Coping with Cancer. Patient Education Cancer Programs. Feeling in Control

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Patient Education Coping with Cancer Many patients find that their first challenge is to feel in control of life again. These resources and tips may help. You can do it! Feeling in control Managing information Dealing with anxiety and stress Using support groups and classes Taking care of yourself Tips for family, friends, and talking with children Most people do not expect a serious illness and are not prepared to deal with the many changes in routine and lifestyle that treatment may require. Coping with cancer may be a totally new experience, that can make patients and their families feel out of control. You may feel overwhelmed by many changes that the illness and treatments demand: giving up goals and plans, redefining roles and family structure, changing communication patterns, and dealing with emotional, physical and financial stress. All this can be very hard, even for the most capable of persons and the most stable of relationships. Feeling in Control Acknowledge that you are dealing with a major issue. Do not minimize your situation. Clarify the problems that bother you most. Defining a problem is the first step in solving it. Ask for help from family and friends if you cannot do as much now as you used to do. Trying to do too much will just cause frustration. Use emotional support. Find someone with whom you can talk openly and share your feelings. A social worker can help patients find a strategy to manage this new and difficult situation. Often talking just a few times can help patients and families find ways to again feel in control of their lives. You can call the Cancer Center social worker at 206-598-4108 to arrange a visit. If you are an inpatient and would like to contact a social worker, call the Social Work Department at 206-598-4370.

Page 2 Managing Information These strategies can help you feel better informed and more in control of your treatment process: Use a notebook. Many people find it useful to have one place in which to write and collect information about their treatment. Bring your notebook with you to the clinic. Write down names of staff, information about your cancer, your medications, your treatments and notes from talks with staff. Ask your doctor to write down the exact type and stage of your cancer, then do your own research. Your social worker can provide you with bibliographies and resources. Write down questions for your doctors before you see them and take notes during your meeting. It usually helps to have someone with you during your visits to help remember all that is said. You can also bring a tape recorder and make a tape of your meeting to replay at home. Keep a calendar. This helps you to keep track of visits to see your doctor, have procedures, tests, etc. Patients use their calendars to look back and see when they had their last MRI, doctor visit, etc. A calendar can be especially helpful for tracking billing charges. Reading books and pamphlets may help you become more familiar with medical terminology so that it is easier to understand what your doctor is telling you. You can also ask your doctor to suggest articles about your illness and treatment. The Cancer Library, located on the inpatient cancer unit, has many useful handouts, articles, books and other resources.

Page 3 Dealing with Anxiety and Stress Many patients have found that using relaxation techniques, meditation and/or imagery for stress management helps them feel better and gives them more energy to cope. Many audio tapes are available; a good one to try is Letting Go of Stress by Dr. Emmett Miller, available through many bookstores and through the hospital gift shop. Many patients have found Dr. Bernie Siegal s tapes helpful for learning techniques of imagery and relaxation. There are some relaxation tapes in the chemotherapy room. The Cancer Library, located on the inpatient cancer unit, offers books, tapes and other materials on dealing with stress and anxiety. Using Support Groups and Classes Support groups can be a good source of emotional support and information about cancer and treatments. You may find it comforting to be with others who really understand what the diagnosis of cancer can mean in a way that family and friends sometimes cannot. To find out what groups meet at UWMC, look for information in the monthly calendar on the bulletin board next to the front desk of the Cancer Center, or ask your social worker. Many community resources are also located there. To learn about other groups, call Cancer Lifeline at 206-297-2500 or 1-800-255-5505, or the American Cancer Society at 1-800-729-1151. For more information about UWMC cancer support groups or classes, ask our staff or call the Social Work Office at 206-598-4370. Taking Care of Yourself Take good care of yourself. This is the time to put yourself first. Your health has to be your first priority. Let go of other responsibilities that you do not want or need. This is the time to learn to say no. This is also a good time to focus on exercise and good nutrition. If you are undergoing treatment, your energy may be limited. Maintaining an exercise routine (even if you must alter it a bit) may help reduce fatigue and increase your sense of well-being. Because good nutrition is key to maintaining your health throughout treatment, a visit with the nutritionist may be a good idea.

Page 4 Continue with some sort of recreation. Finding activities that are fun, that you enjoy and that make you laugh may be a challenge when you feel sick, but distraction and humor are good medicine. Some patients find being with or watching small children or animals brings them pleasure and a good laugh. Make time for your spiritual life. If you have not been part of a spiritual community, this may be the time to look for a group that meets your needs. Some patients prefer finding inspiration in reading or in nature that provides them with peace of mind and spiritual fulfillment. Whatever you choose, this part of your life is important. If you have lost opportunities because of your illness, set new goals. Many patients find they cannot work, but they can do something fun and worthwhile on a volunteer basis. Some patients use the time during treatment to take a class, express their creativity, learn a new skill, or spend more time with family and friends. Limits on activity caused by treatments can present a challenge, but overcoming them can give great satisfaction. For Family and Friends It is hard to see someone you care about in physical or emotional pain. Sometimes it can seem as difficult to be the support person as it is to be the patient. Both roles are challenging. Here are some tips for caregivers: Educate yourself about the illness and the treatment. Your social worker and/or the Cancer Library are good places to start. If you are not sure how to help your patient, come up with suggestions of things you would like to do (for example, cook dinner once a week, provide rides to doctor visits, baby-sit so a patient can nap, read to a patient, etc.). Keep communication open. Do not hide information or your feelings unless the patient asks you to. It is easier to cope with the known, even when it is upsetting, than the unknown. Do not stop talking because you do not know what to say or are afraid of saying the wrong thing. Acknowledge your fears and feelings and ask the patient how you can best support them. Often what they want most is a caring listener.

Page 5 Seek information on how to provide support. When Your Friend Gets Cancer, How You Can Help, a book by Amy Harwell, and the NCI booklet Taking Time Support for People with Cancer and the People Who Care About Them (available in the Cancer Center and the Cancer Library) both provide good ideas. The National Family Caregivers Association publishes a newsletter and a resource guide (available for a small membership fee). 1-800-896-3650. Take care of yourself as well as the patient. Remember that for the person with cancer or the family member, there is no right way to cope. What About Children Many patients have questions about what to tell their children about their cancer and its treatment. Parents often feel torn between wanting to inform their children and wanting to protect them. There is no one right approach. Every situation will vary depending on the nature of family relationships, age of children, role of sick parent, etc. Here are some general suggestions drawn from experience with patients and families and from research on children: It is best to be honest with children and talk with them about your cancer, as they will be affected. If you don t talk with your children, they may harbor fears that can be worse than the reality. They may overhear information about your illness or hear about it from someone else. Children can feel insecure if they sense something is happening and they are not being told. Children need reassurance that they are not responsible for the illness in any way and that their needs for care and comfort will continue to be met. With this reassurance, you will find they are amazingly resilient, and they can cope with almost any event if they feel informed and included.

Questions? Your questions are important. Call us if you have questions or concerns. Social Work Department (206) 598-4370 There are materials written for children available in the Cancer Library and the Cancer Center. Two books that have been found to be helpful are: How to Help Children Through a Parent s Serious Illness by Kathleen McCue, St. Martin s Press, New York, 1994. When a Parent Has Cancer: A Guide to Caring for Your Children by Wendy Harpham, M.C., Harper Collins, 1996. Other helpful materials and resources are: Helping Children Understand A Guide for a Parent with Cancer, a pamphlet from the American Cancer Society. It Helps to Have Friends When Mom or Dad Has Cancer, a pamphlet from the American Cancer Society. When Someone in Your Family Has Cancer, a pamphlet from the National Cancer Institute. Kids Konnected, Inc., P.O. Box 603, Trabuco Canyon, CA 92678, 714-380-4334, or E-mail jwh@kidskonnected.org, or see the Web site at www.kidskonnected.org. This is a national program of kids helping kids, started by a young man whose mother had cancer. It provides friendship, education, understanding and support for kids who have a parent with cancer. Social Work Department Box 356125 1959 NE Pacific St. Seattle, WA 98195 (206) 598-4370 A member of the Seattle Cancer Care Alliance, which includes Fred Hutchinson Cancer Research Center, Children s Hospital and Regional Medical Center, and the University of Washington. University of Washington Medical Center 1/2000