Coping with cancer

Helpful materials > Coping with cancer

Being part of a family that is dealing with cancer, can turn your lives upside down. We will provide answers to 6 common questions many people with cancer and their family caregivers have regarding stress, lifestyle, changing roles and how you cope with this.

  1. How can we cope with the diagnosis?

  2. Are the emotions that we are experiencing ‘normal’?

  3. How can we cope with our emotions?

  4. How can we cope with stress?

  5. How can we maintain a healthy lifestyle?

  6. How can we cope with our changed roles?

Question 1: How can we cope with the diagnosis?

People respond to a diagnosis of cancer in different ways. There are two main types of coping strategy: active and passive.

Active coping strategies

Active coping strategies mean that people tackle problems ‘head on’ rather than avoiding them. Examples include:

  • Staying realistic/adjusting expectations: it helps to stay positive, however, this does not mean that you need to deny what is happening and the challenges you face. Denying the illness and its consequences can be exhausting and unhelpful. If you anticipate the various outcomes of the illness, it can help you prepare for the stress associated with any changes.

  • Looking for meaning: Everyone has their own ideas about what matters most in life. In this situation it is quite normal for the two of you to reconsider what
    is important and to set new priorities. Perhaps there are things that you have always wanted to do but have put off believing that you will get to them ‘sometime’ – you may want to make these things a priority and plan to do them in the near future . You will likely benefit from talking together about how each of you thinks about life, but it may also help you both to talk to a psychologist or chaplain .

  • Legacy: Receiving a cancer diagnosis leads many people to reflect on their life and consider how they would like their family and friends to think about them. Some people may want to leave something tangible for others. If this sounds like something that you want to do, then you might consider one of the following:

    • Write a letter or a story about your life

    • Make a video with special memories

    • Compile a photo album

    • Explore your genealogy through a family tree

    • Make a playlist with your favourite songs

    • Collect your favourite recipes in a recipe book

    • Make your own piece of art

  • Keeping track of your medication: When you are receiving treatment for cancer it is likely that you will require a range of medications. It can be difficult to keep track of your medications particularly as they may change during your illness. To help you keep track of your medications it may be helpful to keep an up-to- date list of your drugs and medicinal products and the reason why you’re taking it. This can be helpful when you have an appointment with your doctors. You can also keep notes about possible side-effects of the medication you’re taking so you can make your healthcare team aware of this.

  • Following a healthy lifestyle: making small changes to your lifestyle may have a positive effect on your quality of your life. Typical lifestyle changes include eating a healthier diet or taking part in more physical activity. It is always advisable to discuss any lifestyle changes with your GP.

Passive coping strategies

Some people prefer to employ passive coping strategies. This means that people leave the situation as-it-is and may avoid or deny certain problems. This isn’t necessarily a bad thing. Denial and distraction can be effective for people who, for example, want to focus on taking things as they come. In other cases, it might not be the right strategy. Some examples where a passive coping strategy may be harmful include:

  • Staying away from family and friends: sometimes, people who have received a diagnosis of cancer report that they find certain social situations difficult and choose to avoid these. Similarly, friends and family members who are aware of your diagnosis may avoid social contact as they do not know what to say to you. However, if you keep your distance from your loved ones, you can very soon end up isolated and this will have a negative impact on your quality of life. Wanting some time to yourself is normal but, try as much as possible, to participate in social activities, even if you don’t really feel up to it. If you have contact with others it will help you to feel supported, accepted and secure.

  • Total denial: some people prefer to deny what is happening to them and try to continue as normal. Denial may seem like a good coping strategy, but it can also stop you from looking for the help you need, attending appointments or fully participating in your treatment.

  • Substance abuse: Sometimes, if people are feeling stressed and believe they cannot cope, they may abuse alcohol or drugs believing it will help them to cope. However, these types of behaviours can cause strain in your relationships with family and friends and are also harmful to your health. When you are undergoing cancer treatments you must make many important decisions and it is best to keep a clear head. Again, misusing alcohol or drugs may cloud your judgement when you are making important decisions.

  • Overworking: sometimes, people try to distract themselves by throwing themselves into their work. This can have benefits; you feel productive, you meet people and learn new things. However, overworking can sometimes be a way that people avoid thinking about their cancer and can lead to you spending less time with family and friends, eating less, sleeping less or not taking good care of your health. Always try to keep a good work-life balance.

Question 2: Are the emotions that we are experiencing normal?

Do you want to know more about the emotions that you or your family and friends are experiencing?

Cancer can cause a wide range of feelings both in the person with cancer and those around them. Your emotions may change often and are a natural response to a life-changing experience. You can both experience similar emotions at the same time or can feel completely different. Again, this is a normal part of dealing with cancer.

It can be difficult to find words that adequately describe how you feel. You may wonder if people understand what you are going through or, perhaps you do not want to burden others by trying to explain your feelings?

Below we’ve listed some common emotions that you may experience. These explanations may help you to recognize certain emotions you are both experiencing. If you are both able to discuss how you feel it might help you to support one another.

Anger: Many people feel angry. Both of you may feel angry because of the cancer and the way it has changed your lives. You may be angry with the doctor who broke the news to you, or just with the world in general. Many people will wonder; ‘why did this have to happen to me/us?’ Sometimes you may feel angry for no obvious reason.

Fear: When dealing with cancer you may sometimes feel afraid. These feelings may be caused by thinking about the illness, your future together or even death. You may worry about work, and your financial situation and the uncertainties that lie ahead. It can be scary to have less control over your life.

Guilt: Some people blame themselves for their cancer, but the reason why someone gets cancer, and how it progresses, is usually unknown. You may worry about the impact of the illness on your family or feel guilty because you are less independent. Sometimes family caregivers feel guilty as they are unable to change the situation and have limited time to spend with you due to other responsibilities.

Loneliness: you may have a good social network but still feel lonely and isolated. It’s normal to think that no-one can imagine what you’re going through. Your family and friends may have some difficulty taking in the diagnosis and some may even (temporarily) keep their distance. The new responsibilities of being a caregiver might also result in you spending less time with friends or on activities you enjoy. Sometimes caregivers can feel overlooked as most people will ask about the person with cancer without considering how the carer is coping.

Powerlessness: following a cancer diagnosis, you may feel that things are out of your control. Many people feel powerless and believe that all they can do is follow the advice of health care professionals and see how their condition progresses.

Sadness: Sadness is a natural response when you receive a cancer diagnosis and are coping with symptoms and worrying about the future. However, sometimes these feelings do not go away and for some people these emotions can become stronger and more intense over time. If you feel that you are sad most of the time, are losing interest in your normal activities or, you no longer feel any motivation, then you may be experiencing depression. If this is the case, it is important that you get help as soon as possible. You can contact your GP or someone in your healthcare team to talk about how you are feeling and talk about possible treatments.

Talk with other people who are going through the same thing as you both are via (virtual) support groups or read their stories online. You might find that there will be plenty of overlap and common ground.

Question 3: How can we cope with our emotions?

Get professional help.

If you feel overwhelmed and believe that you can’t cope, then you should seek professional support from you GP or another healthcare professional. In chapter 5, you can find a list of healthcare professionals and a description of their roles.

Identify what you find helpful.

Try to think of a situation in the past where you were sad/angry. Was there something that helped you then or made you believe that you could cope? These same sources of support may also be helpful to you now.

Get a better understanding of your situation.

You can try and get a better understanding by:

  • Finding the right information about the cancer (e.g. https://www.cancer.ie/cancer-information-and-support/cancer-support/ )

  • Keeping a mood diary. This will allow you to keep a record of how you are feeling at particular times during the day and identify particular things that may affect your mood. You may want to set an alarm on your phone every few hours to remind you to record what you are doing and how you are feeling at this time. In the back of this booklet there are some templates that you can use.

  • Talking with other people who are going through the same thing as you. There are many self-help groups for both people with cancer and for family caregivers. Your FOCUS+ nurse will be able to provide more information on self-help groups in your area, or you can contact the Macmillan support line on 0808 808 00 00.

Unfortunately, dealing with cancer can cause a wide range of emotions and everyone will deal with this in their own way. However, here are some general tips that people have found helpful.

Seek understanding and support from those around you.

People may ask about your physical health and not notice that you are struggling with your emotions. It is important that you feel supported and it can help to share how you’re feeling with friends and/or family. If you need some guidance on how you can talk about your feelings, have a look at chapter 1 for more information.

Processing your feelings takes time.

It can take some time for you to process your own emotions. So, give yourself time and let the people around you know when you are in the mood to talk about things or take part in certain activities.

Question 4: How can we cope with stress?

Dealing with cancer may be one of the most stressful experiences of your life. Unfortunately, many people coping with cancer also have to deal with other sources of stress related to work, family issues or financial concerns.

Stress describes those feelings we experience when we are under mental, physical, or emotional pressure. It is normal to experience some stress from time to time. However, people who experience high levels of stress or experience it repeatedly for prolonged periods may develop health problems (mental and/or physical). Physical signs indicating that you may be feeling stressed include: sleep problems, chronic headaches, high blood pressure or heart conditions. Emotional symptoms that may indicate that you are stressed include: feelings of depression, anxiety, irritability, feeling overwhelmed and having problems concentrating.

Below are some suggestions which may help both of you cope with stress now or in the future. You may find it helpful to discuss them together.

  • Be aware of your limits.

    If you have neither the time, energy, nor interest, to take on a particular task, it is okay to say no. This should not make you feel guilty. Cancer is life-changing and focusing on the things that matter most to you makes good sense. If you are still working, do not volunteer for projects that would make your workload unmanageable. If saying “no” feels difficult, let people know what you can do instead. Perhaps you would feel happy working on a small part of a larger project or, you could ask for more time to complete the task.

  • Ask for help.

    It is also a good idea to ask others for help. Often, people are happy to offer their support, so think about tasks you may need help with beforehand. For example, family or friends may be able to help with shopping, meal preparations, pet-sitting, or picking up a child from school. In contrast, you may have a friend or family member who offers to help you all the time, even when you don’t want it. This doesn’t have to be an awkward situation; you can thank them for offering to help and tell them that you would like some privacy or that (for now) you are able to do certain things yourself.

  • Prioritize your tasks.

    Make a list of routine tasks such as work and household chores. Ask yourself which of these tasks is most important and rank them in order of importance. If you do not have time to do everything, focus on the tasks and activities at the top of your list.

  • Break down tasks into smaller steps.

    Sometimes large tasks can seem impossible, but often, we can break these tasks up into smaller steps. This process can make seemingly overwhelming problems easier to handle. For example, instead of spending an afternoon cleaning your entire house, tackle 1 or 2 rooms each day.

  • Get help with paperwork.

    Financial and administrative problems can build up and start to feel overwhelming. It is best to think about these as soon as possible. Consider talking with a social worker or a financial advisor who knows about administrative and financial matters.

  • Try to exercise regularly or take part in some activities that will help you take your mind off things.
    Moderate exercise such as a 30-minute walk several times a week can help lower stress. If you are unsure about what sort of exercise you can do, talk to your GP or other health care providers.

  • Spend time outside.

    If possible, take a walk outside in a park or other natural setting. Sunlight, fresh air, and the sounds of nature can help brighten your day.

  • Schedule social activities.

    Make time to socialize with family or friends, as this can be a good way to lower stress.

  • Try to get enough rest and sleep.

    Getting enough sleep is essential. It helps make us feel good and helps us stay healthy.

  • Try to do something relaxing.

    Set time aside each day to do something that you find relaxing like reading a book, gardening, or listening to music.

  • Don’t forget to do the things you enjoy.

    e.g. eat at your favourite restaurant or watch your favourite television show.

Many people learn and practice relaxation techniques to lower stress. You can learn most of them in a few session with a counselor. Many hospitals and cancer centres also have classes to teach people relaxation techniques (both for people with cancer and their family caregivers or you may want to try Youtube or an app.

Some online tips for relaxation and managing your breathing:

Question 5: How can we maintain a healthy lifestyle?

Diet

  • Try to choose a variety of meals and ingredients. Food contains the nutrients our bodies need and eating a varied diet will help to ensure that your body gets the nourishment it requires.

  • Many people with cancer have a bigger appetite in the morning. Take advantage of this and try to eat more early in the day - and to eat more of what you enjoy.

  • Try not to worry too much if you don’t feel lik eating anything at all. Once you feel able, try to eat small amounts.

  • It’s a good idea to plan and prepare meals that you will enjoy. However, you should not be surprised or annoyed if one of you loses their appetite. This is quite normal, try not to feel too disappointed when it happens.

  • On days when you have no appetite at all, the best thing to do is to make sure you drink plenty of fluids. Have a glass of water. Water is good for your body and you should try to drink regularly. You may find it helpful to keep a bottle of water to hand.

  • Many of us enjoy an alcoholic drink. Having the occasional drink is fine unless your healthcare team have advised you to abstain from alcohol. You should limit your alcohol use and not exceed safe drinking guidelines.

Do you want more diet tips?

Movement

Feeling tired is a common side effect for people with cancer. Although you may feel tired, doing some regular physical activity may increase your energy levels and help you feel better. For family carers, you may feel that you have little time or energy to take part in physical activities but making time for some exercise will provide you with similar benefits. Being active will have many benefits for you both. For example:

  • Exercise will make you feel more energetic helping you to perform day-to-day

    activities.

  • Exercise can be enjoyable and can help you to relax and take your mind off the

    cancer.

  • Exercising will improve your overall health (you sleep better, you have less

    stress, and have a clear head).

  • Exercising may reduce the effects of certain cancer side effects such as fatigue,

    neuropathy, lymphedema, osteoporosis and nausea.

  • If you exercise together this can also bring you closer together. You can

    motivate each other.

  • Many studies have shown that exercise can have a positive influence on your

    quality of life.

    There are many benefits to staying active. If you are unsure what you can do, you may want to discuss this with your GP, Oncologist or another member of your healthcare team. The hospital may run specialist exercise programs that you can participate in. Family caregivers will also benefit from participating in some form of exercise. Choose something that is not too strenuous and that you enjoy (e.g. walking, swimming, dancing...).

Do you want to know more about how to stay active?

https://www.cancer.ie/cancer-information-and-support/cancer-prevention/physical-activity-and-cancer

Maintaining a healthy lifestyle can help both of you cope. In this part we will discuss healthy eating habits and trying to remain as physically active as possible. However, you should remember that other things can contribute to making you feel well, such as keeping in touch with friends and family.

Note: not all suggestions are applicable to all patients and caregivers. They might be more or less suitable for you, depending on the illness and physical conditions. If you feel that these tips don’t help, you can discuss other options with your doctor or a dietician.

Question 6: How can we cope with our changed roles?

When you become ill or you are caring for someone it can change the nature of your relationship. How this changes and what effect this has on you both will depend on what your relationship was like before the cancer.

Some people find dealing with cancer strengthens their relationship and brings them closer together. Other people miss how their relationship was before the diagnosis.

Someone who was used to being very independent and self-sufficient, might have trouble letting others do things for them. Or someone who has never provided care for someone might feel uncomfortable in their new role as family caregiver.

To help you adjust to your new roles, we’ve provided some tips that other people have found helpful:

  • If you’re insecure about certain responsibilities as a family caregiver, it might help to gain some confidence by becoming more knowledgeable about the disease and everything around it. You can do so by reading books, coming along to appointments and thinking in advance of any questions to ask the health care professionals.

  • If either one of you feels uncomfortable with certain caring tasks (e.g. bathing, dressing...), you can talk to your GP or Social Worker who may be able to arrange some help at home if necessary.

  • Allow the person with cancer to be as independent as they can be. This can allow them to feel more in control. Both of you have boundaries and it’s important to keep them in mind.

  • Give yourself time to adapt to your changing roles. It’s a big change for both of you and it’s normal that you need some time to adjust.