Emotions and CancerDownload this book (pdf, 755.27 kb)
Your coping toolbox
Most of us have different ways of coping with difficult situations that we have learned over a lifetime.
These could include:
- seeking more information
- trying to fix the problem
- having a laugh to feel better
- distracting yourself from unhelpful thoughts and feelings
- talking things through to try and make sense of what is happening
- denying the circumstances.
How you cope depends on the type of situation you are facing, your personality, upbringing, role models and what has worked in the past. You might find your usual ways of coping are not enough to handle the different challenges caused by cancer. There is no single best or right way of coping, but having a few different ways may help you feel a greater sense of control and confidence.
Think of ways of coping as being tools in your toolbox. Different jobs generally need different tools. If one tool doesn’t fit the job, you need to try another one. It’s helpful to consider several strategies or ‘tools’ for coping with a cancer diagnosis and treatment.
Some strategies are generally unhelpful for any situation if used too much, such as, avoiding the problem entirely, self-blame, alcohol or drug use, overeating, or gambling.
Tools to help you cope
- Gathering information - What to do with all the information you are given and how to organise it so that you can find it when needed.
- Looking after yourself - Ideas to nurture yourself and reduce the stress that cancer can cause physically and emotionally.
- Complementary therapies - Different ways to cope with treatment side effects that may help to increase your sense of control over what is happening and help maintain your wellbeing.
- Helpful thinking - How to deal with difficult, unbalanced or unrealistic thoughts, which often occur in stressful situations.
- Making decisions - Suggests different ideas to try when you are faced with making difficult choices in a stressful situation.
Once diagnosed, there is a lot of information to take in – and well-meaning family and friends may give you even more. Too much information may leave you confused about what to do. Instead, you may need more accurate information or a way of dealing with what you already have.
- Get organised - Start a filing system for all your test results, information and records.
- Keep a diary - This may help you to keep track of events and highlight where information may be missing. This will also be a useful, accurate record in the future (especially if you are seeing different professionals in different locations).
- Take time to work out what specific information you need - It may help to write down your questions and to put them in order of how important they are right now. For example, you may know what treatments are available to you but you may not know the specific pros and cons of each treatment for your situation.
- Involve other people - Consider asking people you trust to help gather and make sense of new information.
- Consider different sources of information - Look at websites, books and different organisations. Take care with cancer information from the internet as some of it is unregulated and poor quality.
- Talk to your doctor – specialist or general practitioner (GP) - If you are unsure or confused about certain information, it can help to talk to your doctor. Doctors are usually happy to explain things and point you in the right direction. Consider writing your questions down beforehand so you remember what you want to ask when you see your health care professionals. You can also direct questions you have to the Helpline.
- Organise and update your affairs - Many people with cancer review their insurance policies and update their will. This doesn’t mean you have given up. Everyone needs to do these things and once done you will have less to worry about.
Following a cancer diagnosis many people look for information about new types of treatment, the latest research findings and stories about how other people have coped. Cancer Council has a range of books, CDs, DVDs and medical journals that may be helpful for you. Call the Helpline on 13 11 20 for more information.
* Not available in Victoria and Queensland
It can help to take a close family member or friend to consultations with your doctor to take notes, ask questions and to help you remember the information you are given.
Looking after yourself
Cancer can cause physical and emotional strain. Some days you may feel better than others. Nurturing yourself can enhance your wellbeing and reduce stress during this time.
- Eat well - Eating well gives your body better fuel to help it cope with the stress of illness and treatment.
- Be active - Physical activity has been shown to lift mood, lower blood pressure, improve sleep and reduce stress. It is also an important way to manage fatigue – helping you to feel more energetic and less tired. Even a short walk daily can help.
- Make time for yourself - Even though life may be very busy, it is important to make time each day just for relaxation and enjoyment. Think about things you do (or have done in the past) that help you to relax and feel good.
- Deal with feelings - Blocking out or avoiding your emotions may create extra pressure, leading to increased frustration and anxiety. Talking about the problem with your partner, friends, or members of your cancer care team may be more effective and less tiring, helping to make sense of your feelings as well as lighten your load. You can also call the Helpline on 13 11 20 to talk about your issues confidentially.
- Sort out issues - A cancer diagnosis may happen in the context of other life stresses such as financial problems, work-related issues, relationship concerns and family stresses. Dealing with other sources of stress in your life may help you cope better with the additional burden of cancer treatment.
- Stay connected - Staying connected with the world through work, hobbies, or time spent with family and friends, may help you see a life outside of cancer and provide time out from your worries.
- Tap into spiritual beliefs - Some people find meaning and comfort from their faith and spiritual practices, such as meditation or prayer. Others may experience spirituality more generally. For some people the experience of cancer challenges their beliefs. It may help to talk to a spiritual leader or pastoral care worker about your feelings.
Recognising signs of stress and anxiety
Your body releases adrenaline, your heart beats faster, your blood pressure goes up, your breathing is shallow and fast,
your hands get sweaty, and your mouth gets dry. These are natural responses and useful when dealing with emergencies, but not very helpful in dealing with cancer.
Complementary therapies are treatments that may help you cope better with side effects such as pain. They may also increase your sense of control over what is happening to you, decrease your stress and anxiety, and improve your mood.
- Relaxation and meditation - Both of these therapies can help reduce anxiety, stress, pain and depression. Studies on meditation have shown it enhances wellbeing and can reduce anxiety. Relaxation usually includes slow breathing and muscle-loosening exercises to physically and mentally relax the body.
- Counselling - Through discussions with a counsellor or psychologist, you can identify problems and explore ways of resolving negative thoughts and feelings that impact on your health and day-to-day life. Counselling allows you to express your emotions in a safe, objective environment and learn new coping skills.
- Hypnotherapy - Involves deep relaxation and is used to help people become more aware of their inner thoughts. This may help you to overcome mental blocks.
- Art therapy - Is a way of using visual art to express feelings. An art therapist helps you explore the images you have created to encourage understanding of your emotions and concerns.
Let your doctor know about any complementary therapies you are using or thinking about trying. Some therapies may not be appropriate, depending on your medical treatment. Some may even cause harm. Contact Cancer Council Helpline 13 11 20 for more information about complementary therapies and alternative therapies or for a free copy of the meditation and relaxation audio CDs. These are also available to stream from www.cancercouncil.com.au.
Mind-body techniques are based on the belief that what we think and feel can affect your physical and mental wellbeing.
When your emotions or mental state are under pressure, your physical body can be affected. Similarly, physical symptoms can have a negative impact on your mood and mental wellbeing.
Many complementary therapies focus on the mind-body connection in different ways. Examples include counselling,
support groups, hypnotherapy, relaxation, meditation, visualisation, art therapy and music therapy.
Studies show that mind-body techniques may reduce the symptoms and side effects of cancer, which can all affect mood and overall wellbeing.
They have also been shown to help people feel more in control of their situation, more relaxed and less fearful of the future.
In highly stressful situations, thoughts happen very quickly and you may not even be aware of them. Your thoughts at this time can be unbalanced and unrealistic – that is, they may be overly negative, exaggerate your problems and underestimate your ability to manage your emotions. This can leave you feeling more upset and finding it even harder to cope.
- Notice your thinking - This is not always easy because thoughts are often quick and automatic. When you are feeling upset, it may help to stop and take note of the thoughts going through your mind.
- Write down your thoughts - Writing down your thoughts is helpful because it slows down your thinking and makes it easier to focus.
- Check your thoughts - If your thoughts are making you feel upset, ask yourself if the thoughts are correct, realistic or helpful at this time.
- Find helpful alternatives - If the thought isn’t based on the facts, or realistic or helpful, try replacing it with a more helpful one. This may help you feel calmer and less worried.
- Coach yourself - For thoughts to be helpful they need to be balanced and believable. Encourage yourself through difficulties, rather than undermining yourself. Learn to be kind to yourself. Counsellors can teach you these techniques.
A common belief is that the most important thing in coping with cancer is staying positive.
While it can help to be optimistic, this doesn’t mean denying the reality that cancer is serious or frightening. Trying to put on a brave face all the time and avoiding anything negative is hard work, drains energy, and generally doesn’t work well because the negative thoughts just keep coming back.
Pressure to be positive all the time can lead to people being afraid to discuss fears and feelings, which can make problems worse.
Try to be realistic about what is happening and talk to someone about your fears and concerns so you can better deal with them. Explaining your fears and concerns to those around you may also help you get the support you need.
- Identify where the thoughts come from – When you notice unwanted thoughts check if they are the result of an underlying belief, such as ‘I must do things perfectly at all times’, ‘the world should be a fair and just place’, ‘if I can’t do everything I used to do I am useless’, ‘I am a burden to my loved ones’.
- Imagine what you would say to others – Holding on to recurring thoughts can lead to sadness. One way to challenge them is to think of someone you love and imagine what you might say to them if they felt the same way.
- Check the reality – Having noticed 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?
- Acknowledge small achievements – Check if you are focusing on the difficult things and ignoring the little achievements or happy events that may also be occurring. Sometimes we notice the bad things that happen and don’t notice the good. Writing down three good things that have happened to you each day may help. They don’t have to be major events – just the everyday things that often go unrecognised.
- Practice letting your thoughts come and go – Thoughts are fleeting. Some we notice and many we don’t. Practice letting your thoughts come and go without getting caught up in them, just like clouds floating across the sky (the Cancer Council Mindfulness CD may help you practice this, contact Helpline 13 11 20 for a free copy).
Believing that it is possible to do something, even in the worst situations, is the first step in tackling any problem.
Types of health professionals you may see
- Counsellor – A counsellor’s education may range from a vocational certificate in counselling through to university level studies in psychology or social work. There is no standard of qualifications required. Counsellors listen to clients’ problems, offer support and strategies for dealing with problems. Counsellors cannot prescribe medication.
- Social worker – A social worker is often trained to provide emotional support as well as advocate for the patient, offer practical and financial assistance and help people access support services. Social workers cannot prescribe medication. Check if there is a social worker at your cancer treatment centre.
- Psychologist – A registered psychologist in Australia must complete four years of psychology at undergraduate level, followed by either postgraduate studies in psychology or two years of supervised clinical practice. Psychologists, who specialise in counselling, use their understanding of the mind to guide clients through issues with how they think, feel and learn. They cannot prescribe medication. Check if there is a psychologist at your cancer treatment centre or ask your GP about other options.
- Psychiatrist – A psychiatrist is a trained medical doctor who specialises in the diagnosis, treatment and prevention of mental illness. As well as discussing issues with patients, a psychiatrist may prescribe medication to help a range of emotional conditions. For example, if you are severely depressed, a psychiatrist can work through coping strategies with you and may prescribe antidepressants. You will need a referral from your GP.
During cancer and treatment you are likely to be faced with the challenge of making difficult decisions. These could include the choice of treatment, how to involve or care for your family, returning to work, and what to do about finances.
- Take your time - Even with a cancer diagnosis, there is often time to consider your treatment choices. Generally, people make better decisions – and have fewer regrets later – if they have taken time to make sure they have enough information and considered all the possible consequences. Ask your health care professionals to provide you with details about your treatment choices and the benefits and side effects of each treatment option. Social workers can give you information about financial assistance and community supports that are available.
- Write it down - Write it down Organising your thoughts on paper can be easier than trying to do it in your head. Consider every option available to you. Make sure you have all of the options written down, for example: Option 1 – only surgery, Option 2 – surgery plus other treatment(s), Option 3 – only radiation therapy, Option 4 – active surveillance.
- List what is important to you - Write down all the pros and cons of each option and consider how important each of these are to you. You could rate how important each point is on a scale of 1–5, with five being very important and one being least important. To determine how important a point is, look at how it affects you and others in both the short and long term. Consider the burdens and the benefits of each option.
- Talk it over - Talk through the options with someone close to you, like your partner or a close friend. As most decisions will affect others in your life, it’s also important to talk it through with people who will be affected so that their opinions are considered.
- Get expert advice - Find out all the facts first, then review your options and the points for and against each one with specialists in that area, for example, someone in your treatment team, a financial or legal advisor or a counsellor. Being certain of the facts may make the decision and consequences less overwhelming.
- Expect to experience doubts - Being unsure does not mean you have taken the wrong path. Reassure yourself that you made the best decision you could with the information you had at the time. Also, decisions are not always final – it may be possible to change your mind even after you have already started down a particular path.
Getting a second opinion from another specialist may be a valuable part of your decision-making process. It can confirm or clarify your doctor’s recommendations and reassure you that you have explored all of your options.
Some people feel uncomfortable asking their doctor for a second opinion, but specialists are used to people doing this.
Your doctor can refer you to another specialist and send your initial results to that person. You can get a second opinion even if you have started treatment or still want to be treated by your first doctor. Alternatively, you may decide you would prefer to be treated by the doctor who provided the second opinion.