Coping with feelings when you have advanced cancer
It’s natural to have a mix of emotions when coping with advanced cancer, such as fear or anger.
These feelings can occur at different times, and they may vary in strength and frequency. However, people often find that over time their feelings become easier to cope with.
Many people with advanced cancer feel frightened. You may have times when you feel afraid of the illness itself, the symptoms, or the treatment and its possible side effects. You may worry about the effect it will have on your family. People often worry about the future or about dying.
It’s natural to feel angry if you have advanced cancer. You may feel angry about feeling unwell, going through treatment and having to cope with the side effects. You could also be angry about the impact the cancer has had on your life. It may have affected your ability to work or your relationships. You may feel frustrated that your plans will be disrupted by tests and treatment, and that your long-term plans have suddenly become uncertain. Living with the uncertainty that comes with advanced cancer is likely to be physically and emotionally demanding.
Talking about feelings
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We all express our feelings in different ways. It’s often clear how someone is feeling by their behaviour, what they say and how they say it. Sometimes though, one emotion can disguise another. For example, a person might be frightened but express their fear by being short-tempered and irritable, or angry with those around them. Talking about our feelings can help us understand our behaviour and what’s behind it. This isn’t always easy.
If you can, find someone you can talk to about how you feel, such as a family member or friend. Some people prefer to talk to someone outside their immediate circle of family and friends. Your GP, palliative care nurse or doctors and nurses at the hospital will usually ask how you are. This will give you the opportunity to talk about your feelings and emotions if you want to. You might find this easy if you already know them and feel comfortable with them. If you would prefer to talk to someone else, they may be able to refer you to someone who’s trained to listen, such as a counsellor.
Counsellors are trained to listen and help people deal with difficult situations. They may be able to help you find your own solutions to the problems you’re facing. This can be very helpful, as cancer can affect many aspects of your life. Talking to someone who is supportive and not personally involved in your situation can also help those close to you.
Your GP or hospital doctor may be able to refer you to a counsellor. Or you may prefer to go to someone independent. We can give you information about how to find counselling in your area.
Support and self-help groups
However supportive your family and friends are, you may find it useful to spend some time with people who are going through a similar experience to you. There are many support groups for people with cancer and their relatives. Most have been set up by someone who wanted to meet other people in a similar situation, and others are attached to hospitals. Some hospital cancer units or hospices have day centres or drop-in facilities for outpatients.
Groups offer support and friendship, and it can be reassuring to talk over your worries with someone who has been through something similar. It can also be helpful to meet people who have lived with their cancer for a long time and who enjoy life.
Not everyone feels comfortable in a group, and it’s important to do what’s right for you. You know yourself better than anyone else.
Enter your postcode and select 'support groups' to see where you can find support near you.
Many people now get support on the internet. There are online support groups, social networking sites, forums, chat rooms and blogs for people affected by cancer. You can use these to share your experiences, ask questions, and get and give advice.
Our Online Community is open 24 hours a day to help you find support, whatever the time of day or night. You can share your experiences with people who know what you're going through. Join us at www.community.macmillan.org.uk
Spiritual and religious issues
Some people find they become more aware of religious or spiritual feelings when they’re told their cancer has come back or spread. People with a religious faith are often greatly supported by it during their illness.
Even if you haven’t attended religious services regularly in the past or aren’t sure what you believe, you can still talk to a priest, rabbi, imam or other religious leader. They are used to dealing with uncertainty and won’t be shocked. They’re not there to preach to you, but to comfort you and help you find peace of mind. If you’re in hospital, you can ask for a visit from a hospital chaplain or other religious or spiritual leader.
Some people with advanced cancer find themselves questioning their faith. If you’re in this situation, talking to a spiritual leader may help.
Medicines that can help
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Emotional distress can be reduced with the support of family, friends, support groups, counselling or some of the self-help techniques described in this section.
However, sometimes feelings of anxiety and depression start to affect your ability to deal with everything that’s happening to you. In this case, your GP or hospital specialist may be able to prescribe antidepressants, anxiety-reducing drugs or sleeping pills. These can help you cope with your situation.
Our section on emotional effects outlines the feelings and emotions you may be experiencing and suggests ways of dealing with them.
Things you can do for yourself
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Some people find that keeping a diary or journal helps them express their thoughts and feelings.
Many people use complementary therapies to help them cope with symptoms, stress or anxiety. These therapies include meditation, visualisation, relaxation, aromatherapy or a combination of these techniques. You can learn complementary therapies from CDs or podcasts, or there may be local classes you can go to. Your GP or practice nurse may know more about what’s available in your area.
Mindfulness is an approach that can help you change the way you think about different experiences, to reduce stress and anxiety. It helps you focus on the present moment using techniques like meditation, breathing and yoga. You are encouraged to become aware of your thoughts and feelings, without making judgements about them.
A specific technique is mindfulness-based cognitive therapy (MBCT). It uses the meditation, yoga and breathing techniques of mindfulness along with some cognitive behavioural therapy (CBT) techniques to help you change your thought patterns. Cognitive (thinking) therapy focuses on the ‘here and now’ difficulties and looks for ways to change your current state of mind. This helps your thoughts become more positive.
There are a few centres in the UK that offer MBCT classes on the NHS.
Some studies on women with breast cancer have shown that MBCT can reduce stress and improve quality of life. Other techniques to help address worries about cancer coming back are currently being researched.