QUESTION: Dear Dr. Barton, I was diagnosed with cancer a couple of weeks ago. I’m so scared that I can’t think about anything else and I can’t sleep. My thoughts have run wild, thinking of all the horrible things that could be ahead. I feel like there’s ice in my veins where my blood used to be. I’m crying all the time. I’m embarrassed at how badly I’m handling this. I try to stay calm but I just can’t. My family and friends try to help but I’m afraid they’ll get tired of dealing with my emotional reactions. Can you tell me some ways to cope with this whole thing?
DR. BARTON'S ANSWER: Your initial reactions are absolutely normal. A cancer diagnosis can feel life shaking. My first suggestion is that you practice being patient and gentle with yourself. In time, most people find ways of coping, although granted, some ways are healthier than others.
People dealing with cancer share many common reactions, although they may experience or express them differently. You'll no doubt feel all sorts of emotions. Give yourself permission to be afraid, cry, rage, feel sorry for yourself. Let's look at some of these feelings.
Fear is universal to all who deal with cancer. There’s fear of death, pain, side effects of treatment, losing the way of life you know, being a burden on others, financial fears, fear of recurrence. Sometimes, fear is so overwhelming that it makes us freeze or panic. However, fear can be useful. We can choose to use it as motivation and energizer to do what's necessary to conquer the "beast".
Anger is common, as well. Naturally, you'll be angry with the cancer. You may have moments of blaming yourself for getting the cancer, or at God for allowing it. You may find yourself irritated with those you love, because they're not there for you or because they're hovering too much, because they're healthy, or just because.
Relationships change as a result of illness. You may find yourself re-evaluating your relationships. People may hurt you by saying the wrong thing, or by saying nothing and avoiding the topic. Some of your friends or family may stay away because of their own fears of illness or simply because they don't know what to say or do to help. Others will rally and be there for you in ways you never expected.
Stress is universal. There’s the stress of waiting for diagnosis and the stress immediately after the diagnosis is made. There’s the stress of treatment—dealing with frequent doctors’ visits, dealing with treatments and side effects, worrying about stress on loved ones, waiting to know results, the uncertainty of outcome. Some people fall apart initially but soon find ways to cope. Others seem to handle the initial stress well, only to have a delayed reaction later.
Runaway thoughts can be extremely distressing. You may find yourself plagued by all sorts of unwelcome, unhelpful thoughts that take up brain space and repeat themselves over and over and over. “Why did this happen to me?” “How will I..?” “What if…?” and on and on.
With worry and stress, sleep often becomes difficult. Sleep deprivation can affect mood and ability to think clearly, making it more difficult to cope with daily challenges.
Depression is fairly common. Approximately one in four cancer patients will experience some degree of depression, which complicates coping and can impact relationships with friends or family members.
Over time, most get through their initial reactions to a cancer diagnosis and find a new equilibrium. For example, while fear may not completely go away, it can be tucked away and not be allowed to rule or define your life. As one person put it, “I may have cancer, but cancer doesn’t have me.”
True, a cancer diagnosis can cause life upheaval. Yet, many people also find positive transformation as a result of dealing with their own or a loved one’s cancer. Many people discover resources within themselves, learn new skills for coping, and feel they have become a better, wiser person as a result of the experience.
You may lose some friendships but find new ones, or deepen existing relationships through the shared experience.
Many people connect with their spirituality in new or renewed ways.
Here are a few suggestions as you begin your path through this new territory:
Learn as much about your condition as possible. There is often plenty of reason for hope. Learning about treatment options can be reassuring. Side effects of treatments can often be managed. Don't take anything at face value. Ask questions, and take responsibility for helping to manage your treatment. Enlist family and friends to be your advocate at times you're not feeling well enough.
Organizations such as American Cancer Society and National Cancer Institute provide useful information. Also consult organizations that deal with your specific cancer. Your doctors and cancer center are prepared to answer your questions.
Focus on this moment. Practice turning your thoughts away from the “what ifs”, back to the fullness of this very moment. We can’t do much about moments that haven’t come, but we can do a great deal in this moment, whether it’s savoring the moment, taking control and doing what can be done in this moment, or letting go and flowing with it. A psychologist can help you learn thought management skills and relaxation techniques to help with this. Meditation is a valuable practice, as well.
Emotional support is essential. You may feel an urge to isolate but don't. People do better with support. Doing it alone often results in unneccesary fear and isolation. Ask for help!
- Reach out to family and friends. Encourage them to get help in learning how to help you. Accept their help.
- Join a support group. Getting together with others who share your experiences and concerns can be incredibly helpful.
Focus on activities that you love. Spend time with positive people, work on projects you’re passionate about, journal, look for small and large ways to help others. You’ll benefit both from the distraction and the good feelings these activities generate.
Self-care is essential. Insofar as your doctor and condition allow, exercise, eat nourishing foods, and get enough rest.
Find a psychologist who works with cancer patients. A psychologist may help you understand your reactions, manage stress, re-focus your thoughts, master relaxation techniques to allay anxiety and manage discomfort, and learn techniques for better sleep. You might also consider couples therapy to help strengthen communication and coping as a team with the disease.
If your sleep, mood or reactions seem too difficult to manage, ask your physician about medications that may help you through the rough spots.
Develop a determination to pull good out of difficult situations. Look for the positives. For all the stress, fear and life altering circumstances, good things will also occur along the way. Live every day of your life. Be alert for small blessings, kindnesses, new opportunities, strengthened relationships, new friends, newly discovered strengths, emotional growth, and doors opened along the way.
©Copyright Dr. Geraldine Merola Barton, 2012