We all like to know what’s going to happen to us. It helps us feel secure about our future. Having this feeling of certainty is a basic human need. We all like to feel in control, but people with cancer often feel that this has been taken away from them. Their future may feel uncertain and they may not know what is going to happen to them. They may even talk about feeling out of control because they’re going through an unpleasant situation.

You can help your relative or friend by simply acknowledging how difficult it must be to face this uncertainty. You could also help them by looking at some of the things they can still control. These may be small things, such as when to go out for a walk, what to have for a meal or what to watch on TV. Or it may be a big decision, such as whether to have chemotherapy or to ask for a second opinion about treatment.

Although many people with cancer can be cured, your loved one may have a fear of dying. This fear may always be there in the background but never talked about.

Even when people are cured, they often still worry that the cancer may come back. This fear may fade over time. But it’s important to allow your loved one a chance to talk about it. By simply listening, you can be a support to them.

Tiredness

Tiredness is very common in people with cancer, especially during treatment. It can be constant or it may vary depending on what treatment someone is having. Tiredness can mean someone feels low in mood or more irritable than usual. It can also affect a person's concentration and memory.

Eating problems

Cancer treatment can sometimes cause people to:

• feel or be sick
• have a change in appetite
• have changes to their sense of taste, making some foods taste unpleasant or all foods taste the same.

Cancer treatment can cause changes in appearance. These may be temporary or permanent.

Possible changes include:

• hair loss
• putting on weight or losing weight
• scars from surgery
• skin changes, such as rashes, dry skin, spots or redness.

Changes in our appearance can make us feel vulnerable and self-conscious. Your relative or friend may worry about other people’s reactions to how they look, or the effect it may have on their relationships.

Most people need time to get used to body changes. Support from family and friends can help. Remember, they are the same person you have always known. If they want to, let them talk to you about their feelings.

We have more information about coping with changes in body image.

During cancer treatment, many people stop doing the things that they used to enjoy or do well. They may have stopped work, or stopped doing activities that involved contact with other people. These activities can reassure us that we are competent, needed, talented or funny. They remind us that other people value our skills, knowledge and humour.

Participating in these activities can also give us a sense of self-worth. This is also known as self-esteem. Having positive self-esteem is about having confidence and respect for yourself. Not being able to take part in these activities can affect a person's self-worth and how they think about themselves.

Remember that in spite of all the losses and changes that your relative or friend may have to cope with, they are still the same person inside. Their skills and qualities are still there, even if they don’t have the same chances to use all of them as much at the moment.

It might be helpful to think together about what they still want to do and are able to do, even if it’s a small thing. Whatever they decide, it’s important to support them.

Feeling isolated

Some people can feel isolated from their friends and workmates. If family and friends feel awkward about what to say, they may not visit or get in touch. You can help by keeping in regular contact and being a good listener. You can encourage other people to do the same.

Depending on others

Many people find it difficult thinking of themselves as someone who has cancer. They worry that because they need other people more than normal, they are being weak. But we all depend on each other throughout life, however much we may like to think of ourselves as independent.