, Ph.D. et al., K. A., 2010. Crisis, Social Support, and the Family Response: Exploring the Narratives of Young Breast Cancer Survivors. Journal of Psychosocial Oncology, [Online]. 28(4), 413–431. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904631/ [Accessed 10 December 2018].
  18. Seligman, Ph.D., M., 1991. Learned Optimism. 1st ed. United States of America: Alfred A. Knopf.
  19. Turner, Ph.D., K. A., 2014. Radical Remission. 1st ed. New York, United States: Harper Collins.
  20. Carter, A. & Mackereth, Dr. P.A., 2017. Aromatherapy, Massage and Relaxation in Cancer Care. 1st ed. London, UK: Jessica Kingsley Publishers.

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Related Topics

How does cancer affect a person’s life?

Side effects of cancer and its treatment

Living life with cancer

When you have late stage cancer

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