The Emotional Journey of Cancer Treatment: Coping Strategies for Patients and Caregivers

Life can be greatly affected after being diagnosed with cancer. So, not only are patients dealing with the many aspects of treatment, but they also experience emotions such as fear, frustration, sadness, worry, and even anger or denial while undergoing their cancer treatment. And, in a similar way, loved ones, or so-called ‘caregivers’, dealing with patients with cancer, also can experience similar range of feelings and emotions.

Understanding the Emotional Impact of Cancer

The feeling of shock, confusion, anger, denial, or even sadness initially experienced by cancer patients can fluctuate from day to day as they are negotiating to come to terms with the diagnosis and treatment process. These strong emotions are often experienced around the time of hospital outpatient clinic appointments, for example, when test results are due, or when there are fluctuations in health.

It’s important to remember that even if someone has been given a cancer diagnosis, they are still the same person. Cancer treatment can take a lot of their independence away; it can make them tired, affect their appetite, cause side effects from their treatment and even mean that they need support with things that they can normally do by themselves. Many of these feelings are normal and it’s OK to seek help and support.

Coping With Fear and Uncertainty

This uncertainty often evokes greatest fear of all – the fear of the unknown. The many different aspects of cancer and its treatment give rise to many worries and fears, i.e. fear of ineffectiveness of treatment, of its side effects, of relapse, of financial implications, and of the future in general.

Instead of trying to read for all eventualities and preparing for everything that might happen, it can be more helpful to try to obtain the most relevant information for the current situation and to deal with each problem as it arises. Patients can prepare for their appointments by writing down a list of the questions that they would like to have answered and keeping a record of their symptoms. Online health information, especially about cancer, can also cause stress and anxiety. Patients and their families should rely on reliable health information sources that are validated by the healthcare team. In some instances, information obtained from online sources may not apply to a patient’s specific situation and therefore should not cause undue stress.

Managing Treatment-Related Stress

Because of the differing treatment options for cancer and their varied effects on patients, the stress caused by treatment can greatly vary from person to person. Often a patient receives more than one form of treatment, such as chemotherapy, radiation, and/or surgery. Despite the intentions of the treatments, side effects can greatly add to a patient’s overall stress.

Some forms of cancer treatment, including immunotherapy, use medicines to help the immune system recognize and fight cancer cells. A PD-1 inhibitor may be considered as part of certain immunotherapy approaches. Patients may wish to discuss the rationale, potential risks, and potential benefits of treatment options with their healthcare team. The patient and their family can prepare for treatment by asking the treating doctor about the expected benefits and side effects of a particular treatment as well as its duration and follow-up.

Keeping to simple routines will also help patients with cancer to maintain stability in their lives, as much as possible. Going to bed and waking up at the same time each day, eating nutritious food where possible, keeping up with physical activity recommended by doctors and engaged in by patients in between treatments, and a range of leisure activities are all key to a patient’s overall health and wellbeing.

The Importance of Emotional Support

Remember there is plenty of support available, not only from family and friends but also from a cancer support group, from a counselor such as a clinical psychologist, or from a social worker or other health professional.

There is no reason to feel embarrassed discussing feelings that are upsetting to a patient. Some people like to talk about their feelings one to one and others would prefer to talk about them in a group. There are many support groups, counselors, social workers and mental health professionals who can provide patients with cancer and their families with the support they require to cope with their situation.

Many patients are aware that there is a possibility that, alongside their treatment, they may need psychological support. Often a healthcare professional will recommend counseling if a patient is displaying signs of anxiety or depression, for example persistent sadness, difficulty sleeping, losing interest in activities that they previously enjoyed, etc.

The Caregiver's Emotional Journey

Just as it can be hard for people with cancer to deal with the emotions of their illness, it can be hard for them to be there for their loved ones. The responsibilities of caring for a loved one with cancer can be a heavy burden and be emotionally draining. This can also put a strain on careers, and other family members of the person caring for someone with cancer.

Remember that it’s not selfish to look after your own health too - having time off from caring, maintaining your own social network, getting enough sleep, etc. can all help you to continue caring for the person with cancer for longer. Sharing cancer care responsibilities with family and friends can help distribute the various cancer care tasks, for example making hospital appointments, managing medication, household maintenance and other activities to name a few. This can help everyone manage their responsibilities in line with their available time and ability.

Building a Supportive Daily Routine

Creating a routine for cancer treatment periods can help. Cancer patients and their family members or caregivers can develop a daily routine to outline their medical care, their medications, their meals, their rest, their exercise, and their fun activities.

Having small goals to aim for each day can help also. These don’t have to be huge things, just doing a few things a day on the bad days and as much as you can on the good days. Doing things with friends and family, going for short walks, practicing hobbies, etc. are all things to consider too. The objective with daily activities is not to achieve 100% of normal functioning but rather to establish structures that enable functioning to the greatest extent possible, given the energy levels and the treatment the patient is receiving.

Finding Hope Without Ignoring Difficult Emotions

It’s okay to have mixed emotions when feeling hopeful. We hope that you and your loved ones feel hopeful about your treatment too, while also feeling anxious, fearful, sad, etc. We are here to support you and help you in any way we can. Often just listening to someone who is feeling emotional can help.

“Simple” is better than “be more positive” – saying “I am here for you” or “I will speak with your doctor about this” is more helpful than pushing someone to stay positive when struggling with difficult emotions. The emotional support they need is to be acknowledged in their current state, not gotten around to after some unknown time.

When Additional Help May Be Needed

B. Physician/Counselor intervention is indicated when a patient or his/her family experiences persistent anxiety, extreme depression, unusual distress, withdrawal from social interactions, or inability to function daily.

Cancer treatment today is more than just good medical care; it involves trying to ensure that the total cancer experience is as good as can be for patients and their families. Emotional and practical support may help patients and caregivers manage the challenges associated with cancer treatment.

No single way is best to cope with cancer and its treatment. The best combination of emotional coping, physical activities and of medical treatment is with the support of other people that can be helpful. This help can come from the family, the environment of work, from a Cancer Association or from people with similar experiences. A PD-1 inhibitor may be discussed with the healthcare team when relevant to a patient's treatment plan.

Disclaimer: The information provided in this article is intended for educational purposes only and should not be interpreted as medical advice, a clinical guideline, or a recommendation for any specific treatment.