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Coping With Cancer

When you find out that a friend or loved one has been diagnosed with cancer, it’s hard to know how best to provide help and support. People who have cancer have different treatment plans, different types of cancer, and differing responses to treatment. That means that there’s no one-size-fits-all answer to supporting a friend or loved one with cancer.

You may have just learned that you have cancer. Or you may be in treatment, finishing treatment, or have a friend or family member with cancer. Having cancer changes your life and the lives of those around you. The symptoms and side effects of the disease and its treatment may cause certain physical changes, but they can also affect the way you feel and how you live.

Research shows, though, that the more help and support a person with cancer has during their diagnosis, treatment, and recovery, the more well-adjusted they feel. So, your friendship really matters.

What Might I Feel After My Diagnosis?

We all know that cancer affects your physical health, but it can also bring up a wide range of feelings you’re not used to dealing with. A cancer diagnosis can also make existing feelings seem more intense. They may change daily, hourly, or even minute to minute. This is true whether you’re currently in treatment, done with treatment, or a friend or family member. These feelings are all normal.

Often the values you grew up with affect how you think about and cope with cancer. For example some people:

  • Feel they have to be strong and protect their friends and families
  • Seek support and turn to loved ones or other cancer survivors
  • Ask for help from counselors or other professionals
  • Turn to their faith to help them cope

Whatever you decide, it’s important to do what’s right for you and not to compare yourself with others. Your friends and family members may share some of the same feelings. If you feel comfortable, share this information with them.

Anger

It’s very normal to ask, “Why me?” and be angry at the cancer diagnosis. You may also feel anger or resentment towards your health care providers, your healthy friends and your loved ones.  And if you’re religious, you may even feel angry with God.

Anger often stems first from feelings that are hard to show, such as:

  • fear
  • panic
  • frustration
  • anxiety
  • helplessness

If you feel angry, you don’t have to pretend that everything is okay. It’s not healthy to keep it inside you. Talk with your family and friends about your anger. Or, ask your doctor to refer you to a counselor. And know that anger can be helpful in that it may motivate you to take action.

Denial

When you were first diagnosed, you may have had trouble believing or accepting the fact that you have cancer. This is called denial. It can be helpful because it can give you time to adjust to your diagnosis. It can also give you time to feel hopeful and better about the future.

Sometimes, denial is a serious problem as it make keep you from getting the treatment you need.

The good news is that most people work through denial. Usually by the time treatment begins, most people accept the fact that they have cancer and move forward. This is true for those with cancer as well as the people they love and care about.

Depression

Depression can be treated. Below are common signs of depression. If you have any of the following signs for more than 2 weeks, talk to your doctor about treatment. Be aware that some of these symptoms could be due to physical problems, so it’s important to talk about them with your doctor.Emotional signs:

  • Feelings of sadness that don’t go away
  • Feeling emotionally numb
  • Feeling nervous or shaky
  • Having a sense of guilt or feeling unworthy
  • Feeling helpless or hopeless, as if life has no meaning
  • Feeling short-tempered, moody
  • Having a hard time concentrating, feeling scatterbrained
  • Crying for long periods of time or many times each day
  • Focusing on worries and problems
  • No interest in the hobbies and activities you used to enjoy
  • Finding it hard to enjoy everyday things, such as food or being with family and friends
  • Thinking about hurting yourself
  • Thoughts about killing yourself

Body changes:

  • Unintended weight gain or loss not due to illness or treatment
  • Sleep problems, such as not being able to sleep, having nightmares, or sleeping too much
  • Racing heart, dry mouth, increased perspiration, upset stomach, diarrhea
  • Changes in energy level
  • Fatigue that doesn’t go away
  • Headaches, other aches and pains

You don’t and can’t fix depression on your own. Depression is a very normal part of any life-changing diagnosis. If you’ve been feeling blue for longer than 2 weeks, call your doctor and tell him or her about it. They can help.

Fear and Worry

It’s scary to hear that you have cancer. You may be afraid or worried about any number of things, including:

  • Dying before loved ones
  • Feeling that your life is unfinished
  • Pain
  • Feeling sick and ill before and after treatments
  • Looking different than you once did
  • Providing for and taking care of your loved ones
  • Cost of treatment
  • Taking care of your family
  • Keeping your job
  • Dying

Some cancer fears are based on stories, rumors, or mis-information. To cope with fears and worries, learn as much as you can about your cancer, treatments, support, and all the medications you may take Be an active part of your care team and treatment plan. Ask questions no matter how dumb you feel. It’s been shown through a few studies that people who are more well-informed about their cancer and its reatment are more likely to follow their treatment plans and recover more quickly than those who are not.

Guilt

It may seem odd to you, but many people who’ve been diagnosed with a life-changing illness – such as cancer – feel a lot of guilt. Maybe it’s for upsetting your loved ones, or feeling like you’re a burden. You may be jealousy of the good health of others only to then feel guilty about it. Some people even feel guilty for the lifestyle choices that may – or may not – have led to cancer.This is completely common and may dissipate if you share them with someone else. Try to find and join a local or online support group.

Hope

With acceptance of cancer, many people feel a sense of hope, and for good reason! Millions of people walking around, living life every day have survived cancer. Every single day, your chances of living with and recovering from cancer are better than they’ve ever been. Plenty of people with cancer can lead still active lives, even during treatment.

Some doctors suggest that hope actually makes treatment go by a bit easier. Here’s how to keep some hope alive, no matter how scared you are:

  • Keep planning your life like you’ve always done
  • Unless you need to rest, don’t let cancer dictate how you live your life
  • Write down things that make you hopeful – a favorite holiday, flowers blooming
  • Spend time in nature. Nature is incredibly healing to be in, especially when you’ve got a lot on your mind
  • Reflect on your religious or spiritual beliefs.
  • Don’t dwell on the stories of those who have succumbed to cancer; focus on talking to those who have survived and thrived.

Loneliness

People with cancer often feel lonely or distant from others, just as others with chronic, life-changing diseases do. These may be some of the reasons for your loneliness:

  • Sometimes, friends and loved ones have a really hard time dealing with your cancer diagnosis and may avoid calling and visiting you.
  • You may be too sick to engage in the hobbies and activities you used to enjoy.
  • Sometimes, no matter how supportive your loved ones are, you may feel that no one understands what you’re going through.

It’s also normal to feel alone after treatment. You may miss the support you got from your health care team. Many people have a sense that their safety net has been pulled away, and they get less attention. It’s common to still feel cut off from loved ones. Some think that as treatment is over, you’ll  be back to normal soon, even though this may not be true. Others may want to help but don’t know how.

Look for emotional support in different ways. It could help you to talk to other people who have cancer or to join a support group. Or, you may feel better talking only to a close friend or family member, or counselor, or a member of your faith or spiritual community. Do what feels right for you.

Overwhelmed

When you first learn that you have cancer, you may feel as things have gone completely out of control

  • You wonder if you’re going to live
  • Your life now revolves around doctor appointments, treatments, tests
  • You feel like you can’t do the things you enjoy.
  • You feel helpless and lonely.

Even if you feel out of control, there are ways you can take charge. It may help to learn as much as you can about your cancer. The more you know, the more in control you’ll feel. Ask your doctor questions and don’t be afraid to say when you don’t understand.

These feelings will pass.

For some people, it feels better to stay busy. If you have the energy, try taking part in activities such as music, crafts, reading, or learning something new.

Sadness and Depression

Many people with cancer feel sad. They feel a sense of loss of their health, and the life they had before they learned they had the disease. Even when you’re done with treatment, you may still feel sad. This is a normal response to any serious illness. It may take time to work through and accept all the changes that are taking place.When you’re sad, you may have very little energy, feel tired, or not want to eat. For some, these feelings go away or lessen over time. But for others, these emotions can become stronger. The painful feelings don’t get any better, and they get in the way of daily life. This may be a medical condition called depression. For some, cancer treatment may have added to this problem by changing the way the brain works.

Stress and Anxiety

Stress and anxiety are completely normal after diagnosis, during treatments, and after treatments. This doesn’t make you any less of a fighter. Anxiety means you have extra worry, can’t relax, and feel tense. You may notice that:

  • Increased heartrate
  • Headaches and muscle pains.
  • You may eat more, you may have no appetite
  • You feel sick to your stomach or have diarrhea.
  • You feel shaky, weak, or dizzy.
  • Tightness in the chest and throat
  • You sleep too much or too little.
  • You find it hard to concentrate.

If you have any of these feelings, talk to your doctor. Though they are common signs of stress, you will want to make sure they aren’t due to medicines or treatment.

Stress can keep your body from healing as well as it should.

If you’re worried about your stress, ask your doctor to suggest a counselor for you to talk to. You could also take a class that teaches ways to deal with stress. The key is to find ways to control your stress and not to let it control you.

Gratitude

Some people see their cancer as a “wake-up call,” and it helps them realize how important it is to relish every second we have. They take trips. Finish projects. Spend more time with friends and family. They mend broken relationships.

Maybe you don’t feel that way, but make an attempt to find any joy you can in your life. Watch the birds. Work in the garden. Explore new things. Enjoy all the parts of life we normally take for granted. Write out your feelings. Talk to your loved ones.

You can also do things that are more special to you, like being in nature or praying in a place that has meaning for you. Or, it could be playing a sport you love or cooking a good meal. Whatever you choose, embrace the things that bring you joy when you can.

Coping With Your Emotions:

Express Yourself

It sounds wild, but the more you express to others the strong feelings like anger, loneliness, and guilt, the more you can let go of them. Sort them out with a loved one, a support group, or a counselor. Remember that your loved ones may not have the answers, and that’s okay.If talking makes you uncomfortable, write them down. Do anything you can to get it out of your system.

People differ in the way they communicate their feelings, and in our society, women are generally better at this than men. Take stock of how well you express what you are feeling about your illness. If you feel that you are not doing well in this regard, we encourage you to do better. Many studies have shown that patients who express their emotions and concerns enjoy a better psychological adjustment than people who tend to suppress their feelings or keep quite about them.

Emotional expression is usually helpful because it gives you an outlet for your feelings, a means of working through them, and an opportunity to obtain better emotional support. It can be an enormous help just to know that your feelings are understood by others and seen as valid, but this requires open communication on your part. If you tend to keep your feelings to yourself, it is probably because you have learned to do so. (You were not born with this tendency.) Your earlier experience may have taught you that sharing your feelings led to negative consequences. Perhaps your emotions were not validated by others, or you were criticized for expressing them (Children are to be seen but not heard, Big boys don’t cry and so on). You may have felt that your emotional needs were an imposition on others, and that your role was to take care of the feelings and needs of others rather than expressing your own. It is not uncommon for cancer patients to hide their true feelings as a way of protecting their loved ones.

Some people do not express their emotions because they are not very adept at even paying attention to what they are feeling. They seldom stop and check in with themselves and try to identify the feelings and concerns that are weighing upon them. In this process, we learn that our emotions are important and valid and thus worthy of attention and expression.

As you probably know, cancer patients are consistently encouraged to keep a positive attitude. This can make you feel that there is something wrong or dangerous about your negative emotions (fear, sorrow, anger). Research suggests just the opposite: experiencing and expressing such emotions is psychologically and immunologically healthy.

Finally, timing is important. The period after your diagnosis, when you are learning about your illness and undergoing the initial work-up and treatments, may not be the right time for you to be taking stock of all your emotions. Your plate is already very full. You may need to put your emotions aside for a while as you attend to everything else. Moreover, it will benefit you most to express your emotions with the right people and when their support is available to you.

All You Need Is Positivity

Sometimes this means looking for the good even in a bad time or trying to be hopeful instead of thinking the worst. Try to use your energy to focus on wellness and what you can do now to stay as healthy as possible.

After facing the reality of your illness, it would be good to feel optimistic about the future course of events. Not surprisingly, people who are hopeful and optimistic show a better adjustment to their illness than people who are pessimistic. It is important, however, that your optimism be realistic; otherwise it represents denial or wishful thinking. In most cases, there is a solid and realistic basis for a certain degree of hope and optimism.

Most people tell themselves to be positive, but for many, this is easier said than done. There are several reasons for this, some of which may apply to you. Being optimistic means that you may feel lucky. However, you were unlucky enough to get cancer and may now feel that you are an unlucky person. You would not expect, therefore, that you would now enjoy the good fortune of a long remission or cure. You might feel just the opposite: that good luck is unlikely for you.

Optimism can also seem presumptuous: after all, other people with your diagnosis have not done well, and you might think, What right do I have to expect to recover? Your optimism could also make you feel that you were not worrying enough about your cancer–that is, that you were not giving cancer its due, that you were acting too boldly or confidently in the face of it, and that you were therefore asking for trouble, as if the cancer might come back to teach you a lesson. Finally, if your prognosis is more favorable than for other patients with your type of cancer, you may feel that it is not right to enjoy this good fortune or to take advantage of it (that is, by being optimistic and going on with your life in a positive and constructive manner). Despite these obstacles, you should try to feel as hopeful and optimistic as the medical realities of your case allows.

Facing the Reality of Your Illness

Everyone responds in different ways to their diagnosis, the initial medical work-up, subsequent test results and the implications of all that is happening to you. Many patients respond by confronting the full reality of their illness. They ask pointed and brave questions about the seriousness of their condition and the pros and cons of the various treatment options. They read up on these matters on their own. They react as if they are strongly motivated to know what they are facing. This way of coping has been found to promote their psychological adjustment.

Other patients react as if the realities confronting them are too much to deal with and they therefore retreat into a state of denial. It sometimes seems that a patient in denial is saying, in effect, I can’t cope with all this. Yet the denial is a way of coping. It protects the person from being overwhelmed. But it can also prevent a person from coming to terms with their illness and getting on with other constructive ways of coping. It is therefore associated with a poorer psychological adjustment.

Denial is often a positive coping strategy because it enables the patient to gradually face the reality of his or her illness, in a piecemeal manner, without feeling overwhelmed, and feeling more supported by loved ones. In our experience, patients seldom remain in denial; it fades away over time, as indeed it should, at least for the good of overall adjustment.

As you read this, you might ask yourself how much you really know about your cancer and your individual case. Are there any relevant questions that you haven’t ask? Have you avoided learning more about your illness by not reading about it? You might want to become more proactive in seeking information; the evidence indicates that this will help you.

Adopting a Participatory Stance

How much initiative do you take to actively participate in getting well? Some people tackle their cancer head-on. They have a strong fighting spirit, and they find ways of putting it into action. They go out of their way to learn about their illness and the options for treatment. They pursue the best treatments available and also consider alternative or holistic approaches. If you are like this, you would strongly agree with the statement A lot depends on what I do and how I take part.

Research has shown that patients who respond in this manner have less emotional distress than patients who respond in a more passive manner or try to avoid their situation.

People who adopt a participatory stance believe they can make a difference, and they put this belief into action. They therefore feel less helpless and vulnerable which is why their emotional state is better. This belief in yourself as an active and effective agent is called self-efficacy, and research has consistently documented its positive emotional effects.

People who are coping in this way usually ask their doctors about treatment options and alternative therapies that their doctors had not mentioned. Instead of only following what their doctors say, they come up with ideas of their own. Also, they usually embrace some ways of promoting their physical well-being that go beyond the normal recommendations. These include dietary changes, increased exercise, stress reduction, vitamins, herbs, yoga, acupuncture, meditation, prayer, guided imagery and others. These people often pursue new, experimental therapies that may offer additional hope. In all these ways, the person is actively participating in an effort to recover fully or (if that is not realistic) to maintain the best physical health possible.

In contrast to those who feel they have an active role to play, some people adopt a resigned, fatalistic attitude. One reason for this attitude is that it lets the person off the hook for any extra effort that could make a difference. We have heard patients say, What will be will be. The research on coping has consistently shown that this attitude is linked to a poorer psychological adjustment to one’s illness.

Don’t Blame Yourself for Your Cancer

It’s not your fault. It’s not your fault. If needed, go ahead and say it into the mirror until you believe it.

Some people think that they got cancer due to something inside their control. However natural it feels to blame yourself, remember this: even cancer researchers don’t know why one person gets cancer and another does not.

Cancer can happen to anyone.

Proportion and Balance

Your emotional response should not only be one of optimism and hope. It is also appropriate and helpful for you to be upset and worried, at least to a certain degree. In most cases, the medical situation provides a basis for hope and a basis for worry. The statistics indicate a certain chance of survival, but also a certain chance of dying of cancer. Of course, the chance of survival and the risk of dying vary greatly from case to case.

Ideally, your emotional response would take both aspects into account: you would experience a degree of hope that was proportional to the positive survival chances that applied to you, but you would also experience a degree of worry that was proportional to the mortality rate in similar cases. That is, you would not feel overly worried, upset, or preoccupied, but neither would you feel overly cheerful, complacent or optimistic.

Alternatively, the nature and intensity of your positive emotions should be tempered by, or take into account, the possibility of death. If you are ignoring this possibility, then your optimism involves a denial or minimization of this threat; in the long run, this will not help you. It is better to acknowledge this threat and to work through the negative emotions that stem from it. In short, it is best if your positive and negative emotions balanced each other out such that you would be neither overreacting nor underreacting to the medical realities facing you.

A number of studies have found that patients who maintain this kind of mixed emotional response–well-proportioned to the realities of their illness and well-balanced–enjoy a better psychological adjustment than patients who feel too pessimistic or too optimistic. They feel that they are coping well with the uncertainty inherent in their medical condition, neither dwelling on nor denying their legitimate fears, and yet keeping their sights set on getting better. Again, all this is easier said than done.

Don’t Try to Be Upbeat If You’re Not

There’s no use for you to putting on a brave face. Most people see right through it, and as hard as we try to make others feel comfortable, just be honest. Give into those feelings and let them out.

You don’t have to be sunshine all the time.

Reach Out To Others:

The amount of support available to cancer patients varies across the country, and patients themselves differ in how much they tend to reach out and take advantage of the support. Those patients who have at least a few loved ones available for close emotional support and who call upon their support show a better psychological adjustment to cancer than patients who are largely alone or tend to go it alone in coping with their illness.

Reaching out for support often means just expressing your feelings and concerns to others–which, as we saw, can be a challenge for many patients. It can also mean that you ask your loved ones for the type of support you need most, and this requires that you first ask yourself what that support might consist of. You will probably identify ways that people can help you that have not occurred to them.

For example, family members and friends often assume that they should provide encouragement and stress the positive (this is sometimes called the cheerleading role). Patients generally appreciate the positive intent behind this, yet it can put a damper on patients sharing their fears or sorrows. Often, patients would rather hear that others understand how they feel, regard these emotions as valid and will stick with them regardless of what happens. You might need to tell people that. On a more concrete level, you might ask others to accompany you during a medical appointment, pick up the kids after school, look up information for you (the Internet is a wonderful resource for this) or prepare a nutritious meal for your family.

If you find that you are not reaching out for the support that is available, reflect on the reasons for your stoicism. You may be minimizing your own needs for support, perhaps because you pride yourself on being independent and self-sufficient. It may seem to you that others would be bothered by your need for support or help and resent your imposing on them. More often than not, this is an assumption based on earlier experience. Perhaps you have found in the past that it is best to rely on yourself. While you should continue to draw upon your own internal resources, you should also realize that other people can and want to assist you in meeting the challenges of your illness, and you should give them a try.

Obtaining support often means joining a support group, and research has shown that such groups help patients to cope with and adjust to their illness. Support group members find that they have a great deal to offer each other in the way of mutual support and encouragement, discussion of common problems and ways of coping, and sharing of medical information. Groups also offer a safe and supportive haven for confronting one’s fears. The American Cancer Society (http://www.cancer.org) office or hospitals specializing in cancer treatments in your community will know of support groups that you could join.

Only Talk About Cancer If YOU Feel Like It:

Well-meaning people may want to talk at great length about  your cancer, compare it to their loved ones, and offer you different “cures” and advice. They don’t know any better. It can be hard for people to know how to talk to you about your cancer. Other people mean well, but they don’t know what to say or how to act. You can make them feel more at ease by asking them what they think or how they feel or simply tell them that you’re not into talking about cancer right now.

Finding a Positive Meaning

While the diagnosis and treatment of cancer is an awful experience in many respects, it can also be a challenge and even an opportunity for positive change. In response to their illness, many people step back and take stock of who they are and how they have been living. They reflect on their ultimate values and priorities, and often identify changes that are warranted (and perhaps overdue) in their lifestyle and personal relationships. This is often called the enlightenment or gift that comes with cancer, or the wake-up call aspect of cancer. People who embrace this aspect of their cancer experience have been found to be especially well adjusted and better able to deal with the many trials and disruptions caused by their illness.

It is often noted that growing old forces us to pay attention to what is important in life. The same can be said of a diagnosis of a life-threatening illness. What is important to a person often stems from their spiritual or religious beliefs. Even if you are not inclined toward spirituality, you probably have a basic philosophy of life and your life journey that highlights for you the importance of certain goals and values. These are important because of what they mean to your personal integrity and fulfillment.

To what degree does your lifestyle demonstrate these goals and values? This is a question for all of us, but it can become especially compelling if you are dealing with cancer. For many, illness inspires them to pay more attention to what matters most. This could mean spending more time with family and close friends, making a greater contribution to the causes you believe in, showing more appreciation for all that you have and are, bringing forth aspects of your personality that have been suppressed, taking better care of your physical and emotional needs and seeking to be more honest and true to yourself. In all these ways and in many more, your illness can become an impetus for positive change.

Sometimes the idea that there is a message or lesson in one’s cancer implies that the person needed to get cancer and perhaps even got it for that reason. This kind of self-blame is completely unwarranted, and it fosters feelings of guilt and depression. A more psychologically healthy response was voiced by one of our patients when she said: “It’s too bad that it took cancer to make me see things a bit more clearly, but you know, some positive things have come out of it for me.”

Relax

Whatever activity helps you unwind, you should do it. Meditation, guided imagery, relaxation exercises, taking a bath, and taking a nice walk are just a few ways that have been shown to help others; these may help you relax when you feel worried.

Spirituality, Faith and Prayer

Most people in our society have some fundamental spiritual beliefs, and these beliefs can be called upon for help in dealing with cancer. Patients who do so benefit in a variety of ways: they have a greater sense of peace, an inner strength and an ability to cope, and show an improved psychological adjustment and quality of life. These benefits derive especially from the perspective offered by your religious faith or spirituality and from the power of prayer and religious ritual.

All of us, whether we have cancer or not, are challenged at some point with the question of how to respond to our vulnerability to disease, suffering, and death. For some, these realities lead to a kind of existential despair. Others embrace a perspective that goes beyond these realities, or that penetrates more deeply into them, to find meaning and value that transcends their individual existence or plight. This is the perspective offered, in one form or another, by the world’s religious and spiritual traditions.

This perspective can help with the Why me? question. It is difficult to reconcile how an almighty, loving and just God could allow cancer to happen to a good person. Patients often believe that the illness is a punishment. In our culture, we often assume that what happens to a person is somehow linked to what the person deserves.

The emotional turmoil and doubt that stem from these issues can be soothed by themes of consolation and forgiveness that permeate the world’s major religions. In the Judeo-Christian tradition, it is emphasized that God is with us in our suffering, providing the grace we need to endure rather than doling out suffering to those who deserve it.

Through prayer and liturgy, patients are able to connect to the core of their faith and to their religious community and derive the solace and fortitude they need to cope with their illness. Prayer can also have healing effects–most certainly in healing one’s soul, but perhaps also in healing the body.

Get Out There:

Sometimes, getting out of your environment at home can give you some life. Try anything – take a drive, go grab a cup of coffee, visit a friend, are all things you can do to help you from feelings of crawling the walls.

Maintaining Self-esteem

There are many ways that the experience of cancer can harm a person’s self-esteem. One of these is the stigma of having cancer–that is, that it can imply something bad about the person who has it. In addition, many of the sources of your self-esteem can be threatened by cancer and the effects of medical treatments: your appearance, your physical abilities and activity level, personal attributes (such as being healthy and independent) and your role and identity within your family or in your work life. One of our breast cancer patients lamented: “I used to take pride in how I looked, and in being a good mother and working, helping to support the family. Now look at me.”

These threats to your self-esteem pose a danger and an opportunity. The danger is depression and, with that, the weakening of the will to live and the resilience you need. The opportunity lies in finding additional sources of self-esteem within yourself. For example, you might take pride in the way you are coping with your illness. You might have a new appreciation for how much you are loved–not because of what you do or how you look but because of who you are. Perhaps it has been difficult for you to depend on others because your independence has been overly important; you might now take pride in your ability to express your needs and ask for help. Perhaps your spirituality has been deepened by your cancer experience, and this can also help to renew your self-esteem. The overall emotional well-being of patients is enhanced when they discover or develop new sources for positive self-regard.

You can also protect your self-esteem by maintaining your normal activities and roles as much as possible. Your illness does not suddenly define you as a cancer patient, as if that is your new identity. Patients who continue to do the things that are important to them, to the extent possible, enjoy a better psychological adjustment than those who too quickly abandon these roles and activities or expect too little of themselves because they have cancer. One study specifically noted that patients need to deal with the cancer but also to keep it in its place.

What Do You Enjoy?

Most people do have activities they once – and/or still – enjoy. Why not try to do some? Getting creative, writing your story, these are all ways you can feel productive, even when you’re not feeling well.

You Can’t Control It All

Like addicts and others with chronic illnesses, you can’t control it all. Period. However, putting your life in order may really help you feel as though you’ve achieved something. Work on being involved with your care, keep appointments, and make changes in your life to make you healthier. Sometimes, people find that making – and keeping – a daily schedule keeps them sane. Of course, you can’t control all of your feelings and thoughts, but try not to dwell on the bad ones – and enjoy the positives where you can.

Coming to Terms with Mortality

It may seem that a major challenge when dealing with cancer is to fight against the possibility of death rather than work on coming to terms with it. Certainly the philosophy and technology of modern medicine are preoccupied with this fight. The practitioners of alternative therapies also stress their healing potential. From all quarters, cancer patients hear that they must maintain hope, keep a positive attitude and try not to give up.

It seems that everything revolves around getting better. And yet many patients die of cancer, and even those who do not are living with the possibility that they might. Very little support is offered to people coming to terms with this possibility and reaching some sense of peace about it, and not feeling that it is a failure and outrage to die.

We are not saying that you should accept the possibility of dying, and therefore not rail against it and do all you can to prevent it. Nor are we suggesting that if your cancer progresses, and death seems inevitable, that you should accept it then. Facing death is profoundly personal, and inherently difficult: our survival instinct runs counter to it. The loss of life and everything that entails seems unbearable, and for most of us dying is almost too dreadful to think about. But it is possible to come to terms with death. And patients who do, enjoy the peace that acceptance brings.

The majority of newly diagnosed people have a favorable prognosis. You might think that it would be better to confront death when the time comes. But even now, you are facing the possibility of dying of cancer and striving to prevent or delay it. This fight for your life is bound to be filled with fear, desperation and inner anguish if you are not also striving, in your own way, to come to terms with this possibility. This does not mean that you dwell on it; it means that you deal with it and then go on. It is always wise to review your personal and financial affairs. Having done so, you will be all the better at living in the fullness of life, one day at a time, rather than in the dread of what could possibly happen.

The work of coming to terms with death can draw on our religious, spiritual or philosophical beliefs about what is important in life, and why. These beliefs can provide meaning and purpose to life, and therefore consolation when facing death. Many people have been able to feel, and to know, that their life has been about something important and of lasting value. This is one of the major ways that our religion or spirituality can help us.

We have found that most of our patients are struggling with these issues and longing for a sense of peace, but they are forced to do so quietly because they have so little support for this important inner work. Many patients abandon this effort, and come to feel hopeless about it. We encourage you to go forward, through reflection and reading in the religious or spiritual traditions that appeal to you. One book that many people have found helpful is The Tibetan Book of Living and Dying by Sogyal Rinpoche.

How To Cope If You’ve Been Diagnosed With Cancer:

When you learn you have cancer, you may feel like your life has been turned upside down. Once the shock wears off, the process of making changes begins. You may have to rearrange things in your life as you start treatment. The symptoms and side effects may take a toll on both your body and your emotions. You may have to learn new ways of talking to your loved ones and to your health care team. And you probably have a lot of questions to ask about adjusting to all the new issues that cancer brings.

Learning that you have cancer is frightening – you may feel anxious, depressed, terrified, and overwhelmed. Here are some tips for coping with a cancer diagnosis.

Get the facts about your diagnosis – ask your doctor specific questions and write down the answers. If it’s overwhelming, have a friend or family member do so.

Maintain your normal lifestyle – but be open to changing things around if necessary.

Maintain lines of communication between your doctor, your friends, and your loved ones. A cancer diagnosis is particularly isolating, and this is the time to let people in and let them help. They want to help.

Look into your goals and priorities and find time to do those that are most important to you.

Try to anticipate any physical changes. After a diagnosis is the time to learn more about the physical changes that may occur with cancer and cancer treatment. Ask your doctor about any changes you should anticipate. Pick up some wigs, makeup, and any other items that may make the transition easier on you.

Stay healthy – eat a healthy diet, exercise as best as you can, and get enough rest; this can help combat some of the stress of treatment.

Let people help you. Now is not the time to be proud and put up a strong front – let people in. They want to help. Encourage that. Come up with specific items or areas where you need assistance and ask your friends and loved ones to help with these things.

Talk to others who have been diagnosed with cancer. If you have cancer, sometimes it feels like no one else understands you. Those who have cancer do. Seek out support groups on the Internet or find a local support group.

Figure out how to cope. Your coping mechanisms may not be the same as others, but there will be things that you can do to cope with your diagnosis and illness.

Check into insurance options (if you’re in the US). You may feel trapped at a particular job for fear that you will be denied new insurance. Find out any assistance your state may offer, check into the FMLA Act and the Americans With Disabilities Act – and if you qualify.

How To Help A Friend With Cancer:

Many people going through cancer treatments – or treatments for other chronic illnesses – find asking for help challenging. Instead of waiting to be asked, offer your friend specific ways you can help. It’s up to him or her to decline your offers.

If you have no idea what to help with, ask your friend or their family.

Register to be a bone marrow donor. Even if it’s not something that can help your friend specifically, you are giving the gift of life.

Try not to let your friend’s condition get in the way of your relationship. Treat them just as you always have.

Make sure to provide your friend space, but offer visits whenever they would like.

If you are able to, make space for their uncomfortable feelings. Let them talk about how scared they are (without jumping in to reassure them), or how mad they are (without jumping in to cheer them up), or how frustrating, invasive, unfair this is (without trying to redirect them into “positive” thoughts).

Be supportive if they need more than you can give and if they turn to therapy, a support group, a pastor, etc.

Make sure any plans that are made are easily changeable – just in case something pops up.

Make sure that you can make some plans for the future too – this gives your friend something to look forward to.

Do your best to follow through with any commitments you make. If you promise to pick up groceries or watch their children, do it.

Allow your friend to be sad. Yes, it’s uncomfortable, but these feelings are expected and allowed. Make sure your friend knows that you can hear the hard stuff, too.

Check in once a week via phone or email. Let your friend know he or she doesn’t have to answer the phone if he or she does not want to. Sometimes that level of contact is simply too much.

Be sure to write, too. Some days, when the treatments are too exhausting, your friend may not want to talk on the phone. Instead, postcards, emails, even text messages will be read and reread, lovingly, by your sick friend.

Rotate your visits to the hospital. Your friend needs to rest just as much as he or she needs to see you, so make sure to visit in shifts so as not to overwhelm your friend.

Talk to your friend about non-cancer related topics. Sometimes your friend needs a break from talking about cancer.

Make sure to include the family of the person with cancer – often, they are so overwhelmed by care-giving responsibilities that they do not take proper time and care of themselves.

What Are Some Practical Ways To Help A Friend With Cancer?

Practical help is often very valuable for a friend with cancer. Your friend’s needs will change often due to treatment time-frames, symptoms, side effects, energy, and ability to concentrate. Be creative and flexible in the practical help you offer. These are some suggestions for practical help:

  • Help with house chores – take out the garbage, help out with pets, clean up, help with laundry, bring in the mail, do any gardening.
  • Make dinner or bring some takeout and watch movies.
  • Help babysit children, offer to chauffeur them around town and arrange for play-dates.
  • Put together a phone chain or support team to check in with the friend frequently.
  • Offer to drive your friend to a support group – and join! Friends and family are always welcome.
  • Offer to go with and take notes at a doctor’s appointment.
  • Keep your friend company during a treatment session.
  • Coordinate transportation to treatments.  Work with your friend, their family, and their other friends to take turns driving your friend to and from treatments.
  • Offer to help sorting through medical bills and insurance claims. Those piles of paperwork can be massive.
  • Offer specific help – “can I bring over dinner tonight?” rather than “let me know if you need me.”

What Do I Say To Someone With Cancer?

Sometimes, it’s hard to know what to say to a friend with cancer. You’re afraid of stepping on land mines, toes, or making your friend feel worse. Here are some things you can say:

“I’m really sorry this happened to you.”

“I’m here if you want to talk.”

“I care very much about you.”

“How can I help?”

What Are Some Gift Ideas for a Friend With Cancer?

It’s a nice idea to pick up some gifts for a friend with cancer – huge mood-brightener. But…what to buy?

Gift cards for a Kindle/iPad or other eReader.

Gift cards for music for an mp3 player.

Makeup, jewelry and other beauty items.

Crossword or other books of puzzles.

Money for a housecleaning service.

Gift certificates to a spa, for a massage, restaurants, passes to local museums.

Pajamas or a robe.

How NOT To Help a Friend With Cancer:

The worst thing you can do is nothing at all. Every cancer survivor knows at least one person, who, upon hearing the news, disappeared forever. Your friend will never forget if you’re the one who does that.

Don’t say, “God won’t give you more than you can handle.” It implies that God had a role in the development of cancer and may make your friend feel as though he or she is being punished.

Avoid comparisons. Just because your best friend’s sister’s boyfriend’s girlfriend had cancer, followed THIS diet, and was cured doesn’t mean your friend will.

Send mylar – not latex – balloons to the hospital. Many people are allergic to the latex in balloons, so they may not be allowed on the floor.

Call and check with the hospital to see what their policy is about sending flowers. As cancer suppresses the immune system, anything that has the potential to cause an allergic reaction should be avoided.

Don’t visit your friend if you’re feeling even a tiny bit sick – people with cancer have suppressed (weakened) immune systems and should not be exposed unnecessarily to germs.

Don’t take it personally if your friend doesn’t want to talk. Sometimes, it’s too overwhelming for your friend to even pick up the phone.

Don’t give medical advice. You’re not a doctor and you’re certainly not familiar enough with your friend’s illness to be making medical calls.

Don’t give advice about how to change their lifestyle and diet. They may already be struggling with completing their normal routine.

Don’t make statements that may imply that your friend has caused their cancer in any way – don’t ask about smoking history, exposure to toxic chemicals – what matters is the NOW, not the before.

Don’t bother touting the latest miracle cure. No one wants to hear it.

Don’t tell them to “chin up” or “cheer up.” They are entitled to their feelings, which may or may not be comfortable for you.

Platitudes are bullshit. Don’t use ’em.

Don’t tell horror stories about people you’ve known who had cancer and died from it.

What NOT To Say When A Friend Has Cancer:

It’s easy to want to express trite platitudes when someone you love has cancer. It’s also extremely challenging to know what to say and what NOT to say. Here are some things not to say to a friend with cancer:

“I know JUST how you feel.” (No, you don’t.)

“I feel helpless.” (Imagine how your friend feels.)

“You need to talk about it.” (Your friend will talk when he or she is ready.)

“Here! This is what you should do. I heard about it on Oprah.” (You don’t know your friend’s illness better than your friend.)

“I don’t know how you’re managing it all. I’d die if it were me.” (Thoughtless!)

“You’re going to be fine.” (You do not know that.)

“How much time do you have?” (Morbid!)

If you have any more tips about how to cope when a loved one has cancer, please send it to bandbacktogether@gmail.com!