Cancer treatment can be physically gruelling but also emotionally draining. Here Dr Frances Goodhart, a clinical psychologist, gives her expert advice.
Cancer is the biggest fear for Brits, ahead of knife crime, Alzheimer’s, debt or losing their job, according to the charity Cancer Research UK. However, one in three people will have to face dealing with a personal cancer diagnosis during their lifetime.
But it’s not only surgery, chemotherapy and radiotherapy they have to deal with but the psychological aspects too – including dealing with shock, depression, an uncertain future and, in some cases, worries about their own mortality.
There is growing awareness that cancer patients need psychological support as well as medical treatment, says Dr Frances Goodhart, a clinical psychologist in oncology and palliative care, and joint author of the Cancer Survivor’s Companion .
Dealing with a diagnosis
Patients experience a sense of shock and disbelief after diagnosis – they say it feels unreal and it’s like it is happening to someone else, explains Dr Goodhart.
They can’t take in all the information they’ve been given. Some patients report a feeling of exhaustion too, as if they have been run over by a bus.
Dr Goodhart says the initial shock passes usually within 48 hours though and then patients move into practical mode. “Their energy returns and they begin to see although their life has been changed by cancer − it hasn’t stopped.
Patients start to take decisions about their care and get on the conveyor belt of treatment. Some find the structure and routine reassuring – it normalizes what they are experiencing.
Does a positive attitude matter or not?
The most important message is that there’s no ‘right’ way to deal with cancer psychologically, explains Dr Goodhart. There’s no scientific evidence to say that one method of coping is better than any other.
It’s really about getting through; finding a way to pick yourself up, dust yourself down and get on with it. There’s no reward for being positive all the time and just because you have a down day doesn’t mean to say it will set you back. It’s okay to be miserable and cry sometimes.
Tips for getting through treatment
Dr Goodhart says a number of psychological strategies and other self-help measures may help cancer patients get through their treatment. These include:
Setting short term goals: If you’re on chemotherapy – you’ll usually be on a three week cycle of treatment, advises Dr Goodhart. In week one you’ll have treatment, in week two you might not feel so good and by week three you may feel well enough to schedule in some outings, visits from friends or maybe a weekend away.
Relaxation therapies: Relaxation therapies such as yoga or massage can help you deal with stress and worries connected to your cancer, says Dr Goodhart.
Mindfulness meditation: This is a type of meditation designed to help you focus on being in the moment and not worry about the past or the future, says Dr Goodhart.
Exercise: Exercise can really boost your sense of wellbeing – even if it’s just a walk around the park in the fresh air, it helps you stay connected to the outside world.
Counselling: Sometimes talking to someone completely unconnected with your life can help you deal with your worries, says Dr Goodhart. Often people with cancer will be trying to protect their relatives and won’t open up to them. Psychological support is available in some cancer centre or through charities such as Macmillan Cancer Support and Maggie’s Centres.
Social support: Many patients feel lonely and isolated during treatment and find it helps to talk to friends or family and also others who are experiencing cancer too or who have come out the other side, says Dr Goodhart. Support groups can help.
Coping with uncertainty
There are now two million cancer survivors in the UK and this figure is predicted to double to four million by 2020.
For some patients this is the most difficult time, reflects Dr Goodhart. All the time they were having treatment they felt like they were being looked after, but after it’s over they feel lost and they have to work out how to live with the fear of the cancer coming back.
Many patients can feel isolated, depressed and fearful about their future. This is when counselling can be really useful.
Case study - Keith Hern - I had to reframe things in a positive way
Keith Hern, a 54 year old photographer, was diagnosed with early stage throat cancer in 2004.
When my consultant told me I had throat cancer I was absolutely terrified and imagined myself dying. Over the first few days though, I started coming out the other side and wanted information. I went to see a friend who’d had throat cancer and asked lots of questions, so I could start understanding more of what was coming, and my wife could talk to his wife about the tricky times ahead.
I also went to a life coach/NLP (Neuro-Linguistic Programming) practitioner who helped me to view my cancer treatment as just a small deviation during my life’s plan that I would eventually get back on track.
She also suggested that I view the cancer as two cancerous cells amongst millions of healthy ones. That gave me perspective and it really helped me through. It was all about reframing the cancer in a positive way, so I could remain as positive as possible.
My cancer has returned twice since my first bout of treatment and I now have a tumour in my right lung which is, thankfully, stable – for the moment. My attitude is that I have to make the most of the rest of my life – I’ve done many positive things since my cancer was diagnosed.
I wrote a book Bangers and Mash about my experience of cancer, become a public speaker and got into travel photography. All of these great things might not have happened had I not had cancer. I’ve been packing a lot in.