Coping with Cancer

It is normal to have many feelings when you or your loved one has cancer. Sometimes it can be hard to know where to turn, or who to talk to about these feelings. Getting support can be an important part of your care, and needing to talk to someone about your feelings is not a sign of weakness. It takes a lot of courage and strength to open up to someone about how you feel. Maybe you have had feelings of worry or sadness before, or maybe this is the first time you have ever felt these. When you or a loved one has cancer, it’s common to feel a range of feelings including anxiety, anger, fear, sadness, and guilt. Many people can feel stressed by cancer and treatments, and also all the changes to their daily life that can happen after a cancer diagnosis. Maybe it’s changes or strain in relationships, feeling like friends don’t understand what you’re going though, changes to your work situation, money stress, or simply not being able to take part in things you used to enjoy. It makes complete sense that all these challenges can bring about stress. Asking for help can be an important first step. There are many people who can help you adjust and cope. Many can give support such as social workers, psychiatrists, psychotherapists, psychologists, and spiritual care professionals. They can help you find ways to cope with the challenges that cancer can present, and help you identify and address your feelings. Please see this user friendly resource on coping with cancer.

Sleep

Patients living with cancer often have trouble with their sleep. Some may report sleepiness, where they fall asleep at unwanted times. Others may report problems falling and staying asleep. When a person has trouble falling asleep at least three nights a week for three months in a row it is recommended to speak to a healthcare provider to rule out insomnia. There can be many things that can contribute to trouble sleeping among cancer patients. Cancer-related symptoms such as pain or nausea can cause troubles sleeping. Disrupted sleep can also be a symptom of stress related to the cancer diagnosis, anxiety, or depression.

It is important to see your doctor and have medical causes ruled out or treated. Your doctor may also tell you that having a sleep study may be helpful (where a doctor looks at sleep patterns to find medical causes for sleep trouble). Cognitive-behavioural therapy for insomnia (CBTi) is thought to be the most helpful treatment for insomnia. It works to help change behaviours and thoughts that can get in the way of a good sleep. Some recommended changes included keeping a standard wake-up and bed time, and only going to bed when sleepy. Psychologists, nurses, and social workers can help you look at your sleep and see what you to get a better sleep. Your doctor may also give you medication to help with sleep if other treatments  are not helpful.

Depression

Feelings of sadness or grief can be a very common reaction to a cancer, and may not need treatment. However, depression can also be something many people living with cancer or their families face. It is known that depression can lead to a lower quality of life, and worse health. The most important thing to know is that if you or your loved has depression depression there are helpful treatments and you are not alone. You or your loved one might wish to get support if you have several of the following for two weeks or more. A sad mood most of the day for at least two weeks, no longer enjoying things that used to bring pleasure (such as seeing family, watching a favourite TV show), trouble paying attention, trouble sleeping, low energy, suicidal thoughts or plans, and often feeling restless. If you or your loved is having suicidal thoughts, it is important to get help and support right away. Some of these might have to do with cancer or cancer treatments (e.g., low energy and trouble sleeping). Others such as a low mood that doesn’t get better with time, taking no pleasure in seeing loved ones or in things you used to enjoy, or having thoughts of suicide may mean you or your loved one might need from support.

If you think you or your loved one might have symptoms of depression, there are many treatments that can help. A good first step is to talk to your health worker like a family doctor or oncologist. They can help see if you might need mental health support, and if medication (like an antidepressant), or seeing a psychologist, psychiatrist, social worker, or psychotherapist might be a best match for your current symptoms. Certain types of therapy such as cognitive-behavioural therapy (CBT) (which helps individuals learn to think about behave differently) have been found to be among the most helpful in treating depression.

Cancer Related Fatigue (CRF)

Fatigue is a feeling of low energy that doesn’t seem to go away. Fatigue is a symptom related to cancer or cancer treatment. Cancer-related fatigue is a common symptom many people with cancer have. Those living with fatigue might notice it makes it more difficult to take part in activities with friends and family, finish work or household tasks, or even do activities of daily living (e.g., eating, showering etc.). Clearly, living with fatigue can have a troubling impact on one’s quality of life and lead to stress.

If you have fatigue, it is important to talk to your health care worker, such as a nurse, family doctor, or oncologist. Many issues may cause fatigue such anxiety, depression, treatments and medications, sleep troubles, poor nutrition, anemia (low iron), cancer, or other medical conditions. Therefore, the first important step is to have check-up by your health care provider who can discuss options. Treatments can include moderate exercise (slowly building up to 30 minutes a day, 5 days a week). It is always important to check with your doctor first before starting an exercise plan. Cognitive-behavioural therapy (CBT) can also help give you tools to help better manage fatigue and stress. Mindfulness and relaxation strategies and yoga can help manage both fatigue and stress. While some medications have been studied in lowering cancer-related fatigue, more research still needs to be done (CAPO, 2015). Health care worker such s family doctors, nurses, oncologists, social workers, occupational therapists, physiotherapists, and psychologists, to name a few, can help you manage your fatigue. Ask about programs at the cancer centre that can help you manage cancer fatigue.

Pain

Pain is a common complaint for many living with cancer. Pain is can be effected by body and mental factors. Making sure pain is well managed and treated is important for keeping a good quality of life. Health care workers including family doctors, anesthesiologists, nurses, oncologist, pharmacists, social workers, and psychologists, to name a few, can help you manage your pain. Possible treatments include medication, treatment of medical causes, and therapies such as cognitive-behavioural therapy (CBT) (a type of therapy that helps people change thoughts and behaviour, mindfulness and relaxation strategies). If you are having pain, the first step is to talk to your family doctor or nurse or oncologist to find out what might be causing the pain, and then to find out how best to treat your pain.

Anxiety

Cancer can be a stressful and scary time for you and your loved ones. Many people have anxiety about cancer, medical treatments, and symptoms. Sometimes anxiety can become high enough that it starts to get in the way of your day-to-day life or cause a lot of stress. While there are many types of anxiety, some common symptoms of anxiety are trouble concentrating, finding it hard to control your worry, tense muscles, low energy, racing heart, shortness of breath, dry mouth, upset stomach, feeling fear, feelings of panic, and trouble sleeping. If you feel like anxiety is a problem for you, there are many things that can help. First, talk to your health care worker to look at what might be causing your anxiety. If anxiety is in fact an issue for you, seeing someone like a social worker, psychologist, or psychiatrist would likely help. Treatment can include relaxation exercises, medications, or therapy such as cognitive-behavioural therapy (CBT), which helps individuals learn to think about react differently to situations in a way that helps lower anxiety.

Nausea and Vomiting

Nausea and vomiting are sometimes experienced by people living with cancer. Like with other medical symptoms, it is important to talk to your nurse, doctor, or pharmacist to find out what might be causing these problems (such as side effects from medications, or medical conditions). There are many things that can be used to help manage nausea and vomiting. Your dietitian, nurse or doctor may recommend some changes to your diet such as avoiding foods with strong smells and tastes, eating smaller, more frequent meals, sucking on hard candies, and making sure you stay hydrated (drinking enough water). Your doctor can also talk to you about whether medications may be helpful for you to manage your symptoms. Therapists can help you use things like visualization, distraction, and cognitive-behavioural therapy (CBT) (a type of therapy that helps people change thoughts (cognitions) and behaviour) can also be helpful. Acupuncture may also be of use in treating nausea and vomiting. Family doctors, nurses, oncologists, and psychologists, to name a few, can help you manage your nausea. Ask about programs at the cancer centre that can help you manage your nausea.