Emotions


Your coping toolbox

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
  • trying to be strong and "soldiering on"
  • distracting ourselves from unhelpful thoughts and feelings
  • talking things through to try to make sense of what is happening.

How you cope depends on the type of situation you are facing, past experiences, your personality, upbringing and role models. It is important to think about what has worked for you in the past, but accept that after a cancer diagnosis you might need more than your usual ways of coping. There is no best or right way of coping, but having a few strategies may help you feel more in control.

Some coping strategies are less helpful, however. Many people go back and forth between denial and acceptance as they come to terms with a cancer diagnosis. When denial is ongoing, it can become hard to make decisions about treatment, or it could mean you avoid treatment or follow-up appointments. Some people use alcohol and drugs to cope with stressful situations. These may appear to provide relief in the short term, but can cause emotional and physical harm and could affect how well the cancer treatment works.

If you think you might be in denial or starting to rely on alcohol or drugs to cope, it is important to talk to your cancer care team about getting professional support. With the right help, it is possible to learn new ways of coping.

Tools for coping

A coping toolbox is a set of strategies or "tools" you can use to help you cope with a cancer diagnosis and treatment. Each person's toolbox will look different, but it's useful to consider a range of strategies. Some of these are ways to solve particular problems; others aim to enhance your general wellbeing during this stressful time.

Find out what to expect

Information about the diagnosis and treatments can help you make decisions and plan ahead, and may make you feel more secure.

Eat and drink well

Eating healthy food and drinking plenty of water will help your body cope with physical and emotional stress, but this can be challenging when you are feeling unwell. Talk to a dietitian and see Nutrition and Cancer for tips.

Be active

Research has shown that regular physical activity can help with feelings of anger, stress, anxiety and depression. It can also help manage fatigue and improve sleep. Even a short daily walk offers benefits. See Exercise for People Living with Cancer.

Seek support

Share your concerns with a family member or friend, or with your general practitioner (GP), nurse, social worker or psychologist. Other options include calling Cancer Council 13 11 20, visiting the Online Community, or joining a support group. Accepting help with practical tasks such as shopping or housework may also make it easier to cope. See more sources of support.

Take a break

Make time each day just for relaxation and enjoyment. Think about things that help you to relax and feel good, such as listening to music, reading, taking a bath or having a massage. Keeping in touch with the world through work, hobbies, or time with family and friends may help you see a life outside of cancer and provide a break from your worries.

Sort out issues

A cancer diagnosis can cause or add to financial problems, work-related issues, accommodation difficulties, relationship concerns and family stresses. There is support available – talk to the hospital social worker or call Cancer Council 13 11 20.

Draw on spirituality

Some people find meaning and comfort from their faith and spiritual beliefs. Others may experience spirituality more generally. A cancer diagnosis can challenge the beliefs of some people. It may help to talk about your feelings with a spiritual care practitioner or religious leader.

Clear your mind

Complementary therapies, such as relaxation, yoga and counselling, may increase your sense of control, decrease stress and anxiety, and improve mood.

Gathering information

Once diagnosed, there is a lot of information to take in – and wellmeaning family and friends may give you even more. This "information overload" can leave you overwhelmed and confused about what to do. You may only need information that is relevant to your situation right now or a way of dealing with the information you already have.

Look for reliable information

Make sure your information comes from recognised cancer experts and is based on evidence. Cancer Council has information and podcasts about different cancer types, treatments and issues. Some information on the internet is not trustworthy – see a list of reliable websites.

Ask questions

If you are unsure or confused about certain information, it can help to talk to your treatment team. Write down your questions beforehand and put them in order of how important they are right now. You can also call Cancer Council 13 11 20 to discuss your concerns.

Involve other people

Ask people you trust to help gather and make sense of new information. You could also choose a close family member or friend to come to your appointments with you. Let them know if you'd like them to take notes and/or join in the discussion.

Find out about suitable clinical trials

Your doctor or nurse may suggest you take part in a clinical trial. Doctors run clinical trials to test new or modified treatments to see if they are better than current methods. Over the years, trials have led to better outcomes for people with cancer. You can find trials online at australiancancertrials.gov.au.

Get organised

Start a filing system for all your test results, information and records. You also have the option of using My Health Record, an online system provided by the Australian Government.

Keep a diary

You can use a paper diary or smartphone app to keep track of appointments and side effects, and highlight missing information. This will also be a useful record in the future (especially if you are seeing different professionals in different locations).

Update your affairs

Many people with cancer review their superannuation and insurance policies, and update their will and other legal documents. This doesn't mean you have given up hope - everyone needs to do these things at some point and you might feel relieved once they are done.

Find support

There are many ways to connect with other people in a similar situation. Cancer Council runs face-to-face and telephone support groups, or can put you in touch with someone who has had a similar cancer experience. You could also join our online discussion forum. See more about support from Cancer Council.

"The first thing is, I found it useful to read fact-based articles about the cancer I had. The second thing was doing physical activity that needs a high degree of concentration. And the third thing was talking in a peer group. I found those three things very useful in managing fear." - Matt

Making decisions

After a cancer diagnosis, you will probably need to make a number of decisions. These could include which treatments to have, how to involve or care for your family and friends, whether or when to return to work, and what to do about finances.

Know your options

Understanding the disease, the available treatments, possible side effects and any extra costs can help you weigh up the options and make well-informed decisions.

Take your time

Check with your specialist how soon treatment should begin. If it is safe to wait a while, use that time to think about your decisions. Generally, people find it easier to make 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 professionals to clearly explain your treatment options, and the benefits and side effects of each. Social workers can advise you and your carer about non-medical concerns such as financial assistance, how to get extra help at home, and support for relationship or emotional difficulties. You can also call Cancer Council 13 11 20 for information and support.

Write it down

Organising your thoughts on paper is often easier than trying to do it in your head. Start by identifying the purpose of the treatment (is it to cure the cancer, to control it or to be as comfortable as possible?), then list the pros and cons of each treatment option. You could rate how important each point is on a scale of 1–5, considering the short-term and long-term effects on you and others.

Talk it over

Discuss the options with those close to you, such as your partner, family members and close friends. You may feel worried about how your decisions will affect them, so hearing their opinions could put your mind at rest. Sometimes, however, you might prefer to talk to someone neutral, such as a member of your treatment team or one of the health professionals at Cancer Council 13 11 20.

Consider a second opinion

Some people ask for a second opinion from another specialist to confirm or clarify their specialist's recommendations or just for reassurance that they have explored all the options. Specialists are used to people doing this. Your GP or specialist 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 specialist. You might decide you would prefer to be treated by the second specialist.

Use a decision aid

Decision aids are online or printed resources that help you choose between treatment options by answering a series of questions and focusing on what matters most in your own case. There are decision aids for certain cancer-related issues (e.g. whether to have breast reconstruction) - ask your treatment team 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 decisions you could with the information you had at the time. Asking yourself, "Did I make the right decisions?" 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.

Remember it's your decision

Adults have the right to accept or refuse any treatment that they are offered. For example, some people with advanced cancer choose treatment that has significant side effects even if it gives only a small benefit for a short period of time. Others decide to focus their treatment on quality of life. You may want to discuss your decision with the treatment team, GP, family and friends. See Cancer Care and Your Rights.

Using complementary therapies

Complementary therapies, such as relaxation, meditation, counselling and art therapy, are widely used alongside conventional cancer treatments such as surgery, chemotherapy and radiation therapy. Many complementary therapies focus on a mind–body connection. They may offer physical, emotional and spiritual support, help reduce side effects from medical treatment, and improve quality of life.

Relaxation and meditation

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, to clear the mind and calm the emotions
  • 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
  • Body-based practices such as yoga, tai chi and qi gong combine a series of movements with breathing and meditation exercises to improve strength and flexibility while reducing stress and anxiety.

Counselling

Through discussions with a counsellor, social worker 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. It can provide an opportunity to talk about thoughts and feelings that you might not feel comfortable sharing with family and friends.

Art therapy

This technique uses visual art (drawing, painting, collage, sculpture or digital work) to express feelings. It can be done individually or in groups, and some hospitals run programs. You do not need artistic talent to participate or benefit – the focus 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.

Let your doctor know about any complementary or alternative therapies you are using or thinking about trying. Some may not be appropriate and could be harmful with some medical treatments. See Understanding Complementary Therapies, or listen to our meditation and relaxation recordings (available as free CDs or online).

Alternative therapies are therapies used instead of conventional medical treatments. These are unlikely to be scientifically tested and may prevent successful treatment of the cancer. Cancer Council does not recommend the use of alternative therapies as a cancer treatment.

Managing your thoughts

People affected by cancer may find themselves going over and over the same distressing thoughts about the past, present 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. The strategies listed below may be a helpful starting point if you are finding it hard to manage your thoughts.

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 family and friends". Or perhaps you have a tendency to give 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 parking spot, you might think, "Nothing ever goes right for me. I don't know why I'm bothering with the treatment, I know it won't work".

Consider your own advice

Think of someone you love and imagine what you would 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 work out if a thought is based on facts, realistic or helpful.

Recognise the little positives

Some days it might be hard to find something positive. This is understandable, but if you feel like that every day, check whether you are ignoring any little achievements or happy events. Some people make a habit of writing down three good things that have happened to them each day. These don't have to be major life events – they could just be an encouraging smile from a radiographer or a nice chat with a receptionist on a tough day.

Practise letting your thoughts come and go

Thoughts are fleeting. Some we notice and many we don't. Try to let your thoughts come and go without getting caught up in them. Cancer Council's free meditation recording may help you practise this.

Be kind to yourself

Use encouraging thoughts to talk yourself through difficulties, rather than undermining yourself. This does not come naturally to everyone, but counsellors and psychologists can teach you some techniques.

Seek professional help

Social workers, psychologists and other health professionals are trained to help people manage how they're feeling. Check what support is available at your treatment centre, or ask your GP for a referral. See more information.

Some people find online self-help programs or smartphone apps useful for tracking how they're feeling. Visit moodgym.com.au or mindspot.org.au, or see the list of health and wellbeing apps at healthdirect.gov.au.

Improving sleep

Sleep can help your body cope with the physical and emotional demands of cancer treatment. You may find your sleep is affected by worry, pain (e.g. after surgery), nausea, hormonal symptoms (e.g. hot flushes), and some medicines (e.g. steroids). If you aren't as physically active during treatment, your body may not be as tired and you could find it harder to sleep. Feeling sad or depressed can also make it difficult to sleep well at night.

Ways to improve sleep

  • Go to bed and get up at the same time every day
  • Do some physical activity every day, but avoid exercising two hours before going to bed
  • Put screens (mobile phone, tablet, computer or TV) away an hour before bedtime and do something relaxing
  • Have a bath, read, listen to music or drink a glass of warm milk
  • Avoid coffee, tea, chocolate and cola after early afternoon
  • Avoid alcohol before bed. It may seem to help you relax and fall asleep, but it can keep you in the lighter sleep stages and rob you of deep sleep
  • Don't eat big meals late at night as indigestion can interfere with sleep
  • Try not to sleep during the day. If you can't stay awake, limit naps to 30 minutes
  • Use relaxation practices, such as Cancer Council's relaxation for people with cancer recording
  • Before bed, keep your bedroom dark, cool and quiet
  • If you can't sleep, get up and sit on the couch until you feel sleepy again. Avoid turning on bright lights, TV or reading, as these may wake you up more
  • Listen to our Sleep and Cancer podcast.

Expert content reviewers:

Dr Anna Hughes, Liaison Psychiatrist and Psycho-oncologist, Canberra Region Cancer Centre, Canberra Hospital, ACT; Mary Bairstow, Senior Social Worker, Cancer Centre, Fiona Stanley Hospital, WA; Anita Bamert, Psychologist, Cancer Council Queensland, QLD; Kate Barber, 13 11 20 Consultant, Cancer Council Victoria, VIC; Sally Carveth, Assistant Coordinator, Cancer Support Leader Program, Cancer Council NSW; Matt Featherstone, Consumer; Dr Charlotte Tottman, Clinical Psychologist, Allied Consultant Psychologists and Flinders University, SA; Shirley Witko, Senior Social Worker, Comprehensive Cancer Centre, Sir Charles Gairdner Hospital, WA.

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