For many people diagnosed with cancer, a full recovery and a cancer free life may not be possible. The cancer may have been diagnosed at an advanced stage where treatment cannot guarantee recovery or the cancer has returned. The prognosis is extremely difficult to accept and they experience a lot of mixed emotions. However, after some time, many who are in this situation eventually choose to live the best they can, focusing on the things that matter most.
Coming to terms with the news of advanced cancer brings out many emotions, and it would be healthy if you expressed them rather than hide the emotions.
- Fear of losing control of your life, depending on others or dying. These fears are normal and talking to others may help.
- Guilty that you caused cancer or did / did not do enough to keep it from coming back. Remember, cancer can happen to anyone. You may feel bad about having to trouble your family to take care of you, yet most family members will be willing to help out.
- Angry because you already dealt with cancer earlier.
- Denying that you have cancer or advanced cancer. If denial stops you from getting treatment, it becomes a problem.
- Sadness or depression. Talking about how you feel can be helpful but if depression becomes more serious, tell your doctor as medication or counseling may help.
- Loneliness as you feel nobody understands what you are going through or you are unable to join friends for usual activities.
Hope
Hope is important, possibly the most important element in living well with cancer. Chances of successful recovery may be slim but hope gives you the spirit to fight on. When you have hope, you are more likely to make positive changes in your lifestyle for better health.At different stages of cancer, you may hope for different things. Sometimes, you may just hope for a good day with friends and family. Or you may hope to be pain-free. Some people find hope in doing something they always wanted. Hope can also be related to religious beliefs although it may be hard to explain.
Think Positive
This is most likely to be the most common advice given to people with cancer. While positivity does help in the way you look at life, there is no evidence that positive or negative thinking will influence the outlook of cancer. It is only natural to feel scared, down or lonely when you find out you have to live with cancer. When you are being encouraged to focus on the good, you may end up feeling bad if you express negative feelings. Stopping yourself from acknowledging your true feelings may make coping even harder. Recognising positive or negative feelings does not mean you are losing hope in the journey.
Celebrating Life
People living with advanced cancer often take the opportunity to reflect on their life and all they have accomplished. There are some who want to leave some sort of special item to their family and friends as a memory of themselves – some suggestions may include; putting together a photo album, writing letters, compiling a DVD or others. While there others who take on new challenges or hobbies to simply try out new things and to enjoy the experience. You decide how best you want to lead your life.
Cancer not only changes your life, it has effects on your family and friends as well. Like you, they need time to adjust to the fact and make changes to accommodate you, especially if they are very close to you. It is important that they have adequate information and advice so that they do not feel distressed. There will be some family members or friends who may stay away from you as they are afraid of cancer and how things have changed. Their behaviour can be hurtful, but it is important that you accept that and focus on other people who are beside you through this experience.
People walking alongside you will often offer help but you may find it hard to accept their help all the time. Allow friends to help up to a level you are comfortable with, assure them you appreciate their efforts but you would like to do things on your own sometimes.
Talking to your partner
Your relationship will face some sort of changes because of cancer and studies have found that having a good relationship will benefit both parties throughout the experience. Both of you may have different feelings and attitudes. It is possible to find that as each new event occurs, one of you would be optimistic while the other less hopeful. Some partners will try to protect you and disallow you to do anything on your own, at the same time, some partners will totally ‘tune off’ from what is happening. To find a balance, you may want to work out what you need most from your partner and ask for his / her help. If both of you find difficulty in talking about cancer in your lives, a relationship counselor may be able to help.
Talking to your children
It is understandable that you may not want to let your children know about cancer as it may frighten them. Although younger children may not be able to express themselves, they can sense that something is wrong. If you do not tell them, they could start imagining the worst. Here are some tips to start a conversation with a young child:
- Listen to the child before you begin, it will give you an idea on how much the child can handle.
- Explain in simple terms how your situation is like. Communicate feelings as well as facts.
- Answer their questions honestly and in simple language.
- Give them feelings of hope, even if things may not be that positive.
- If possible, explain what will happen next (e.g. treatment, change in routines).
- Don’t promise anything unless you are sure you can keep it.
- Try to keep their routine as normal as possible.
- Your child may become clingy or withdrawn which are normal reactions to deal with their feelings.
Talking to Teenagers
Sometimes parents may think that a teen is able to take care of himself/herself. However, the teen is likely to feel neglected as the family focuses on the sick person. You may notice different behaviour or you cannot understand them. They may be reacting to feelings that are not really aware of, or cannot acknowledge, like anger, guilt or grief. Teenagers react in different ways, from withdrawing to offering to help and assure you of their love.
It is important for teenagers to keep as much of their normal routine as possible. Sometimes this may be hard to manage when you feel unwell. Even if you have a partner, he or she may need to juggle work, caring for you and the family, leaving little time to cater to a teenager’s needs.
- If you feel upset at your teen’s behaviour, remind yourself that it does not mean that they do not care.
- Ask them once in a while how they are coping and if they are well informed.
- It is important to ask if your teen is willing to help with certain duties. Welcome their help but do not expect it.
- Let them know that although cancer is difficult for them, it also matters that they are around you at times.
- Provide information or keep them updated but understand that they may not want or need to talk about the cancer.
Talking to Adults
Adults struggle with the news that their parent has cancer. They may feel unable to meet all the needs of their own family, needs at work as well as responsibility to you. At the same time, you may feel discouraged that you are unable to carry on as the head of the family, instead now you need to rely on them. Involving your adult child in decision making or the type of activities you enjoy may help them cope with the situation.
Talking to Parents
Your parents may find it difficult to accept the news that their child has cancer. They feel that it is not natural that they may outlive their children. Sorrow and helplessness will overwhelm them at first as they slowly adjust to the situation. Explaining your condition and giving up-to-date information about treatments may help lessen their fears. You can also try attending a course together about living with cancer.
Talking to Friends
Some people may not have family who are nearby or helpful. In this case, friends are almost always people one can rely on. Some friends are able to listen without complaints, without judging you or without that extra involvement a partner or relative may feel. However, you may find some friends who choose to limit their contact with you to only phone calls or emails. If you feel hurt by them, remember there are still friends who will stand by you.
Advanced cancer usually means a new cycle of treatment, which is most likely different from primary treatment that you had. Although most advanced cancer cannot be cured, some treatments can keep it under control for months or years. In certain cases, treatment is given to control symptoms such as pain. Cancer is looked at as a chronic disease, which can be managed over some time. Types of treatment commonly given can include:
Chemotherapy
- Using drugs to kill or slow the growth of cancer cells
- Given over a few hours or days, followed by a rest period of 2-3 weeks
- Usually given intravenously or as pills
- Side effects include nausea, depression, tiredness, hair loss
Surgery
- Removal of tumours, affected organs and relieve discomfort caused by tumours that cause bleeding or obstruct organ functions
Radiotherapy
- Using x-rays to kill or injure cancer cells to stop them from multiplying
- Therapy is precisely targeted to the cancer area to prevent harming healthy cells
- It can shrink tumours or relieve pain from secondary cancer in the bones
- Side effects include tiredness, skin problems, appetite loss
Hormone therapy
- Using drugs to surpress the growth of hormones that can cause cancer
- Commonly given for prostate, breast or uterus cancer
- Some hormone drugs can promote menopausal symptoms, regardless of age
- Hormonal drugs that are given if you are past menopause may cause osteoporosis and vaginal dryness
- For men, hormone therapy can result in hot flushes
Rehabilitation
- Restoring physical functions with physiotherapy, prostheses, occupational therapy, speech therapy or emotional support (where necessary)
- Returning to work is also a form of rehabilitation but if you are unable to work full time anymore, you may want to find other activities to fill up your spare time