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Coping with a Cancer Diagnosis

After the Shock, Educate Yourself, Process Your Emotions, Ask for Support

By James Clyde Sellman, PhD

Updated September 24, 2008

(LifeWire) - “There’s no 'right way' to cope with cancer,” says Julie Schnur, a licensed clinical psychologist and researcher at Mount Sinai School of Medicine in New York. There are, though, important issues to consider.

Often when patients hear cancer, little else the doctor says really sticks. According to a 2003 study, information from physicians had "no effect" on stress levels of women newly diagnosed with breast cancer.

Cancer Varies Greatly

Some types of cancer -- for example, pancreatic cancer and the skin cancer melanoma -- are difficult to treat. Others (such as the more common skin cancers squamous cell carcinoma and basal cell carcinoma) are highly treatable. Some cancers are aggressive; others (for example, most cases of prostate cancer) develop slowly and can be slowed even more with treatment.

Early detection of cancer is very important, because finding cancer at an early stage results in a better prognosis. The 10-year survival rate for women with breast cancer is approaching 100% — if the cancer is detected early.

Generally speaking, a newly diagnosed patient should not have to rush to make a treatment decision, unless the cancer is aggressive, or relatively large, and has spread beyond the original tumor site. It's important to take time to learn more about your diagnosis, process your emotions, and gather your support team.

Getting Information

Diagnosis typically unleashes a blizzard of information: treatments, medications, side effects, follow-up tests and appointments. The problem is keeping track of it all.

If you have questions, ask someone on your cancer care team (the doctors, nurses and other professionals involved in your care). You may also want to seek a second opinion.

To get the most from appointments:

  • Write down questions as they come to mind, and don’t forget to take them to your appointment.
  • Have someone join you to offer support and take notes.
  • If you don’t understand something, ask your doctor to explain it.

Managing Stress

A cancer diagnosis has emotional consequences. A 2004 study found that, after diagnosis, people with lung cancer showed deterioration in social and emotional functioning.

Some patients experience anxiety or depression. More than just feeling “worried” or “blue,” these conditions interfere with the tasks of daily life . They, however, can be treated with medications, therapy or both. There’s no reason to take on both cancer and depression or anxiety.

Physical activity, such as exercise or yoga, can also help maintain your equilibrium. And research suggests that moderate exercise after a breast cancer diagnosis (the equivalent of three to five hours walking per week) improves survival rates.

Many hospitals offer alternative therapies, such as acupuncture, to address some symptoms and side effects. Schnur says, though, “It’s important for patients to take the initiative. Usually, such therapies won’t be offered unless you express a particular interest.”

Getting Support

Greta Greer, director of Survivor Programs for the American Cancer Society and a licensed clinical social worker, notes that cancer has "an existential element that’s not present in many other illnesses.

“When I ask patients, What helps you get through the tough times?" says Greer, " the top three things [are] family and friends, my relationship with God and taking one day at a time — [that is,] being able to leave the past behind and not worry about the future.”

Support groups, which many hospitals sponsor, can also help, as can online chat groups for people with cancer.

“Cancer patients learn a lot from others who’ve had cancer," she says. "Even if someone goes to a support group and doesn’t say a word, they’re still getting important information.”

Being active in such groups can be strengthening. Greer notes, “You hear over and over from cancer patients, ‘I ... never thought I’d be able to give to somebody else … but I found that in giving, I get back.’”

The American Cancer Society also offers I Can Cope classes in various communities and online.

Staying True to Yourself

In coping with cancer, what matters is what’s right for you. Some people take charge, learning all they can and playing an active role in their treatment decisions. Others draw back, avoiding the details, trusting in their cancer care team and focusing their energy inward.

“If you’ve never been outgoing,” Schnur says, “it may not make sense to join a support group. It’s important to have someplace where you can talk if you want to, but if you don’t want to talk about your cancer, that’s OK too.

"I’ve seen patients [become] upset when Breast Cancer Awareness Month comes around. They feel bombarded with messages [saying] that they should tell everyone about their cancer, but they’re more private and just don’t want to.”

Still, Greer suggests not ruling anything out: “Crisis is the best time to try new things. That’s when you’re most open to something new.”

On the Horizon

Researchers continue investigating new ways to help cancer patients. For example, Schnur studies the use of hypnosis to reduce patient anxiety before surgical breast biopsies or lumpectomies.

“The hypnosis isn’t what most people imagine,” she explains. “You don’t start clucking like a chicken or anything. It’s more like being so lost in a book or movie that you lose track of time. Women who get hypnosis experience less pain, less nausea, less fatigue and less emotional distress.”

This treatment still isn’t generally available, but Schnur is hopeful that it will eventually be a real option.

Sources:

Anxiety, Fear, and Depression.Cancer.org. 2008. American Cancer Society. 29 Jul. 2008.

Coping with Cancer in Everyday Life.Cancer.org. 2008. American Cancer Society. 30 Jul. 2008.

Greer, G.E., MSW, LCSW. Telephone interview. 6 Aug. 2008.

I Can Cope.Cancer.org. 15 Aug. 2006. American Cancer Society. 5 Aug. 2008.

Lheureux, M., C. Raherison, J. M. Vernejoux, L. Nguyen, C. Nocent, M. Tunon De Lara, and A. Taytard. “Quality of Life in Lung Cancer: Does Disclosure of the Diagnosis Have an Impact?Lung Cancer. 43:2(2004):175-82, (subscription).

Montgomery G. H., D. H. Bovbjerg, J. B. Schnur, D. David, A. Goldfarb, C. R. Weltz, C. Schechter, J. Graff-Zivin, K. Tatrow, D. D . Price, and J. H. Silverstein. “A Randomized Clinical Trial of a Brief Hypnosis Intervention to Control Side Effects in Breast Surgery Patients.Journal of the National Cancer Institute. 99:17(2007):1304–12, (subscription).

Montgomery, G. H., D. David, A. B. Goldfarb, J. H. Silverstein, C. R. Weltz, J. S. Birk, and D. H. Bovbjerg. “Sources of Anticipatory Distress Among Breast Surgery Patients.Journal of Behavioral Medicine. 26:2(2003):153-64. (subscription).

"Physical Activity and Cancer: Questions and Answers." Cancer.gov. 23 Apr. 2008. National Cancer Institute. 8 Aug. 2008.

Schnur, Julie B., Ph.D., LCP. Telephone interview. 6 Aug. 2008.

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. James Clyde Sellman, a freelance writer and editor in Newton, Mass., specializes in a broad range of consumer health topics. His work has appeared in the Harvard Health Letter, Harvard Women’s Health Watch, Revolution Health, Infertility Source and My Student Body.com.
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