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Counseling

Coping, Counseling and Cancer
The Holmes and Rahe Stress Scale ranks personal illness or injury as the sixth most stressful life event experienced by adults. Clearly, a cancer diagnosis is very stressful, often resulting in increased levels of anxiety, sadness and fear. Learning to cope with these challenging emotions can promote healing on many levels: mental, physical and spiritual. According to the National Cancer Institute, emotional and social support can help patients learn to cope with the stress of cancer. Studies suggest that psychological support can reduce levels of depression, anxiety, and disease/treatment-related symptoms among patients. The following approaches have been beneficial to many cancer patients during and after treatment:

• Instruction and practice in relaxation, meditation, or stress management:
• Counseling or talk therapy
• Cancer education sessions
• Social support in a group setting (i.e., Women LISTEN Friday Group)
• Medications for depression or anxiety
• Exercise and physical therapy

Living with and surviving cancer can present enormous challenges for patients and their family members. In cases of intense and long lasting stress, anxiety or depression, seeking professional psychological support is very important. This is particularly true if the overwhelming feelings interfere with one’s ability to carry out daily activities. Also, individual counseling may be helpful even if a person’s distress level is less severe. Just a few counseling sessions are likely to be helpful in decreasing distress and helping establish a new normal. Counseling can help restore hope, motivation and positive feelings by:

• Increasing ability to cope with the diagnosis
• Decreasing sense of feeling overwhelmed by feeling more in control
• Enhancing self-advocacy/communication skills for dealing with the medical team
• Managing difficult feelings, such as depression and anxiety
• Learning techniques to manage symptoms and treatment side effects
• Addressing relationship, financial and work-related issues
• Exploring and resolving cancer-related sexuality issues
• Talking about end-of-treatment questions and concerns
• Learning how to help your family understand and adjust to life changes as a result of a cancer diagnosis

A variety of mental health professionals offer counseling, so it is important to think about the type of service that would be helpful for each situation. Psychologists, clinical social workers, marriage and family therapists, clinical nurse specialists, psychiatrists, licensed professional counselors and licensed pastoral counselors are the most common professionals who offer services. Health care providers and other people who have experienced a cancer diagnosis can be good sources for seeking referrals to community providers.

Taking Care of Yourself

During our first few support group meetings, one of our founders, Jan Porterfield, used to ask, If not now, when? What a perfect question to pose about self-care. As women, we are often the givers rather than the receivers of care; and, when a woman is diagnosed with cancer, she may have difficulty adjusting to the shift from taking care of others, to being cared for. However, receiving care is paramount to healing, and self-care is essential for long-term health and recovery.

There is no single right way to heal, to feel better, to cope with a cancer diagnosis to seek treatment and to recover. Therefore, it is important to intentionally think about which ways of healing and feeling better are the best fit. Here are some suggestions for designing a Healing and Recovery Plan:

Diagnosis and Planning

• If options are available to you, find health care providers you trust. Find a new provider if you feel you cannot trust and work with your doctor.
• Get a second-opinion if you have unanswered questions or concerns.
• Allow a friend or family member to be your advocate. It is extremely helpful to have someone go with you to appointments, especially to initial diagnostic visits when your emotions may interfere with your ability to understand all of the information being presented.
• If you decide you want to do your own research, consider asking a tech-savvy friend or relative to do the research for you. Information on the Internet may be inaccurate, very confusing and/or may not pertain to your particular situation. So, it is important to fully understand the facts about your disease before going online. If you do go online, access the reputable, research-based sites. The National Cancer Institute or the American Cancer Society are good places to start. Also, many large cancer centers have excellent sites for patients. When searching for complementary medicine, the Annie Appleseed Project has many helpful links.
• Ask questions. If possible, prepare questions in advance of your appointments. Have your advocate ask more questions and take notes for you. Some women audio-record their meetings with the doctor, so they can listen again at home. Ask more questions!
• Seek genetic counseling, when recommended and/or appropriate.
• Along with your provider(s), decide the course of treatment you will pursue.
  

Treatment

• Accept help from others. Doing this is a gift to them and to you. People who love you feel powerless and want to do something to help.
• Ask for help even if this is not something you typically do. You need to conserve your energy for healing. Ask people to do specific things for you (cooking, housework, help with children and pets, transportation to appointments, shopping, visiting, etc.)
• Learn your limits. Let people know what you can handle at work, at home and in relationships. Only you can determine how much or how little you can manage from day to day. Allow yourself to say no when you need to.
• Nourish yourself by drinking water throughout the day, especially if you are taking medicines and chemotherapy. Figure out which nutritious foods taste good to you and eat well whenever you can. Seek nutritional counseling, if that is available to you.
• Take care of your skin and hair. Chemotherapy targets all of the fast-growing cells in your body, which is good for killing cancer, but very
  hard on your hair, skin and finger/toenails. Find skin and hair care products that work for you. Moisturize your skin generously. Be careful of scented or strong-smelling products, as you may experience sensitivity to aromas during treatment. Watch closely for signs of skin infection and seek treatment immediately. Protect sensitive fingers and toes if you lose your nails.
• Keep moving. Depending on your typical level of exercise and activity, continue physical activity at a pace and intensity level that feels right. Gentle exercise, such as walking, can help decrease pain and discomfort. Many cancer centers offer Oncology Rehabilitation Programs that can be implemented during treatment, depending on your physician’s recommendation. Also, movement can help the digestive process, which is highly impacted by chemotherapy and medications for nausea and pain.
• Explore complementary therapies such as naturopathy, oncology massage, acupuncture, imagery, relaxation, yoga, meditation, qi gong, art and music therapy, to name a few. Many women find these therapies to be beneficial during and after the treatment phase. Always inform the medical providers and the therapists of the entire scope of treatment you are pursuing.
• Find support. Research suggests that women manage treatment-related symptoms more successfully when they are connected to a supportive community during treatment. Support can come in many forms such as a circle of friends/family, a faith-based group or a cancer- focused supportive group, like Women LISTEN.

Survivorship
Most cancers have no absolute causes, and this can lead to uncertainty, fear and confusion, especially as medical treatments come to an end. Although there are no foolproof ways to avoid a cancer recurrence, incorporating principles of healthy living can, at the very least, empower women to improve their health and energy level and create a sense of well-being. Sometimes women have the opportunity to work with a medical professional in developing a Survivorship Plan. Whether that is an option or not, designing a plan for surviving and thriving is helpful because evidence suggests that women feel better when they are taking good care of themselves. Here are some questions to consider when developing an Individual Long-term Recovery Plan:

• What are my self-care skills? Do I make self-care a priority or do I take care of myself last? What skills do I need to develop in order to implement my plan to improve my overall health?
• How am I eating? Do I drink enough water? Am I an emotional eater? Do I feel guilty about eating junk food or confused about the right and wrong foods to eat? What are the roadblocks to nourishing myself and how can I overcome them?
• Do I sleep well? What interrupts my sleep and rest? How are my before-bed behaviors contributing to sleep issues? Am I anxious and worried?
• Do I smoke cigarettes?
• Do I drink excessive alcohol?
• What are the stressors in my life? What can I change? What can I respond to differently? Am I experiencing depression or extreme anxiety?
• What is making me feel badly? What are the barriers to changing that?
• Do I move my body? Which ways of exercising are the most pleasant and doable? Where can I incorporate more movement into my life?
• What makes me happy? What gives my life meaning and purpose? Do I give-back or pay-it-forward? What is my passion; what stirs my creativity?
  

Answers to these questions may help you chart a course of self-care, recovery and renewal. Depending on your answers, you may want to seek counseling, take classes, work with a nutritionist, find an exercise-buddy, travel, kick bad habits or addictions, join a group or volunteer. Lifestyle change is a dynamic process, and change is rarely easy. But it is possible. The first and biggest step is to care enough about yourself to take care of yourself. If not now, when?