If you or a loved one is facing cancer, emotional support is paramount. We sought expert advice on coping with a diagnosis
Around 352,000 people are diagnosed in the UK with cancer each year, and more than 2.5 million are either living with or post-cancer today. This number is expected to rise to four million by 2030 due to increased life expectancy, earlier diagnosis and lifestyle choices. And while the NHS is very well equipped to treat the physical aspect of disease, there is less information available on how to cope with the emotional side of things. We spoke to the experts for advice…
Managing anxiety
A cancer diagnosis can seem overwhelming. With so much uncertainty about the future there often comes a huge amount of anxiety which can be quite disabling. “It is very natural to feel anxious,” agrees Sarah MacDonald, services operations manager at Penny Brohn UK, a charity set up to help anyone over the age of 18 with a cancer diagnosis and their close supporters. “Our thoughts can sometimes seem to take over us. It’s important to remember that thoughts are not facts – just because we are thinking something, doesn’t mean it’s true.”
Sarah says there are various ways you can challenge your thinking when you notice you are being swept away by anxious or intrusive thoughts. “For example, some people find it helpful to make a ‘worry time’. Whenever you notice an anxious thought at other times, tell it it has to wait until worry time. Or you might like to think of some things that lift your spirits or that you feel grateful for. Every time you notice an anxious thought, deliberately match it with a happy thought. Many people find mindfulness and meditation helpful with anxiety. And if you feel overwhelmed by anxiety, talk to your GP or your oncologist, who can refer you for psychological support.”
For Jo Emerson, confidence coach and author (jo-emerson.com), focusing on the here and now and finding acceptance was key. “When I had my breast cancer diagnosis in 2011, I had to learn to manage my anxiety fast,” she explains. “I told myself the truth: that all any of us have is today and so today must be the day I focus on. I put all my energies into making the most of every moment – taking deep lungfuls of fresh air, watching local children play and birds soar over the fields outside my home, savouring the taste of fresh coffee, cuddling my babies for a little longer and taking my time over the little things like washing my hands, chopping vegetables, talking to clients, putting on make-up, and so on. I literally focused on the moment and it became so absorbing that I had a lot less time to spend worrying.
“I also repeated to myself daily that none of us know when our time is up – I just had a heightened awareness of that fact at the time. This helped hugely because it gave me the gift of acceptance,” she says.
Loved ones
When facing illness you need the support of those close to you, but you might also be worried about upsetting people or worrying them unnecessarily. Sarah says this is your news to break, and you have complete control over it. “It’s up to you who you tell and how much you tell them,” she says.
“There’s no rule that says everyone has to know, and there could be good reasons for not telling even the people closest to you, so don’t feel pressured into sharing more than you want to.
“Think about what information you actually have to share. You may want to wait until you know what you’re dealing with and are able to give clear answers. This might include giving yourself time to get over the initial shock and to work out what you need and how you want the people you are telling to support you.”
Telling little ones can seem like an overwhelming task, but managed well, it can be done without causing too much upset, says Jo. “Depending on their age, I would tell them that you’re poorly and the doctors are working hard to make you better,” she says. “Unless you have an imminent terminal diagnosis and need to say your goodbyes, I can’t really see the benefit in worrying little people unnecessarily.
“Children will usually know something is up and it can be reassuring for them to know what’s going on,” says Sarah. “It’s easy to think that a serious conversation has to take a long time, but a few minutes or a few sentences can be enough. There are books about cancer aimed at children of all different ages that might be helpful, and remember, it doesn’t have to be you who does the talking.
A partner or friend may be able to do it for you or with you.”
“I would, however, be clear with your children on how much rest you will need in order to recover, and let them know what they’ll need to do to adjust to accommodate your recovery,” advises Jo.
When friendships suffer
They say you find out who your friends are when you go through hardship. But for some people, not knowing what to say or do to help can lead to them avoiding you all together, which can seem like a blow when you’re already low. “It’s a painful position to be in that can bring up many emotions,” says Sarah. “Many people say that people they thought would be there for them disappeared, and that others who they never considered stepped up and became friends.” Don’t take it personally, says Jo, and don’t write them off altogether. “Send blessings their way and leave them alone for now. They can’t cope and therefore they won’t be able to help you right now. They can’t help it – it’s just who they are, so don’t be bitter about it. Focus on the people who can support you and be grateful for them. There are friends for every season and those who are avoiding you when you’re ill may just turn out to be amazing at another later juncture in your life.”
“If you want to find a way through, wait for a time when you are feeling strong in yourself and then broach the subject,” says Sarah. “As with all difficult, personal communication it helps if you can stick to ‘I’ statements, saying what you feel, think and experience. Try and avoid judgement or accusation. Again, support from a counsellor can be helpful, or talk it through with a good friend first.”
Getting help
Employment conditions vary greatly when it comes to sickness, and Sarah advises that you check your company’s guidelines and policies. “Talking to your employer about cancer may feel difficult. However, it is important to know that you will be protected by the Equality Act 2010 in England, Scotland and Wales and The Disability Discrimination Act 1995 in Northern Ireland,” she says.
“You may want to speak to your line manager, HR team or occupational health adviser. They will be able to help with changes to support you during treatment such as making work adjustments, giving you time off and telling you about sick pay entitlements. Ask if you can speak to them privately and if you are feeling nervous you could take someone with you.” And remember, you don’t have to tell your employer anything if you really don’t want to. “The decision to tell them will depend on the type of job you do and your health,” says Sarah. “Telling your place of work is the first step to getting the support in place you may need but how much you disclose to wider colleagues, if anything, is up to you.” Macmillan can offer advice on any entitlements to financial help. Visit macmillan.org.uk
Sarah also advises that you should speak to your GP or district nurse who can advise you on the support available in your area. “They will put you in touch with your local council who will do a needs assessment and work out a care and support plan,” she says. “They may also be able to give you information about useful equipment, services and transport.”
Complementary therapies
“Complementary therapies can be really helpful in supporting you,” says Sarah. “Make sure the practitioner is registered with their professional body, which ensures members are properly qualified and insured. Talk to therapists first to find out their experience with cancer or take recommendations from friends. Different therapies suit different people and different circumstances. Most of them aim to support your body to be as healthy as it can be. Some therapies – such as massage, reflexology and shiatsu – focus on touch. These can be really useful for easing tension and related symptoms such as pain and difficulty sleeping. Your body will be putting up with lots of difficult kinds of touch throughout treatment, so gentle caring touch can be very helpful.
“Other kinds of therapy aim to treat symptoms more directly. There is good evidence that acupuncture can help with nausea and other side effects of chemotherapy, for instance. Many people are interested in changing how they eat to help them through cancer and its treatments. A nutrition therapist can offer guidance and support on healthy eating. The most important thing is that you feel safe and confident with the therapist you choose and that you feel the benefit of your sessions with them.”
Breathing and visualisation
Try these self-help tools when you need to feel calm and gain some head space, from Gail Marra, a clinical hypnotherapist based in Harley Street (gailmarrahypnotherapy.com)
“I work regularly with cancer patients and have done so for many years. As a therapist, my role is to help patients relax and cope better both physically and emotionally with their diagnosis, anxiety surrounding test results, treatment and surgery, helping patients feel more comfortable and more in control of their situation.
“Diaphragmatic breathing is an incredibly useful coping strategy and something I teach regularly. Breathing through the diaphragm at a controlled pace stimulates the parasympathetic nervous system. Deep diaphragmatic breathing releases those ‘feel good’ chemicals like dopamine, oxytocin, serotonin and endorphins which combat adrenalin and cortisol released when we’re stressed and anxious.
“You can try this yourself: place both hands on your stomach with only your two middle fingers touching. Take a deep breath in through your nose and imagine your lungs are two beautiful big balloons filling up your entire torso as you breathe slowly in to the count of seven until your fingers part. At the top of your breath, begin to push the air out of your lungs from the bottom out, using your stomach muscles to push every last bit of air out slowly and gently. Do this to the count of 11 and until your fingers touch again. Aim for five cycles of this breath in the space of one minute. At first it may only take 30 seconds, but with practice, you can control the release of chemicals from your brain, reduce your blood pressure and lower your heart rate. It’s simple and effective.
“Visualisation is also key. We are visual creatures. We think in pictures. Science tells us that over 90 percent of the information transmitted to the brain is visual and, as luck would have it, hypnotherapy is very much a guided visualisation. At home you can try self-hypnosis.
“A quick and easy way to start would be to perform an imaginary body scan. Sit or lay down in a quiet place at a time when you are unlikely to be disturbed. Starting at the top of your head, close your eyes and begin to travel through your body all the way down to the tips of your toes. Imagine a soothing sensation, a colour or anything else that comes to mind, and move through and around your body, stopping from time to time in any areas where you sense tension or in areas that need healing. You can do this any time of day but in bed at night it can also help you drift off to sleep quickly.
“Today there is little doubt that the mind-body connection is real and that we have a lot more control over our physical wellbeing than previously thought.”
Get involved
This February marks ten years since breast cancer charity, CoppaFeel! started its mission to educate the female nation on the importance of checking their boobs. The charity, which aims to educate people on the signs and symptoms, was founded in 2009 by Kristin Hallenga, after she was diagnosed with secondary breast cancer at 23. To mark this special year, CoppaFeel! has teamed up with Prostate Cancer UK and Dream Challenges for Walk the Night 2019. This incredible charity event brings hundreds of people together against breast and prostate cancer, walking a full or half marathon through London at night to raise vital awareness and funds for CoppaFeel! and Prostate Cancer UK. Join them on 27 July for Walk the Night and support the cause. Visit dream-challenges.com to find out more.
Helpful charities
Penny Brohn takes an integrated whole person approach, exploring ideas like diet, exercise, emotions, relationships and managing stress. Visit pennybrohn.org.uk
Macmillan offers emotional, physical and financial support for those diagnosed with cancer. Visit macmillan.org.uk
Odyssey is a charity created to help people with cancer rebuild their confidence and enjoyment of life. Visit odyssey.org.uk
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