Most of us have various ways of coping with difficult situations, which we have learned over time.
These could include:
- seeking more information
- trying to fix the problem
- having a laugh to feel better
- distracting ourselves from unhelpful thoughts and feelings
- talking things through to try and make sense of what is happening.
How you cope depends on the type of situation you are facing, your personality, upbringing, role models and what has worked in the past. You might find after a cancer diagnosis that you need more than your usual ways of coping. There is no best or right way of coping, but having a few different strategies may help you feel a greater sense of control and confidence.
Some coping strategies reduce stress and anxiety temporarily, but don’t reduce it in the long run and can cause other problems. Denial, drugs and alcohol are some examples of less effective coping strategies.
Building coping skills
A coping toolbox is a set of strategies or ‘tools’ you can use to help you cope. Each person’s toolbox will look different, but this section includes a variety of techniques that may help. It’s useful to consider several strategies or tools for coping with a cancer diagnosis and treatment.
Once diagnosed, there is a lot of information to take in – and well-meaning family and friends may give you even more. Too much information may leave you confused about what to do. Instead, you may need information relevant to your situation or a way of dealing with the information you already have.
Start a filing system for all your test results, information and records.
Keep a diary
This may help you to keep track of appointments and side effects, and highlight where information may be missing. This will also be a useful, accurate record in the future (especially if you are seeing different professionals in different locations).
Take time to work out what you need to know
It may help to write down your questions and to put them in order of how important they are right now. For example, you may know what treatments are available to you, but you may not know the specific pros and cons of each treatment for your situation.
Involve other people
Ask people you trust to help gather and make sense of new information.
Find out about suitable clinical trials
Research shows that people who take part in clinical trials often have better outcomes than people treated outside of a clinical trial. They help test new or modified treatments to see if they are effective. You can find trials online at australiancancertrials.gov.au.
Consider different sources of information
Look at websites, books and different organisations. Take care with cancer information from the internet as some of it is unregulated and of poor quality.
If you are unsure or confused about certain information, it can help to talk to your doctor. Write down your questions beforehand so you remember what to ask when you see your health care team. You can also call Cancer Council 13 11 20 Information and Support service with your questions.
Take a close family member or friend to consultations
They can take notes to help you remember the details. If you are comfortable with it, they can also ask questions.
Update your affairs
Many people with cancer review their insurance policies and update their will. This doesn’t mean you have given up or that your prognosis is poor. Everyone needs to do these things at some point.
Some people join a support group as it gives them the opportunity to talk to other people in a similar situation. If you think a support group is not for you, there are other ways to connect with people.
"My family members don’t really understand what it’s like to have cancer thrown at you, but in my support group, I don’t feel like I have to explain." - Sam
Looking after yourself
Cancer can cause physical and emotional strain. Some days you may feel better than others. Looking after yourself can enhance your wellbeing and reduce stress during this time.
Eating well gives your body better fuel to help it cope with the stress of illness and treatment. See Nutrition and Cancer.
Physical activity can lift mood, lower blood pressure, improve sleep and reduce stress. It is also an important way to manage fatigue – helping you to feel more energetic and less tired. Even a short daily walk can help. See Exercise for People Living with Cancer for useful suggestions.
Make time for yourself
Even though life may be very busy, it is important to make time each day just for relaxation and enjoyment. Think about things you do (or have done in the past) that help you to relax and feel good.
Sort out issues
A cancer diagnosis may happen in the context of other life stresses such as financial problems, work-related issues, relationship concerns and family stresses. Dealing with other sources of stress in your life may help you cope better with the additional burden of cancer treatment.
Keeping in touch with the world through work, hobbies, or time spent with family and friends may help you see a life outside of cancer and provide a break from your worries.
Tap into spiritual beliefs
Some people find meaning and comfort from their faith and spiritual practices. Others may experience spirituality more generally. A cancer diagnosis may challenge the beliefs of some people, and it may help to talk to a spiritual leader or pastoral care worker about your feelings.
Recognise signs of stress and anxiety
In times of stress, your body releases adrenaline, your heart beats faster, your blood pressure goes up, your breathing is shallow and fast, your hands get sweaty, and your mouth gets dry. These natural responses help people deal with a crisis. For most people, these feelings settle, but for others they are ongoing. See ways to reduce stress and lower anxiety levels below.
Does thinking positively help?
A common belief is that the most important thing in coping with cancer is staying positive.
While it can help to be hopeful, this doesn’t mean denying the reality that cancer is serious or frightening. Trying to put on a brave face all the time drains energy, and generally doesn’t work well because the negative thoughts just keep coming back. Pressure to be positive all the time can lead to people being afraid to discuss fears and feelings, which can make problems worse.
Try to be realistic about what is happening and talk to someone about your fears and concerns so you can better deal with them. Explaining how you feel to those around you may also help you get the support you need.
Using complementary therapies
Complementary therapies are widely used by people with cancer in Australia. They are generally used alongside conventional cancer treatments such as surgery, chemotherapy and radiotherapy. They may offer physical, emotional and spiritual support, reduce side effects from medical treatment, and improve quality of life.
Complementary therapies are different to alternative therapies. Alternative therapies are used in place of conventional cancer treatments, but many alternative therapies have not been shown to be effective treatments for cancer.
Many complementary therapies focus on a mind–body connection. These techniques are based on the belief that thoughts and feeling can affect physical and mental wellbeing. When your emotions or mental state are under pressure, your physical body can be affected. Similarly, physical symptoms can have a negative impact on your mood and mental wellbeing. Below are examples of some types of mind–body complementary therapies.
Relaxation and meditation
Both of these therapies can help reduce stress, anxiety and fatigue, and improve quality of life.
- Relaxation usually includes slow breathing and muscle-loosening exercises to physically and mentally calm the body.
- Meditation involves focusing on a single thing, such as breathing.
- Mindfulness meditation helps you to take things one day at a time. It allows you to focus more easily on the present, rather than worrying about the past or fearing the future.
Through discussions with a counsellor or psychologist, you can identify problems and explore ways of resolving unhelpful thoughts and feelings that affect your health and day-to-day life. Counselling allows you to express your emotions in a safe and supportive environment, and to learn new coping skills.
This technique uses visual art (drawing, painting, collage, sculpture or digital work) to express feelings. It can be done individually or in groups – some hospitals run programs. You do not need artistic talent to participate or benefit – the emphasis is on the process of producing artwork, not the end result. An art therapist helps you explore the images you have created to encourage understanding of your emotions and concerns.
"The most significant change that occurred for me from art therapy was finding a way to express difficult feelings. Art therapy helped me find a way to share my experience. It was very positive." - Ray
Let your doctor know about any complementary or alternative therapies you are using or thinking about trying. Some may not be appropriate and may be harmful if you are having some types of medical treatment. Some alternative therapies may even cause harm.
See Understanding Complementary Therapies or order a free copy of our meditation CD and relaxation CD.
Dealing with unhelpful thoughts
People affected by cancer may find themselves going over and over the same distressing thoughts about the past or future. Ignoring such thoughts or trying to distract yourself may work at first, but they often return once you are no longer distracted – for example, during the night or early in the morning.
Identify where the thoughts come from
Ask yourself if your thoughts are the result of an underlying belief, such as ‘The world should be a fair and just place’, ‘If I can’t do everything I used to do, I am useless’ or ‘I am a burden to my loved ones’. Or perhaps you have a tendency to attribute personal meaning to everything that is happening, even to events that are beyond your control. For example, if you arrive at the treatment centre and can’t find a carpark you think, ‘Nothing ever goes right for me. I don’t know why I’m bothering with the treatment, I know it won’t work’.
Imagine what you would say to others
Think of someone you love and imagine what you might say to them if they felt the same way.
Check your thoughts
Ask yourself if you are jumping to conclusions or exaggerating the negatives. If so, is there something you can do to change the situation or improve it?
Write down your thoughts
This helps slow down your thinking and makes it easier to focus. It may also help you determine if a thought is based on facts, realistic or helpful.
Acknowledge life events
Check if you are focusing on the difficult things and ignoring the little achievements or happy events that may also be occurring. Sometimes we notice the bad things that happen and don’t notice the good. Writing down three good things that have happened to you each day may help. They don’t have to be major events – just the everyday things that often go unrecognised.
Practise letting your thoughts come and go
Thoughts are fleeting. Some we notice and many we don’t. Practise letting your thoughts come and go without getting caught up in them. Our free Mindful Meditation CD may help you practise this.
For thoughts to be helpful, they need to be balanced and believable. Use encouraging thoughts to talk yourself through difficulties, rather than undermining yourself. Learn to be kind to yourself. Counsellors can teach you these techniques.
There are a range of professionals who help people manage how they’re feeling. See below for a list. Check if one of these is available at your treatment centre, or ask your GP for a referral. Medicare provides rebates for mental health services provided by a psychologist – talk to your GP about this.
Believing that it is possible to do something, even in the worst situations, is the first step in tackling any problem.
Types of health professionals you may see
Mental health nurse
A registered nurse who has completed further study in mental health nursing. Role includes assessing people, giving medicines and assisting in behaviour modification programs.
A counsellor’s education may range from a vocational certificate in counselling through to university-level studies in psychology or social work. There is no qualification standard they have to meet. Counsellors listen to what’s going on and offer strategies for dealing with issues.
A social worker must complete a four-year undergraduate or two-year masters degree. They provide emotional support, offer practical and financial assistance and help people find support services.
A registered psychologist must complete four years of psychology at undergraduate level, followed by either postgraduate studies in psychology or two years of supervised clinical practice. Psychologists who specialise in counselling use their understanding of the mind to guide clients through issues with how they think, feel and learn. They often develop expertise in particular approaches.
A psychiatrist is a trained medical doctor who specialises in the diagnosis, treatment and prevention of mental illness. As well as discussing issues with patients, a psychiatrist may prescribe medicines to help manage a range of emotional conditions You need a referral from your GP to see a psychiatrist.
Tool to help measure distress
Distress is an unpleasant emotional state that may affect how you feel, think and act. It can include feelings of unease, sadness, worry, anger, helplessness and guilt. While everyone with cancer experiences distress at some point, it can be difficult to know if how you are feeling is a typical reaction or something more serious.
The National Comprehensive Cancer Network has developed a tool called the Distress Thermometer that you can use to measure how you are feeling. It asks you to rate the level of distress you have been experiencing in the past week, including today. The scale ranges from ‘no distress’ (0) to ‘extreme distress’ (10). If you have a distress level of 4 or more on the thermometer you may benefit from professional support.
The thermometer also includes a list of specific problems people diagnosed with cancer may experience and asks you to check or mark any that have been a problem for you in the past week, including today.
Use the Distress Thermometer below to rate how you’re feeling and answer the simple questions. It should take only a minute to complete.
Talk to your health professional about the Distress Thermometer. Your responses to the problem list help health professionals to identify issues that are of concern to you and offer suitable support services. You may want to show the completed thermometer and questions to your doctor.
After a cancer diagnosis, you will probably need to make several decisions. These could include the choice of treatment, how to involve or care for your family and friends, whether or when to return to work, and what to do about finances.
Take your time
Even with a cancer diagnosis, there is often time to consider your treatment choices. Generally, people make better decisions – and have fewer regrets later – if they take time to gather information and think about the possible consequences.
Get expert advice
Ask your health care professionals to explain your treatment options and the benefits and side effects of each. Social workers can give you details about financial assistance and support services.
Write it down
Organising your thoughts on paper can be easier than trying to do it in your head. Write down the aims of the treatments available to you, and the pros and cons of each option. Identify the purpose of the treatment – to cure the cancer, control it or to be as comfortable as possible. Think about what treatments will help to achieve the aim you want. You could rate how important each point is on a scale of 1–5, with five being very important and one being least important. To determine the importance of a point, look at the short-term and long-term effects on you and others.
Talk it over
Discuss the options with those close to you, like your partner or a close friend. As most decisions will affect others in your life, it’s also important to consider their opinions.
Use a decision aid
Decision aids are available for some particular issues, for example, whether to have breast reconstruction. A decision aid is designed to help you make choices about different treatment options by focusing on what matters most in your own case. You could ask your doctor or cancer care coordinator if a decision aid is available for your situation.
Expect to experience doubts
Being unsure does not mean you have taken the wrong path. Reassure yourself that you made the best decision you could with the information you had at the time. Asking yourself, ‘Did I make the right decision?’ is rarely useful. Also, decisions are not always final – it may be possible to change your mind even after you have already started down a particular treatment path.
Get a second opinion
Asking another specialist what they think can be a valuable part of your decision-making process.
It can confirm or clarify your doctor’s recommendations or reassure you that you have explored all of your options. Specialists are used to people doing this. Your doctor can refer you to another specialist and send your initial results to that person. You can get a second opinion even if you have started treatment or still want to be treated by your first doctor. Alternatively, you may decide you would prefer to be treated by the doctor who provided the second opinion.
Expert content reviewers:
Prof Jane Turner, Psychiatrist, Faculty of Medicine and Biomedical Sciences, The University of Queensland, QLD; Andreea Ardeleanu, Social Worker, Cancer Counselling Service, Phillip Community Health Centre, ACT; Dr Lisa Beatty, Research Fellow, School of Psychology, Flinders University, SA; Joshua Chalmers, Consumer; Valmai Goodwin, Psychologist, Cancer Council Queensland, QLD; Karen Hall, Clinical Nurse, Cancer Services Division, Flinders Medical Centre, and Nurse Health Counsellor, Cancer Council SA, SA; and Judith McGrath, Consumer.