Coping & Emotions

How to cope with your feelings

You might feel numb and shocked when you are told that you have cancer. You can feel swamped with many different emotions ranging from disbelief to anger. At first the news may be very hard to take in. It may all seem ‘unreal’. All these feelings are normal and to be expected. It does not mean that you are not coping. Rather they are part of the process you must go through in coming to terms with your illness. Your family and friends may also be feeling the same way and need time to get used to it.

Reactions differ from one person to another. There is no right or wrong way to feel.

Reactions differ from one person to another. There is no right or wrong way to feel.

Shock and disbelief
‘I can’t believe it.’ ‘It can’t be true.’

Shock is often the first reaction when a diagnosis of cancer is made. Most people think, ‘It will never happen to me.’ It will take a while for the news to sink in. At this stage you may be getting a lot of information about your illness. You may ask the same questions over and over again or seem to accept the news calmly. These are common reactions to a diagnosis of cancer. Because you don’t quite believe what is happening, you may not want to talk about your illness, especially to your close family and friends.

Fear and uncertainty
‘Am I going to die?’ ‘Will I be in pain?’

For most people when they are told they have cancer the first question is ‘Am I going to die?’ Cancer is a very scary word. It brings to mind many stories – most of them untrue. In fact, nowadays many cancers can be cured. When cure is not possible the cancer can be controlled for a number of years using modern treatments. There are new treatments being developed all the time.

Another common fear is that cancer is always painful. This is not true. Some cancers cause no physical pain at all. If you have pain there are many drugs that can control it. Other methods of pain relief include radiotherapy and nerve blocks.

Being concerned about your future is a normal way to feel. It can be hard for your doctor to predict the outcome of your treatment. Not knowing can make you feel anxious. The more you find out about your illness and its treatment, the less anxious you will be.

The real facts about cancer and its treatment are not as frightening as you might imagine. Talk to your doctor about your concerns, he or she should be able to help you. Discuss what you have found out with your family and friends, as they are probably worried too.

Denial
‘There is nothing really wrong with me.’ ‘I haven’t got cancer.’

Many people cope with their illness by not wanting to talk about it. If that is the way you feel, then just say quite firmly to the people around you that you would prefer not to talk about your illness, at least for the time being.

Sometimes, however, it’s the other way round. You may find it is your family and friends who are denying your illness. They appear to ignore the fact that you have cancer. They may play down your worries and symptoms and keep changing the subject. If this upsets or hurts you because you want them to support you, try telling them. Start perhaps by saying that you do know what is happening and it will help you if you can talk to them about your illness.

Anger
‘Why me of all people?’ ‘And why right now?’

Anger can hide other feelings such as fear or sadness. You may find that you vent your anger on those closest to you. You might also feel angry towards the doctors and nurses who are caring for you. If you have a religious belief you may feel angry with your God.

It is easy to see why you may be deeply upset by many aspects of your illness. There is no need to feel guilty about your angry thoughts or irritable mood. Relatives and friends may not always be aware that your anger is really aimed at your illness and not against them. If you can, it might be helpful to tell them this at a time when you are not feeling so angry. Or if you would find that difficult, perhaps you could show them this section of the booklet.

If you are finding it difficult to talk to your family, tell your nurse or doctor. He or she may be able to help you.

There is no need to feel guilty about your angry thoughts or irritable mood. Don’t bottle up your feelings – express them.

Blame and guilt
‘If I hadn’t …this would never have happened.’

Sometimes people blame themselves or others for their illness. Or else they wonder why it should have happened to them at all. This may be because we often feel better if we know why something has happened. As doctors rarely know exactly what has caused cancer, there is no reason for you to blame yourself. Don’t bottle up your feelings – express them.

Resentment
‘It’s all right for you, you haven’t got to put up with this.’

It is not unusual to feel resentful and miserable because you have cancer while other people are well. You may notice that similar feelings crop up from time to time during the course of your illness for a variety of reasons. Relatives too can sometimes resent the changes that your illness can make to their lives.

It is usually helpful to bring these feelings out into the open so that they can be aired and discussed. Bottling up resentment can make everyone feel angry or guilty.

Withdrawal and isolation
‘Please leave me alone.’

There may be times during your illness when you want to be left alone to sort out your thoughts and feelings. This can be hard for your family and friends who want to share this difficult time with you. Let your family know that while you do not feel like talking about your illness at the moment, you will talk to them about it when you are ready.

Sometimes depression can stop you wanting to talk. It might be an idea to discuss this with your GP or hospital doctor who may prescribe a course of antidepressant drugs. He or she may decide to refer you to a doctor who specialises in managing the emotional problems of cancer patients. It is common for patients with cancer to feel depressed, so there is no need to feel you are not coping if you ask for help.

Call the National Cancer Helpline 1800 200 700 if you would like a free copy of The Emotional Effects of Cancer. Another useful booklet is Who Can Ever Understand? Talking about Your Cancer.

Learning to cope

After any treatment for cancer it can take a long time to come to terms with your emotions. Not only do you have to cope with the knowledge that you have cancer, but also the physical effects of treatment.

Even though the treatment for cancer can have some unpleasant side-effects, many people manage to live a relatively normal life during treatment. You will need to take some time off for your treatment as well as time afterwards to recover. Just do as much as you feel like and take plenty of rest. It is not a sign of failure to ask for help or to feel unable to cope on your own. Once other people understand how you are feeling they can give more support.

What if you are a relative or friend?

It can be hard to know what to say when someone close to you is diagnosed with cancer. It may seem best to pretend that everything is fine and carry on as normal. You may not want to add to the person’s worry by seeming afraid or by saying the wrong thing. Sadly, denying strong feelings like this can make it even harder to talk openly together and can lead to the person feeling very lonely.

Partners, relatives and friends can help by listening carefully to what the person with cancer wants to say about his or her illness. Don’t say too much. Just let them do most of the talking. Above all, let them know that you are there when they want to talk or need help.

A useful booklet called Lost for Words – How to Talk to Someone with Cancer is available from the Irish Cancer Society for relatives and friends of people with cancer. Call the National Cancer Helpline 1800 200 700 if you would like a free copy.

Talking to children

How much you tell children will depend on how old they are. Very young children don’t understand illness and need a very simple account as to why their parent or friend has had to go to hospital. Slightly older children will need to be told more. A simple story talking about good cells and bad cells may help. Every child needs to know what will happen while you are in hospital. Who will look after them, prepare their meals and take them to school? They also need to be reassured that your illness is not their fault. Whether they show it or not, children feel they may somehow be to blame and may feel guilty. Most children over 10 years of age can grasp fairly detailed explanations of what is wrong.

Adolescents can understand much more. They may have special needs in learning to cope with the situation. They may be torn between concern for you and trying to become more independent. An open honest approach is usually the best way for all children. You may find that your children rebel or turn quiet. This may be their way of showing their feelings. Even very young children can sense when something is wrong, so don’t keep them in the dark. They may think that things are much worse then they are.

An open honest approach is usually the best way for all children.

There is a booklet available called What Do I Tell the Children? A Guide for the Parent with Cancer. Call the National Cancer Helpline 1800 200 700 if you would like a free copy.

What you can do

Many people feel helpless when they are first told they have cancer. They think there is nothing they can do other than hand themselves over to the doctors and hospital. This is not true. There are many things that you can do at this time.

If you and your family understand your illness and its treatment you will be better able to cope.

If the idea of changing your diet or taking exercise does not appeal to you, don’t do it. Just do whatever suits you. Some people find pleasure in keeping to their normal routine as much as possible. Others prefer to take a holiday or spend more time on a hobby.

Who else can help?

There are many people ready to help you and your family throughout treatment and afterwards.

Remember that there are people ready to help you.

The medical social worker in your hospital can help in many ways. He or she provides support and counselling to the patients and their families and can provide advice on benefits, entitlements and services available when you go home.

Some of the major cancer treatment hospitals have oncology liaison nurses and/or cancer nurse co-ordinators. These specially trained nurses provide support to patients and their families from the time of diagnosis and throughout treatment. These people along with other members of your medical team work together to meet your needs.

In some larger hospitals there are special units that provide psycho-oncology services. This means that psychological care and support is given to patients with cancer during diagnosis, treatment and recovery by a team of experts. Usually the team consists of psychiatrists, clinical psychologists, nurses and medical and surgical doctors working closely together.

When you go home there are various community health services available from your local health centre. These centres have family doctors, public health nurses (who can visit you at home), welfare officers and home-help organisers. If you live in an area which is remote or far from the hospital where you have been treated, your community welfare officer can also help with practical issues such as financial worries, etc. All the above people in the community health services can provide advice and support. You can get more information on the services available either from the social worker in the hospital before you go home or at your local health centre.