A loved one has cancer! What to do? Advice from oncopsychologist

According to the Ministry of Health, beyond 1 million Ukrainians are fighting cancer, while more than 160,000 new cases of oncological diseases are detected in Ukraine every year. This means that each of us has at least one person around who is being treated for cancer.

Passing this can be difficult, not only for the patient but also for his relatives. How to properly communicate with a loved one who has cancer? How should the relatives of a cancer patient behave in order not to burn out themselves and find strength for support? The editors of MEDplus found answers to these questions together with oncopsychologist Victoria Kostecka.

Kostecka Victoria

Oncopsychologist

• Consultant of the program for cancer patients
• CBT consultant
• Member of IPOS — International Psycho-oncological Community
• Co-founder of UPOA — Ukrainian Psycho-oncological Association

How to react when you find out about a cancer diagnosis in a relative?

Unfortunately, this can happen in any family. Most likely, the first thing you will feel is shock, intense anxiety, and fear. Almost the same feelings that your loved one will feel. The shock reaction can last from several hours to several days.

What should you do?

If you are nearby, focus on your loved one. Ask simple questions (like “Can I get you some water?” or “Do you want to sit here a little longer?”) to track the reaction to the news, offer water, a handkerchief, etc. It is important to firmly say that you will go through this together, no matter how difficult it may be.

If you are not with a loved one right now, allow yourself to feel any emotions, cry, and talk to someone you trust. Give yourself a few days to realize, and then turn on your rational part and critical thinking. Connect acquaintances and colleagues. Put together a plan and start taking action.

Remember that there is no need to rush to start treatment without an accurate diagnosis!

According to the protocols, the time between the first examinations and the start of treatment can be up to 4 weeks. It is crucial to get several opinions from different specialists, especially if the case is complex.

It is worth asking the patient to choose the right moment and tell other relatives, friends, acquaintances, and colleagues about the diagnosis. Be prepared for ambiguous reactions: someone will disappear from your life, someone will cry or feel sorry for you, and someone will offer to treat you with alternative methods. However, in most cases, the family will receive real sympathy and a desire to support and help, and this will be very useful. From those people who will stay around, you can form a “support team”.

It is possible and even necessary to treat it as a job, with a certain regime, frequency, and plans. This switches the focus of vision from suffering to action, reduces excessive tragedy, and makes you think critically, calculate various options, and plan actions.

Encourage your loved one to keep a journal and record all information related to treatment, well-being, side effects, necessary contacts, daily routine, diet, medication, exercise, as well as water intake, rest, preferences, and entertainment. This will help to deal with uncertainty, focus on details, and help the doctor in his work.

Create folders and collect all doctor’s appointments, test and examination results, statements, and bills. Moreover, positive examples of people living with a diagnosis of “cancer” will help a lot. Find and offer online cancer support groups and cancer communities.

What definitely should not be said to a person with an oncological disease?

No one is an expert in the life of a cancer patient or in your life except yourself. Only you can know (or guess) how mom will react to the offer of help or involving another doctor.

Ambiguous phrases include “God does not give a person more than he can bear” and “All diseases are from nerves/offense. Just stop being nervous/offended”, “You don’t look sick”, etc.

The main rule: to get feedback from a person. Ask exactly what they want. Assess your strengths and offer only the help that you really can and intend to provide. Respect the wishes and choices of your loved one!

How to find the “golden mean” between caring and annoying?

A significant issue is the organization of a supportive environment without “disabling” the patient. It is not necessary to exclude the patient from the usual tasks that he can and wants to perform. It is important for a person to have significance and control over his life. A person who receives a diagnosis does not cease to be a person with his or her aspirations and beliefs. They are entitled to decide what to do with their life. You should not often ask about well-being, it looks like distrust of words or feelings. Relatives suppress their own anxiety in this way. It doesn’t help! Yes, family members may feel a lot of anxiety and fear, but this needs to be worked through with a psychologist or psychotherapist.

How to understand that a relative who is being treated for cancer has depression?

An accurate diagnosis of depression is established by a psychiatrist or psychotherapist. Unfortunately, cancer patients are quite often given such a diagnosis. This is due not only to multicomponent stress, but also to the treatment itself. There are side effects of several drugs. Treatment of depression in cancer patients is important not only because it significantly improves the quality of life, but also because successful treatment increases patient survival.

How can relatives notice depression?

If they have these symptoms for more than 2 weeks:

• Feeling sad or depressed
• Loss of interest or pleasure in activities you used to enjoy
• Changes in appetite
• Sleep problems
• Feelings of worthlessness or guilt
• Difficulty thinking, concentrating, or making decisions
• Thoughts of death or suicide

You can frankly talk to the cancer patient about the fact that there is help for this condition. It is medical support and works with an oncopsychologist. Your help can be in finding a psychiatrist who works specifically with cancer patients, this is critical for the correct combination of drugs with the main treatment. Relatives of cancer patients may also need psychological support because they are also at risk due to burnout.

How to help the patient on the way to recovery and remain in the resource?

The ability to negotiate is of great importance. It is worth talking honestly and frankly about the state of health currently, about the real capabilities of a person. Occasionally, it is difficult because, due to stress, cancer patients often close in on themselves and cannot clearly talk about their own needs. They can get annoyed or even aggressive, so it is better to immediately offer your specific help: “Let me check the children’s lessons (make lunch, go to the store).”

It is worth directly discussing and drawing up a new list of household duties for everyone. Do not deprive the patient of work completely, so he may lose a sense of significance. Moreover, due to a large amount of free time, the cancer patient can start to listen more to his body, which in turn can increase anxiety or even lead to depression.

If your elderly relative is ill, try to leave some routine for him. Let mom water the flowers on the windowsill instead of in the garden, and let dad rearrange the books in the library, as before, although it now takes much more time.

Each family member must find time for himself, for rest, pleasant activities, and communication. This will preserve and restore the physical and emotional resources of all family members, as well as help maintain vitality on the long road to recovery. It does sound trite, but “First put the oxygen mask on yourself, then on the weaker (child/patient)”. Take care of yourself, and then you can help your loved ones!