Coping with Cancer

Cancer is a disease of the physical body, however the effects extend much beyond our physical self. The feelings and life priorities undergo drastic change after a cancer diagnosis is made. Sometimes these changes are volatile and depends on treatment result as well as symptoms of cancer. One should understand that there is no right or wrong feeling, one can feel both positive or negative types of emotions. These feelings are expected and one should accept its existence.

The internal beliefs and values we have affect the feelings as well. Some people show courage and try to protect their loved ones in various ways. For example, many patients choose to undergo treatment not for their own sake but for their children, spouse or other family members. This is a great way of coping.

On the other hand some patients become emotionally labile and seek support from their loved ones, cancer support groups, counsellors or religious priests.

It is important to understand that both types of feelings are normal and you should not compare with other patients and their way of coping with emotional stress.

Most patients go through feelings of denial, anger, depression, anxiety, loneliness and guilt.

Minority of patients may experience hope of good outcome of treatment, gratitude for living a comfortable life till now, as well as motivation to complete the treatment

Following are descriptions of each emotion for better understanding of the topic and at the end I have covered some coping mechanisms which I prescribe to my patients.

Overwhelmed- You start feeling as if life is out of control because you don't know about the outcome of the treatment, your normal routine is disturbed by frequent hospital visits and various procedures .

Since most of the patients are not from Medical background they are dumbfounded by medical terms which also adds up to an overwhelming feeling.

What can you do about being overwhelmed? The most important step towards getting control over this feeling is to develop your knowledge on the topic. The more you understand about your disease, the more comfortable you will feel undergoing treatment. Feel free to discuss with your doctor what you have learnt and still don't understand. Some people choose not to get involved with information about cancer, for those patients it is best to keep themselves occupied with some activities they like. It is much better to learn new skills like music or languages than to sit in front of the television.

Denial- Denial is a situation where you have difficulty accepting the diagnosis of cancer. It is a normal coping mechanism before any major change in life. The purpose of denial is to feel hopeful about the situation, however it becomes a serious problem if you take too long to adjust or refuse treatment.

How to deal with denial? most people who have symptoms of cancer come to terms and overcome the feeling of denial by the time treatment is initiated. People who don't have symptoms sometime undergo repeat tests or second opinions out of denial. Whatever method opted, it is best to accept the cancer diagnosis and move forward with the treatment aspect.

Anger- A significant majority of patients who are diagnosed with cancer ask this question to themselves or to the treating physician “ why me?”. This feeling of anger sometimes get ventilated towards care providers including doctors or your close friends who are actually there to help you out. In a country like India many feel angry about the religion they follow!

How to overcome anger? the most common wrong method people take to overcome anger is to pretend that everything is ok. It’s an unhealthy method of coping with anger. There are various behavioral techniques to channel your anger towards motivation or other resourceful actions, hence don't feel shy to take professional help

Anxiety, fear or worry- There can be many reasons for anxiety. Some patients perceive cancer treatment as painful, this may cause fear. Patients can be worried about dependent family members or the financial aspect of treatment.

Overcoming anxiety fear or worry? Most fears are baseless. For example, the belief that cancer treatment is painful, this is largely based on WhatsApp stories or posts containing wrong information. Here Knowledge Is Power. Discuss with other patients who have undergone similar treatment to have a first-hand information .

Depression- It is also a common feeling after a cancer diagnosis, in most situations information about cancer does not help in overcoming this feeling. Depression is often accompanied by tiredness, lack of appetite and lack of motivation.

Want to seek help for depression? You need to seek professional help if you persistently feel sad, emotionally numb or do not enjoy things which were previously enjoyable.

Also if you cry over a significant amount of time for many days or if you feel suicidal.

Sometimes depression reflects on physical body and you may have nightmares, fatigue or upset stomach with or without increased sweating.

Guilt- This is a common feeling especially among patients who are dependent on others, for example old age or unemployed person. Many a times guilt is about the lifestyle you have been following which you consider has lead to cancer. People who are religious, sometimes consider cancer to be the result of their sin. Often a counsellor or a clinical psychologist is required to overcome this feeling. I often tell my patients that cancer can happen in the absence of risk factors as well as in children. Also sometimes even people who have been following unhealthy lifestyle do not develop cancer. Guilt is an unresourceful state and hence should be overcome at the earliest.

Few words on resource full emotions that cancer patients show.

Gratitude or thankfulness: few patients consider cancer diagnosis as their second chance to enjoy things they have been neglecting or in other words fulfill their bucket list. In my practice I ask almost all of my patients with non curative cancer to see this movie “ bucket list”. Some patients utilise the time available to finish important responsibilities for example one of my patients arranged a trust for her children once she passes away.

Forgiveness: Many a times patients forgive their old foes and mend relations with them.

Hope: Many people after accepting a cancer diagnosis show a feeling of hope. In most cases it is a healthy coping mechanism and help patients to live an active fruitful life. However, sometimes hope leads to unjustified expectations out of treatment.

Practical Advice to cope with emotions:

Accept and Express:- You cannot overcome a feeling if you refuse its existence. So I ask patients to express exactly what they are feeling. Sometimes when they refuse to express in front of me I ask them to write it down, so that we can take corrective actions to overcome that emotion
Focus on the positive aspect of life:- It is easier said than done, however focusing on things which you can do at this moment and to feel grateful about it is much more resourceful than feeling angry about it. Focus on what actions you can take today even after a cancer diagnosis, for example avoiding smoking
Constructive writing:- In my practice I always ask my patients to write down things which make them feel hopeful are grateful about. It reminds them about things which they can focus on once the disease starts progressing. I also encourage patients to continue working and to go on with their routine life.
Depending on religion & spirituality:- Depending upon the health of the patient, sometimes I also offer meditation to promote development of resource full feelings. Examples include vipassana, guided imagery, hypnosis.
Physical activity:- Physical activity can actually release pleasure hormones known as endorphins and help us in overcoming unhealthy emotional state. Although physical activity depends on the general health of the patient, stretching can be done in most cases.
Explore new options for enjoyment:- Many of my patients develop new hobbies like musical instruments, dance, drawing, travelling etc. During the treatment personal desires like travel should be taken care of and I plan the treatment accordingly.

Free reading material on coping with care by National cancer institute

Taking Time