| Life with cancer | Your Bill of Rights | Learn more about your cancer |
| Living each day | Self-image & relationships | Coping within the family |
| Seeking support | The world outside |
Reviewed by: Dr Raymond Snyder, Director Of Oncology,St Vincent's Hospital; Prof David Clarke, School of Psychology, Psychiatry and Psychological Medicine, Monash University
On this page: Talk it over | Who should you tell? | If the family knows first | Should children be told? | Coping with your feelings | People adjust at different rates | Supporting each other | Getting help and support when you're alone
Discovering that you or someone close to you has cancer can be devastating. Even if you suspect it, actually hearing the word ‘cancer' is shocking. It may be difficult to take it all in. Your thoughts may spin and you may be overwhelmed. You hear the words, but somehow you don't believe it (‘It's not me - they've got the wrong person').
You will probably absorb only the most basic information at first, and even that might need to be repeated. This is normal. People absorb information at different rates, often this is a gradual process beginning when they are ready to accept it.
Death is one of the first things people who are diagnosed with cancer usually think of. Most people become less anxious about this over time, and some people come to feel that the diagnosis has given them a new outlook on life.
You may be tearful and flat for some weeks. You may feel stunned and resentful to see life going on normally around you. It is normal to be afraid of many things, such as the cancer itself, treatment, pain, the effect the cancer has on your family, and even death. You may not be able to think straight. It can be difficult to make decisions about treatment, what you want to tell family and friends or what to do at home and at work.
‘I don't remember the journey home. It was like a film without any soundtrack - a jumbled mass of meaningless images.'
It is important to remember that over half the people who get cancer will be cured and for many others, cancer and its symptoms can be controlled so they can live comfortably for months or years. There is always something that can be done for someone with cancer.
Talking about what you're going through is one of the best things you can do to help yourself. Some people need to think through their feelings, thoughts and emotions before doing this. Talking to people gives you an outlet, and will help you to sort out your emotions.
It can also help you to clarify your situation and to make your own decisions about things like treatment, finances, work, who to tell, and many other things.
Choose someone you feel comfortable with. It may be someone you are close to, like a relative or friend, or it may be someone outside your normal situation, such as your doctor, a nurse, a psychologist or psychiatrist, a support worker or a spiritual or religious adviser. You can telephone the Cancer Council Helpline on 13 11 20 and talk with a cancer nurse - you don't have to give your name if you don't want to. You may also want to join a Cancer Support Group.
Questions many people ask are ‘Should I tell anyone?' or ‘Who should I tell?' Most people with cancer find it is easier to tell others about their diagnosis and their fears and hopes rather than trying to hide them. You should consider telling at least a few close family members or friends.
Telling people you love about your cancer gives them a chance to express their feelings, fears and hopes, and offer you support - this may help both you and them.
People close to you will almost certainly sense that something is wrong and usually find out in the long run. If and when they find out, they may be offended that you did not share your fears and feelings with them or offer them a chance to help you.
Often people can deal with problems more easily if they understand the situation rather than being unsure and unable to be open about things.
People usually find ways to deal with illness and the possibility of death, even when it involves those they love most. Each person needs a different amount of time to adjust.
Not everybody will cope easily or on their own. Some people may find it difficult to talk with you or to be around you. Relatives and friends may need to talk to other people about how to deal with the effect your cancer has on them.
Sometimes family members are the first to know about a person's diagnosis of cancer. It is important to tell the person with cancer about their illness as they will usually learn or guess the truth sooner or later. They may then be angry, hurt, bitter or unable to trust the family or their doctors.
A person with cancer has the right to know about the cancer and to decide what they will do and how they will live. There are exceptions to any generalisation, but most people relate that ‘Mum took the news much better than we thought she would'. For many people, their fears are far worse than the truth of what is actually wrong with them.
A woman who has cancer recalled how things have changed since her mother was diagnosed with cancer in 1930:
‘My relatives never told my mother that she had cancer. Looking back I realise no one fooled her. In not telling her, though, she was deprived of a very valuable outlet for her emotions.'
Family members usually need to share their feelings, fears, anxieties and hopes with each other - this becomes impossible and creates loneliness if you hide the diagnosis from the person with cancer.
Children are able to sense very quickly when something is wrong, even if they are not told. It is impossible to hide that someone in the family is ill. If you pretend that everything is fine when it obviously is not, they may feel confused, hurt and left out and often imagine things to be far worse than they are.
Children, especially when they are young, may feel they are somehow to blame for the illness. They may dwell on ‘terrible' things they have done or said that might have caused it. If you can discuss the cancer with them, you can reassure them that it is not their fault. If they understand what is happening, children usually cope well.
What and how much you should tell children will depend on how old they are and how much they can understand. Children do not usually want many details - a simple explanation about the cancer and its treatment, and maybe how your cancer will affect their day-to-day lives, will usually be enough.
A parent with cancer might want to tell the children directly. For instance:
‘I've been sick a lot lately, haven't l? I have a disease called cancer. The doctors are doing everything they can to make me well. I can't spend as much time with you as I want to. I won't be able to pick you up from school, but Granny will be there. It's going to be hard on all of us, but I still love you very much.'
If you prefer, a close and loving relative or friend might explain things. For instance:
‘Your daddy is sick. The doctors are almost sure they can make him well, but sometimes his treatments make him feel sad or grouchy. It's nothing you kids have done but he just needs you to love him.'
Give children the chance to ask about the cancer and express their feelings about it. People often want to shield their children from pain, but pain they understand is generally easier to cope with than the things they imagine.
People may experience a whole range of emotions after a diagnosis of cancer. These may include shock, fear, anxiety, sadness, uncertainty, anger, guilt, denial and, for some people, depression. You may feel you've lost control of your life. These are all normal reactions.
The emotional effects of cancer may last long after the end of treatment. People often find they continue to feel anxious about minor signs of illness or pain, fearing a recurrence. Regular check-ups may be necessary and these can be difficult times.
Talking to family and friends may be helpful. The hospital social worker will also be able to put you in touch with a counsellor if you need to talk about your feelings. The cancer nurses on the Cancer Council Helpline, 13 11 20, are specially trained to listen and provide you with information and support.
People react differently to cancer, and adjust at different rates. Each person will be ready to talk at different times. No one should feel forced to do so. This may create frustration or tension within the family. Some people need to sort out conflicting emotions before they can express them. Others may want to talk immediately. Sometimes everyone may hold back from talking in case others are not ready to talk.
It is important that the family allows the person who has cancer to decide when they want to talk. Being part of the family doesn't mean you can make people talk about their feelings before they are ready. As part of a family you can show your support by simply being there, and being ready to listen when others want to talk.
If others in the family want to talk about the cancer before you are ready, try to postpone the discussion without rejecting the person. For example:
‘Thanks for your concern, but not yet. I can't talk yet.'
It is not always easy to talk openly with family and friends, particularly during a crisis, however much you need support. In this situation, it might help to look outside the family for emotional support, to friends, the Cancer Council Helpline, or a professional counsellor.
The strongest reason for sharing the diagnosis is that cancer can create loneliness.
There will be times when you feel totally alone. No one needs to cope with cancer alone, as there are people and services available to assist you. You may feel tempted to keep things to yourself rather than admitting that you need help. However, trying to convince others that you don't need help makes the feeling worse. When everyone is under stress, it does not help to shut each other out. As well as sharing anxiety and sorrow, families and friends can share love and joy, and offer each other mutual support. Facing cancer together makes things easier.
Having a serious illness when you feel that you have no close friends or family can be especially hard. It's not unusual for people to find themselves alone sometimes in their lives: marriages break down, people move away or die, family relationships can be poor, and people leave jobs and lose contact with work colleagues. When you are alone and receive a cancer diagnosis, it can be very difficult indeed.
You don't have to tough it out by yourself. You may find that simply getting some help with practical things is all you need: like having your dog walked while you have treatment, getting your lawn mowed or having your groceries or meals delivered. The hospital social worker, your local council or the Cancer Council Helpline can tell you what services are available.
The hospital social worker will also be able to put you in touch with a counsellor if you need to talk about your feelings. Remember also that there are Cancer Support Groups you could join. If you prefer, you can talk with a Cancer Connect volunteer by telephone. If you need to talk about your spiritual reactions to your cancer diagnosis, the pastoral care worker at the hospital could be a useful resource. You should also receive kind support from most religious or spiritual groups near you, although it may take a little time before you find a group that you feel comfortable with.
The Cancer Council Helpline can discuss any of these things with you and link you in with the appropriate resource.
