COPING WITH A CANCER DIAGNOSIS. Tips for Dealing with What Comes Next

About half of all men and a third of all women in the United States will be diagnosed with cancer at some point in their lives. Millions more will have a loved one affected by the disease. This difficult experience often comes with little warning. After your diagnosis, you may feel overwhelmed and afraid, wondering how to cope with what lies ahead. ½ ⅓ If you or someone you love have been diagnosed with cancer, knowing what to expect and making plans for how to proceed can help make this stressful time easier. Here, Gary McClain, PhD, a therapist, life coach, author and founder of JustGotDiagnosed.com, offers his advice on how to cope after a cancer diagnosis. 2012 Alliance Health Networks www.alliancehealth.com 1

Go Ahead and Ask the Why me? Question Learning that you have cancer inevitably brings up the question, Why me? Sure, it s a question without an answer. But that doesn t mean you won t ask it. After all, it s only human to wonder why life is throwing you a curveball. Asking the Why me? question is an important part of the process of coping with an HIV diagnosis. Along with the Why me? comes a lot of strong emotions sadness, frustration, anger, fear, disappointment. Feelings that are all part of the experience of being diagnosed with cancer. Asking Why me? helps you to bring those feelings to the surface, so that you can deal with them, rather than pretend they don t exist. Why me? is often about having control of your life and not having control. A cancer diagnosis has a way of pushing you to look at the control you have in your life, what you thought you had control of and what you don t have control of. Control can be hard to think about, especially lack of control. But it s an important part of coming to terms with your cancer diagnosis. Here s what to do when the Why me? question comes up for you: Some venting may help. Sometimes it can help to just sit down with someone who can be a non-judgmental listening ear, and ask them to just let you vent about your feelings. It can be helpful to release those pent up emotions, to let them out in the air rather than keeping them bottled up inside. You might want to let your listening ear know that you just want to talk and aren t asking them for advice, unless you want their advice. Ask yourself: How much control do I have? You might want to use some mindfulness here. Stand back and take a look at the situation as if you were an uninvolved observer. What s going on with that person (you)? What is in that person s control? What isn t? This may help you to get a perspective on what s going on. A cancer diagnosis has a way of pushing you to look at the control you have in your life, what you thought you had control of and what you don t And then ask yourself: What can I change and what can I fix? By taking a more objective look at your life, you can begin to sort out what you can actually do something about and what may be less in your control. Acceptance is the beginning of a more peaceful attitude. Knowing what you can change is the beginning of empowerment. Understanding both will help you to find your way out of your frustration. 2012 Alliance Health Networks www.alliancehealth.com 2

Show yourself some compassion and patience. Feeling out of control can result in beating up on yourself, which can, in turn, affect your self-image. Go easy on yourself, tell yourself that you are facing a lot and that you are doing the best you can under the circumstances, and that you will find a way to face his challenge, as you have faced others in the past. Turn your compassion outward. If you can stop blaming yourself you will also be less likely to blame others. Get involved in activities you enjoy, and with people you enjoy them with. Take time for activities that give you pleasure and help to keep you calm. Keeping a journal can help. Get together with friends or family members that you enjoy being with. Basically, distract yourself from all that frustration. Reach out and celebrate what s going well in your life. Don t neglect your spirit. If you have religious or spiritual practices that are part of your life, or that you want to make a part of your life, there is no time like the present. Be patient. The world doesn t run on our personal clock. Things take time. This includes managing medications, getting diet and lifestyle on track and communicating with healthcare professionals and loved ones. Bumps along the road don t have to mean that the road can t be traveled with some work and a new strategy. In the meantime, don t neglect your self-care; this is not a time to neglect yourself. Strategize with someone who can help. Speaking of strategizing, it can be helpful to talk with someone who can help you to brainstorm on solutions to whatever situation is causing your frustration. This should be a person who can help you to look at things objectively, who can help you to consider things from various angles and who might have some suggestions. It s not this person s job to solve your problem for you, just to help you to open up to what s possible, to help you gain some perspective. Support groups can be helpful here. Consult the experts. Talk to people who can offer you professional advice. This might mean a conversation with your physician or another medical professional. 2012 Alliance Health Networks www.alliancehealth.com 3

Consider reaching out to a mental health professional. If you are feeling overwhelmed by your feelings, if they are affecting your attitude, causing self-doubt or conflict with loved ones or other people in your life or interfering with your self-care in any way, this may be a good time to consult with a mental health professional. Don t go through this alone. Fight the Fear with Facts One of the first reactions to a cancer diagnosis is fear of what s to come. Medications and treatment. Paying more attention to your health. Telling others. Change can be scary. First, get the facts about your cancer diagnosis. Try to obtain as much basic, useful information as possible. Find out the name of the cancer, its size and location, where it started and if it has spread. Learn whether it s viewed as a slow-growing cancer or an aggressive one. Ask about the available treatment options, the success rate of each treatment and what side effects to expect from each. Without that information, you can t get an accurate understanding of the problem and know what to expect from the treatment. Consider bringing a family member or friend with you to your first few doctor appointments. This is a stressful time for you and your ability to retain information may be less than normal. It can be helpful to have someone with you to remember what the doctor said, unscramble messages and help ask the questions you want answered. Write down your questions and concerns beforehand and bring them with you. Here are some more ideas to help you deal with your own fear factor. Ask yourself: How real is my fear? The way the human brain works is that without real information, our mind fills in the gaps. But unfortunately, the gaps may be filled with scary thoughts and misinformation generated by your fear. In this way, you can end up working against yourself as your fear increases. Ask yourself how realistic your fear is. Is this the only possible outcome? Are there other possibilities as well? Am I looking at this as an either-or and not considering the options? Questions to Ask When You re First Diagnosed What kind of cancer do I have? What is the cancer s size and location? Where did the cancer start and has it spread? Can my cancer be treated? Can my cancer be cured? What are the chances of this? Do I need to see a specialist? Who would you recommend? What are my treatment options? How will the treatment benefit me? What are the side effects of the treatment? And if you aren t sure, get some answers. To understand how real your fears are, talk to people who can give you real information. Get the facts. When you have real information, then you are in a better position to determine what your options are and take action. 2012 Alliance Health Networks www.alliancehealth.com 4

Focus on the present, not the future. Take small steps. Try to move your focus away from the What if? and toward the What now? Do you what you need to do to get through each day, focusing on your self-care, getting support, working closely with your treatment team, basically handling the small stuff, one step at a time. The day-to-day is what you do have some control over. The What if? will become clearer over time. Don t give in to the positive thinking police. It s OK to be scared, angry or frustrated. It s normal to have a lot of different feelings. Don t let anyone tell you that you should think positive and stop feeling how you feel. That s just denial. Feelings are feelings, so don t keep them inside. You will most likely find that, once you have let some of the feelings out, your mind is clearer to focus on that next step, as well as to listen and process information. Accept Help from Family and Friends Learn to accept help. The person diagnosed with cancer may feel like they are letting down others by not being able to do as much for them. Or they may push him or herself even harder, hoping that by keeping things as normal as possible, so others won t notice they aren t feeling well. But allowing others to help is not a sign of weakness or giving up. Accepting help gives those who care about you a sense of making a contribution at a difficult time and helps you focus on getting well. This advice goes for family members as well. A cancer diagnosis affects the entire family and adds stress, especially to the primary caregivers. Accepting help with meals or chores from neighbors or friends can go a long way in preventing caregiver burnout. Talk with supportive people and get ideas about the best way to cope. Learn what you can from their experiences, consider advice that makes sense for you and let them know what you re going through. Being on the journey with people who really know how hard the road is can make a lot of difference. Reach out for a spiritual connection. What is your personal definition of spirituality? This may be a time to reconnect with religious or spiritual practices from your past or to develop new ones. Having a sense of the meaning of it all, and a connection to something great than your day-to-day experiences, can be a great antidote for fear and a great addition to your tool kit. Have a strategy in place. As much as possible, be clear with yourself on how you want to live your life. Your strategy might take into account day-to-day self-care, communicating with your treatment team, finances, emotional and practical support, up-to-date information, spirituality and any other aspects of your life that you want to build into your plan. Having a strategy in place for your life helps to balance the uncertainty of the future with a measure of certainty for today. Again, one step at a time a good strategy evolves over time, based on trial and error, experience and taking that step back to make adjustments as needed. 2012 Alliance Health Networks www.alliancehealth.com 5

Cancer Diagnosis: Take Care of Your Family Relationships It seems like I am always reading discussions that are focused on the challenges that families face when one family member has been diagnosed with a chronic condition or disease like cancer. And so I want to share some of experiences that I have had with clients and their families, and what they have taught me through the years. The biggest lesson that I have learned, and that I want to start sharing with you, is the importance of communication. From my perspective in counseling patients and families, when one family member is diagnosed with cancer, all family members are affected. In that way, everybody in the house is diagnosed. A chronic condition or disease means change for everyone in the family. How daily responsibilities are shared, new responsibilities, treatment regimens that everyone has to adapt to, adjusting to good days and bad days that the sick individual may be experiencing, accommodating dietary requirements, financial concerns and on and on. Change results in a lot of feelings: anger, frustration, fear, sadness, disappointment. The family member with the diagnosis may be experiencing some or all of these feelings, depending on what s happening at that moment, and so are family members. Keep the Lines of Communication Open But so often, nobody wants to talk about how they feel. They are protecting themselves from acknowledging feelings that may be uncomfortable or negative in some way. Or they are protecting the other family members or so they think.family members may fear that they will say the wrong thing, or assume that the family member cancer doesn t want to talk. They may all hope, unrealistically, that by ignoring their feelings, they will go away after awhile, or everybody will just get used to it. They may think that they need to stay positive for each other. Or, they may fear that if they start to talk about how they are feeling, the feelings will come out in such force that they will lose control, blow up, and do damage to the relationship. But we re all human, right? So what do you do? Change results in a lot of feelings: anger, frustration, fear, sadness, disappointment. The family member with the diagnosis may be experiencing some or all of these feelings, and so are family members. 2012 Alliance Health Networks www.alliancehealth.com 6

Be Honest about Your Feelings You can start by talking about your own feelings, not just physical but emotional. When a family member asks that usual question, How are you doing? you might want to start introducing some emotional words. I am feeling a little sad today. I am worried. I m kind of mad. Let them know what s going on, how your diagnosis is affecting you emotionally. Talking about your emotions can accomplish a couple of things. First, it gives you a chance to let out some of your own feelings and be heard. And, it communicates to your loved ones that talking about feelings is okay, that you aren t holding back, and that you don t expect them to. Check in with Others And here s another way to get the ball rolling: Ask your family member how they are feeling. I m a little bit sad today. How are you feeling? I m frustrated about my new diet. How are you feeling about it? Often, because family members are at a loss as to how to get the conversation about feelings started, they need to take their cue or get permission from the family member who is facing the diagnosis. Are you ready to start that conversation? You may not get much response, at least not at first. Some families are better at the emotional stuff than others, regardless of the situation. But opening up communications is a step-by-step process. You may have to lay a lot of groundwork, starting by dipping your own toes into the emotional waters, and showing your family members that you can talk about your own feelings, even the uncomfortable ones. Whew, I said it. And the house didn t come crumbling down. You will be helping yourself by not bottling up your own emotions, and you ll be a role model to your family members by showing them that talking about feelings the good ones and the uncomfortable ones is okay. By the way, I am not trying to promise you pie in the sky (my favorite banana cream or any other kind). I know that some families just aren t hardwired for communication, and that family members can be downright insensitive. Still, I encourage you to give it a try. Sometimes family members can step up to the plate, in their own sweet time, and surprise you. 2012 Alliance Health Networks www.alliancehealth.com 7

Talking to Children about Cancer Children may need some additional help in opening up. Children learn to stay positive out of fear that they will cause their parents additional worry. They may also interpret your own insistence in maintaining a positive attitude as a signal that they aren t supposed to express their own feelings. Start the conversation by simply asking your child is feeling, along with reassurance that you want to hear whatever it is they want to tell you, even the scary stuff. Give a few extra hugs and reassuring words. Cancer demands that we take a look at how we are living and create changes that promote well being. Family communication is a critical element in your self-care. Take care of yourself; take care of your relationships. 2012 Alliance Health Networks www.alliancehealth.com 8