After successful but very difficult treatment for tonsil cancer, Mary Lou Rossano-Collier was ready to get on with her life. But the treatments that saved her life also took an emotional toll. She knew she needed to talk to someone about what she was feeling. After seeing an ad in her local paper, Mary Lou decided to visit a cancer survivor support group. When she arrived, the only other person there was the social worker organizing the new group. She told Mary Lou that although it was just the two of them that she could stay and they could talk. She could even cry if she wanted to.
And so Mary Lou did. After a couple more visits, Mary Lou told the social worker to call when the group formed and she would come back. She has been attending ever since, and is now a mentor for other survivors.
Why it is important
Fear, anger, stress, and hopelessness can affect you and your relationships. You may wonder how to deal with these feelings. You may have difficulty talking with family and friends about them. You may need help, but are unsure how to ask for it. All of these reactions and concerns are normal and can come up at any point in your cancer experience.
Improving emotional wellness can:
- Make you aware that your feelings are normal
- Teach you strategies to feel less afraid and more hopeful
- Help you deal with stress and improve your emotional well-being
- Help you manage relationships with family and friends
- Help you talk about your feelings
- Encourage you to ask for and accept help
What you can do
According to the Association of Oncology Social Work, to improve your emotional wellness, you can:
- Keep track of your feelings. Keep a journal of how you are feeling emotionally. It does not have to be in writing. You can also use photos, drawings, or music to express how you feel.
- Share your feelings with people close to you. This can be hard because you may feel like you are burdening someone else with your problems, but it is very important to talk with someone you trust. If not a family member or friend, find a support group or counselor.
- Consider learning a self-care practice such as mindfulness meditation. Mindfulness meditation is a practice that teaches you to be more aware and “in the moment”; knowing what you are doing, when you are doing it. It can reduce stress through breathing exercises and help to keep you focused on the present moment, reducing “what if” thinking that can often cause stress for cancer survivors. In his groundbreaking book, The Relaxation Response, Harvard Medical School Researcher, Dr. Herbert Benson, writes that practicing simple self-care techniques like meditation can help improve anxiety, depression, fatigue and the side effects of cancer.
- Tell your doctor or nurse about your feelings. Your doctor and care team want you to have the best quality of life possible. Talk to them about your emotions before, during, and after your treatment. They can refer you to supportive counseling and, if necessary, evaluate and treat you for anxiety or depression.
- Seek individual counseling with a professional. There are professional social workers; psychologists and doctors who can help you deal with the powerful emotions you may feel. It is important to find a counselor that you can connect with, and one with experience working with people who have been diagnosed with cancer.
- Join a support group. Taking part in a group with people who are going through similar experiences can help you feel less alone, and provide help in a safe supportive environment. Whatever group you decide to join, if you are joining one for the first time you should consider a group that is led by a professional counselor. Find out the group’s focus, the leader’s qualifications, and the type of cancer survivors attending the sessions.
Other ways to manage stress include
- Being physically active
- Practicing yoga or Tai Chi
- Massage therapy
- Acupuncture (by a qualified practitioner, using single-use, disposable needles for each patient to lower the risk of infection)
Relationships with family and friends
Cancer can have a profound effect on relationships. In many cases, dealing with cancer will deepen the bonds you have with people closest to you. However, it can also cause changes that you might not expect. You may find that family members are not as supportive as you thought they would be. Longtime friends may have drifted away. Others may try to offer support in ways that are not helpful or wanted.
These challenges are common, and can often be dealt with through open and honest communication.
- Keep the lines of communication open. Some family and friends may not have any experience with cancer. They may not know what to say or worry about saying the wrong thing. Let them know what works for you. Let them know if they can talk openly with you about cancer and your experience with it. Tell them how they can also stay in touch through email, texting or through social networking sites. Let them know that sometimes you just need them to listen. For those who find communication exhausting, there are programs like CaringBridge® that offer a way of communicating with many people in one posting.
- Ask for and accept help. Be specific about what you need. Do you need help with meals, errands or transportation to medical appointments? Ask your family and friends to keep including you in get-togethers, even if you cannot attend.
- Accept changes. Cancer will change your perspective about many things. That change in perspective can mean changes in your relationships with family and friends. It also means that you may find new friends through your treatment and recovery. Focus on relationships that provide you the support you need.
Talking with children
If you are a parent, few things can be more difficult than answering questions from both young and adult children. They are likely deeply worried about you and may not know how to express their fears and concerns. In some cases, they may be worried about their own future and if they too may someday be told they have cancer. These discussions can be different based on the age of the child.
A word about sexual health
In her book, After Breast Cancer, Hester Hill Schnipper says, "Sex is one way we say, ‘I’m alive!’ The sensations, the intimacy, the closeness and sense of healthy well-being that it creates is unique."
How you feel about yourself, anger, fear, depression, fatigue, and your body image can all influence your sexual health. In addition, your treatment, along with the effects of cancer can cause physical problems that can make wanting, having, and enjoying sex more difficult. This is normal and help is available.
Tips from the American Cancer Society include:
- Learn about how your cancer treatment might affect your sexual activity
- Remember that you may still be able to feel pleasure from touching
- Keep an open mind about ways to feel sexual pleasure
- Talk to your partner about sex; what works and what does not, so that sex is pleasurable for both of you
- Feel good about yourself and take part in activities that increase that feeling
- Talk to your doctor or nurse about questions you have about sex during and after treatment, and how to get help if necessary
Talking about sex and sexual health is very difficult for most people, even if cancer is not involved. However, taking that first step of talking to your partner, or care team if necessary, may get you the help you need.
Questions to ask yourself
- How am I feeling emotionally?
- What can I do to feel less stressed, sad, angry or depressed?
- If I need help with my feelings, do I have friends who have had cancer who can recommend a support group or counselor?
- What do I need from family and friends to help me through my treatment and recovery?
- How much information should I share with family, friends and my children about my diagnosis and treatment?
Questions to ask your doctor or care team
- If I am feeling sad, anxious, angry or depressed, how long should those feelings last and what can I do to help cope with those feelings?
- What can I do to manage the stress I’m feeling?
- Are there support groups or individual counselors that can help me?
- Am I healthy enough to be sexually active, and is there any type of sexual activity I should avoid?
- If I am having difficulty with sex, can I (perhaps with my partner) be referred to a sexual
- Cancer.org’s Emotional Support page, from the American Cancer Society, offers helpful links including a searchable database of programs and services.
- Screening For Mental Health’s online depression screening tool, which was developed in Massachusetts and has been used annually for National Depression Screening Day.
- The Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital
- Sexual Health Program for Cancer Patients and Survivors at Dana-Farber Cancer Institute
- Living With Cancer, a blog written by Hester Hill Schnipper, LCSW, author, director of Oncology Social Work at Beth Israel Deaconess Medical Center
- The Kripalu Center for Yoga & Health, in Stockbridge Massachusetts
- Cancer Connection, a nonprofit in Northampton offering peer support, complimentary therapies and other programs for cancer survivors in Western Massachusetts
- Cancer Survival Toolbox, an award winning, free audio program produced by the National Coalition for Cancer Survivorship, the Oncology Nursing Society, and the National Association of Social Workers
- Cancer Survival Toolbox (En Español)