«I have a cancer! How to live?» Tips from a psychologist with cancer

When you hear the diagnosis «cancer» for the first time, it is difficult to see the future and accept the situation. Candidate of psychological sciences and onco- and crisis psychologist Svitlana Lukomska shared professional tips and her own experience in the fight against cancer with the editorship of the magazine MEDplus.

Then direct speech:

Lukomska Svitlana

Psychologist

• Candidate of Psychological Sciences
• Oncology and crisis psychologist

I have had cancer for 10 years. I found out about it accidentally. My friend went to the ultrasound after childbirth and took me with her. I was diagnosed with a small tumour there, which did not bother me in any way.

I am 31 years old. All life is ahead. I recently defended my dissertation thesis. And I have cancer? This cannot be! In particular, none of the family members experienced breast cancer.

It happened on October 10, and in December I was scheduled for a Christmas tour of Europe. I didn’t want to put it off because of cancer. So I lost two months—that is, two months I denied even the likelihood of the disease. A great role in the diagnosis was played by my older friend, whose family had already had life experience with oncology. It was from him that I first heard that cancer is a way of life, not a constant war or struggle.

In fact, the struggle is exhausting; it is usually not designed for a long time. It seems that you will do chemotherapy, they will cut out the tumour, and everything will be as before, but cancer becomes a constant companion. He breathes into your back and intermittently moves away from you, but he can come back. Therefore, it is worth learning to live with a diagnosis, if necessary — to undergo treatment, visit preventive examinations, and try to live a full, productive life.

How should doctors properly inform a patient about the detection of cancer so as not to psychologically traumatise them?

The population’s access to cancer care has been impacted by the war; there aren’t enough medical professionals, and there isn’t enough time for patients to receive psychosocial counselling. No one can give guarantees to the oncological patient about complete recovery. His entire future life is marked by uncertainty. One loses perspective on life and the meaning of existence when they are unable to regulate their condition. Loneliness is intertwined with social isolation: people around often do not know how to behave, although they are ready to help the patient. At the same time, the patient himself sometimes does not want to accept the help offered to him because he is immersed in his concerns.

Doctors typically employ the SPIKES technique when informing a “cancer” diagnosis to a patient. The procedure for terrible news is as follows:

• S – setting — preparation, beginning of conversation: what the doctor wants to tell the patient and what the patient wants to know about his diagnosis
• P – perception — awareness, the first minutes of a person’s “coexistence” with his diagnosis, his emotions, thoughts, and behaviour
• I – invitation — invite: outline further prospects of treatment and clarify the understanding of received information
• K – knowledge: it is important to voice information in a language understandable to the person, step by step, between messages to hold off breaks;
• E – empathy — emotions: evaluation of emotions and active listening
• S – strategy — planning the next steps.

Where can patients find the strength to fight on a psychological level?

First of all, I will give you advice on what questions you should ask doctors to understand your own actual condition better.

1. What type of cancer do I have? How much of my body is affected by cancer? Exist metastases, if so?
2. What tests should I undergo right now? What are the most important and/or suitable for me in terms of price?
3. What are the chances of recovery?
4. What negative effects are there from cancer treatment?
5. What must I do if I experience new symptoms or if old ones worsen?
6. What diagnostic procedures or tests will I require? How frequently?
7. Where should I go if I need to get tested or undergo procedures? How do I get ready for them?
8. What clinical research opportunities are there for me? Where are they located? How can I find out more about them?

I adhere to the view that cancer is not psychosomatic. And therefore, accusations by other people, such as “I am guilty of everything”, should be categorically rejected. The most crucial thing is to avoid blaming oneself for the sickness; there are numerous causes of cancer. Lack of guilt, cooperation with doctors, sincere conversations with relatives and friends—this is a guarantee of psychological well-being, which really positively affects the quality of life with the diagnosis. People with oncology should not feel socially isolated.

What are your top recommendations for people who found out about the «cancer» diagnosis?

• Consider bringing a family member or friend to your first appointment with a new doctor. Also, be honest with yourself about how much information regarding your diagnosis you want to know. Some people need all the facts and details, so they can be very involved in the decision-making process regarding treatment and rehabilitation. Others prefer to know the basics and leave the details and decisions to their doctors and/or relatives. Choose the strategy that works best for you.
• Write down your questions before your appointment with a doctor. It can reduce the level of stress and help you find out more about your situation.
• Bring a notebook or recorder to the appointment. Write the answers down or make an audio recording during the appointment.
• You can also ask a family member or a friend to record the answers for you. It gives you the opportunity to read or listen to the information later and spend the time needed for information processing.
• Tell your doctor if you have problems understanding an explanation or certain medical words. Sometimes they can draw a picture or give an example that will help you understand your condition.
• Ask your doctor where you can find additional information about your illness.
• Discuss the information you found on the internet or in books and magazines with the doctor. Not all information is accurate and reliable.

Decisions regarding treatment are individual, and you should feel comfortable with your choice:

1. Try to create a plan.
2. Respect people who help you. Cancer treatment is similar to work that cannot be completed solely by conflict. You should look for chances to comprehend and consider the unique cultural aspects of the area or nation you travelled to for treatment.
3. Find out all your treatment options. Take into account all therapies and therapeutic research that is accessible, and find out whether or not displaced people or refugees can obtain it.
4. Save part of your life “without cancer” and “before the war”. This does not mean that you are denying that you still have cancer or that there is war in your country. Having a safe space in the form of old hobbies, music, and habits is an important resource for your survival.
5. Practise gratitude. Try to answer the following questions: “Are there things in your life that bring you joy and make you happy? Where and when were you fearless, or did you do something in spite of your own fears? Whom did you help?” Who and how did you help?” Express gratitude for each person, opportunity, experience, and material goods.
6. Respect and pride in yourself. Give up all expectations. We all have a lot of expectations from the world around us. From early childhood, parents, teachers, coaches, and others tell us how we should behave, who we should be friends with, what a successful job looks like, and what a good life looks like. Let them go. It’s time to be yourself and enjoy the moment.
7. Develop your own self-help strategy. Since each person’s cancer treatment is unique, the strategy of self-help is significantly different for people with different courses of disease or who are in different conditions of combat.
   • Practise relaxation.
   • Share your feelings with family and friends.
   • To order your thoughts, keep a diary.
   • When faced with a tough choice, list the pros and cons of each choice.
   • Look for a spiritual resource to help you.
   • Spend some time alone.
   • Try to stay active.
8. I recommend joining the Facebook community «Афіна. Жінки проти раку – група взаємодопомоги онкопацієнтів». This is not only a community of cancer patients who support one another, but it is also a very potent informational tool that will be helpful to cancer patients and their loved ones. Take care of yourself!