Survivorship

Life After Breast Cancer

supportive-friendsBreast cancer is the most frequently diagnosed cancer in women according to the American Cancer Society. This year alone, more than 234,000 cases of invasive breast cancer will be diagnosed in the United States. Most women with breast cancer do quite well and have long lives after completing treatment. One of the hardest things for survivors is living with the worry that the cancer may come back. We recommend scheduling regular follow-up appointments with an oncologist and following the screening and/or prevention guidelines that your provider recommends. I also tell my patients to try, as best as they can, not to worry.

It is easy to see how breast surgery, radiation, and some of the side effects from systemic therapy (which, depending on treatment, can include hair loss, nausea, fatigue, weight gain, hot flashes, joint aches, or other unpleasant symptoms) can wreak havoc on a woman’s self esteem. In addition, many women are used to serving as a support system for their spouse, children, parents, or other loved ones; and to being responsible for important matters at work and at home. Learning to accept help and support rather than giving it can be very challenging. I always recommend honest conversations with family and loved ones, and involving a social worker, psychologist, or psychiatrist if patients are interested and willing to pursue this. Sometimes it can be helpful to talk with someone outside of one’s immediate network of family and friends to try to sort through some of the feelings surrounding the diagnosis and treatment of breast cancer. Support groups can also be helpful; hearing from others who are going through the same thing (perhaps at similar points in life and/or stages of the disease), can help normalize the experience.

Physical changes to the breast – scars from lumpectomy or mastectomy, getting used to the look and feel of reconstructed breasts (if this approach is chosen), and radiation-related changes – can make women less comfortable with their bodies and therefore less comfortable being intimate. These changes can also make them worry about whether a partner will still find them attractive. In addition, some of the systemic treatments used in breast cancer, such as chemotherapy or anti-estrogen therapy, can change hormone levels and decrease interest in intimacy. I always recommend sharing these concerns with your doctor or health care team. Talking with a social worker, psychologist, or even sex therapist can be helpful in dealing with some of the complicated feelings surrounding the look and feel of the breasts after treatment for breast cancer. There are also a number of options for managing symptoms like vaginal dryness, which can be a result of chemotherapy or anti-estrogen therapy and can make intimacy uncomfortable. Finally, open communication with significant others is critical, as they too may be struggling to find the best way to show affection in this new situation. I have actually seen many situations where the diagnosis of breast cancer actually brings couples closer together, as they navigate the path from diagnosis to treatment and finally to recovery together.

About Dr. Meisel

jane lowe meiselJane Lowe Meisel, MD, joined the Glenn Family Breast Center at Winship Cancer Institute as a practicing physician in January 2015. Prior to her arrival, she was Chief Fellow at Memorial Sloan Kettering Cancer Center in New York. Dr. Meisel is a medical oncologist with a special interest in women’s health and in cancers that affect women, including breast, cervical, endometrial, and ovarian cancers. Her goal is to provide exceptional, state-of-the-art individualized care to patients fighting these diseases and to conduct research that improves treatment options for these patients.

 

RELATED RESOURCES:
Exercise, Diet and Breast Cancer
Take-Aways from Breast Cancer Chat with Heather Pinkerton, BSN
Advancements in Imaging for Early Breast Cancer Detection
Latest in Breast Cancer Research
Breast cancer care at Winship
Social services at Winship
Support groups at Winship

Cancer Survivor Exercises for Health

Winship at the Y was established to provide cancer survivors with better access to specialized exercise programs. This program, which is unlike any other in the country, is open to any cancer survivor, not just patients at the Winship Cancer Institute.  In addition to physical benefits, exercise may provide a psychological and emotional benefit during and after cancer treatment. Breast cancer survivor, Janel Green, who was treated at Winship Cancer Institute of Emory University, talks about how the special exercise program has helped her regain her health.

RELATED RESOURCES:
Winship Cancer Institute of Emory University
Bringing Survivorship Tools Closer to Home

Massage Therapy Used to Combat Breast Cancer-Related Fatigue

cancer and massage therapyFatigue is the most common side effect of cancer treatment according to the National Cancer Institute. Many breast cancer survivors describe their fatigue as more intense than the feelings of being tired that we all experience from time to time. Reported characteristics include feeling tired, weak, worn-out, heavy, slow, or lack of energy and difficulty getting-up-and-going.

Currently, researchers from Winship Cancer Institute of Emory University are investigating the benefits of massage therapy on breast cancer survivors with extreme fatigue.

“We decided to look at massage therapy for cancer fatigue because cancer-related fatigue is one of the most prevalent and debilitating symptoms experienced by people with cancer,” explains Mark Rapaport, MD, principle investigator for this study. “Many studies investigating massage for patients with cancer have been focused on depression, anxiety or pain.”

“We already know that frequent massage can enhance the immune system and reduce anxiety, and it has been reported that massage therapy can stimulate energy, and reduce symptoms such as nausea and pain,” says Mylin Torres, MD, associate professor in Emory’s Department of Radiation Oncology, serves as a co-investigator on the study. “We believe that there are many positive effects to be gained by therapeutic massage and we hope to prove that, among other biological advantages, massage may diminish the incapacitation that cancer-related fatigue can cause for our patients.”

Participants in the six-week study are post-surgery breast cancer patients, between the ages of 18 and 65, who have been treated with standard chemotherapy, chemoprevention and/or radiation, and are suffering with breast cancer-related fatigue. They are broken into three groups.

  • Group one receives a typical Swedish-type massage
  • Group two does not receive a massage
  • Group three receives a light touch massage.

Throughout the clinical trial, participants’ vital signs are taken and blood drawn to check for immune markers. The study staff also regularly checks in with each participant to record any changes in their life or their health. So far, the findings are promising.

View this Fox21 news clip to learn more about recent findings from the cancer fatigue trial!

 

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Coping with Survivor’s Guilt After Cancer

cancer survivor guiltBeing diagnosed with cancer can bring on many different types of emotions from fear to sadness to relief; however, many patients don’t think about how they might feel after they complete their treatment. Many are surprised when they begin to feel guilty. This is known as survivor’s guilt. It is a feeling that is often experienced by those who have survived a major or traumatic event such as being diagnosed with cancer. The feelings may come from a sense of guilt that they survived the disease and another patient did not or they did well with treatment while another had a very difficult time recovering.

Here are some things to keep in mind if you think you might be suffering from survivor’s guilt:

  • You are not alone. Survivor’s guilt is very common. It is a natural response for many cancer patients. It often feels like sadness, depression or even grief.
  • Tell someone about how you’re feeling. Talk with a friend or family member you trust. You can always reach out to a social worker to help you process these feelings. Acknowledging those feelings can be help you process them and ultimately overcome them.
  • Consider keeping a journal. Sometimes it is helpful to write down how we are feeling in order to help us manage those emotions. Starting an art project is another creative way to cope with survivor’s guilt.
  • Remind yourself that every patient’s cancer journey is different and that’s okay. It is unrealistic to compare your treatment outcomes to someone else’s because everyone is different.
  • Be supportive. If you know someone who is going through treatment and having a difficult time, it is important to provide them with as much support as possible. As a cancer survivor, you offer a unique type of support because you have been there.
  • Attend a cancer survivor’s support group. Reaching out to other survivors can be helpful.

Don’t wait to get help if you think you are experiencing survivor guilt. It is important to acknowledge and address the issue sooner rather than later. Patients can talk directly to oncology social workers through the following community organizations: www.livestrong.org, www.cancer.org and www.cancercare.org.

About Joy McCall, LCSW

Joy McCallJoy McCall is a Winship social worker with bone marrow transplant, hematology and gynecologic teams and their patients. She started her professional career at Winship as an intern, working with breast, gynecologic, brain and melanoma cancer patients. She graduated with a Bachelor of Science in Psychology from Kennesaw State University and a Master of Social Work from the University of Georgia. As part of her education she completed an internship with the Marcus Institute working on the pediatric feeding unit, and an internship counseling individuals and couples at Families First, supporting families and children facing challenges to build strong family bonds and stability for their future. She had previously worked with individuals with developmental disabilities for over 4 years, providing support to families and caregivers.

Related Resources

 

With a Little Help from Friends

lex gilbert cancer survivorI always assumed that cancer would catch up with me one day. After all, my mother and two of my aunts had breast cancer so I figured I must be next in line. Yet it never occurred to me that the rectal bleeding I’d been experiencing could be colon cancer. Surely the sigmoidoscopy ordered by my doctor would lead me to a quick fix and that would be that. Surprise! When I woke up after the procedure, she came to my bedside and told me I had colon cancer.

When I heard those words I went numb. The world looked as it might if viewed through a funhouse mirror. I remember someone standing nearby handing me a box of Kleenex. I didn’t need the Kleenex. I didn’t cry until many weeks later and boy did I need Kleenex then. I think my soul just closed up shop so it could absorb the gravity of my situation at its own pace, and when it was ready to let go of the emotions, it let go.

Believe me, I am not one of those survivors who talk about what a gift it was to have cancer! I certainly would have preferred to learn the lessons taught by cancer in a less painful way, but all things being equal, there were important lessons learned and I think they are clearly worth passing along. Here’s one.

I pride myself on being self-sufficient and independent. One of the most difficult aspects of being a patient was accepting help from friends. When they offered, I’d say that we didn’t need anything even though that was utterly and completely false. Husbands come in handy sometimes and mine immediately jumped on my reluctance to let folks “in.” At the same time, a dear friend and colleague set up an on-line calendar where I could post what I needed and friends could sign up to help. I could ask for someone to buy me groceries on Wednesday, or help me get the house in order on Saturday, or mow the lawn, drive me to an appointment, or just plain keep me company.

The overwhelming response to the calendar and the ensuing discussions made me realize that when people offer help, they want to help! What a revelation! Too many of us deny our friends the satisfaction and fulfillment that helping someone in need gives them. Allowing folks to help also brings them into our lives in a deeper way, resulting in even more satisfying friendships. The Jedi mind-trick is that letting people help is a gift to them, as well as a gift to you.

About Lex Gilbert

Lex Gilbert is a cancer survivor and very active volunteer with Winship Cancer Institute. She originally comes from southern California, where she ran her own marketing and promotions company serving major corporate clients from throughout the U.S. She has been a life-long volunteer and was awarded “top volunteer” by the County of San Diego for her work mentoring a child in foster care. She moved to Atlanta in 2007 and now works in the Office of Health Promotion at Emory. She was awarded the CLASS Distinguished Service Honor in the Division of Campus Life. Bruce Gilbert, her husband of 32 years, is a musician fighting Parkinson’s disease and also volunteers at Winship as a pianist.

Related Resources

Colon Cancer Chat Transcript

An Intro to Colorectal Cancer Part I: Risk Factors, Symptoms & Diagnosis

An Intro to Colorectal Cancer Part II: Prevention, Diagnosis & Treatment

Winship Cancer Institute – Colon Cancer Resources

Find a primary physician through our Emory Healthcare Network or call Health Connection at 404-778-7777 to learn more from a registered nurse.

When Your Partner Fails You

Cancer Support(This blog was originally posted on Friday, February 20, 2015 on the WebMD website)

Along with the worries, sadness and frustrations of dealing with cancer, many patients experience the heartbreak of their loved one failing to support them. How could a life partner or spouse fail you during cancer? There are many ways, some more obvious than others.

Jan’s husband never came to any appointments, ever. He never learned about her diagnosis, her treatment plan, the side effects of the medicines or the recommendations for how she might improve her energy and strength. He blamed the lymphedema in her arm after her surgery on her “lazy lifestyle.” He told her that support groups were for “wimps” and even took some of her pain medicine for himself.

Sally’s partner came to every appointment – he would never let anyone else bring her. He kept a medical notebook with her test results and argued with every doctor about each treatment plan. He would not let her eat any ice cream or cookies because he thought the sugar would make her tumor grow, even though Sally was at a very healthy weight and ate a very balanced diet.

Gary’s girlfriend would never stop talking about herself. At appointments with the oncologist she would ask questions about breast cancer even though Gary had lymphoma. She repeatedly complained about Gary being at home instead of work, “having him around the house all day is making me crazy, I need my space!” She had no understanding of cancer fatigue: “he looks fine, no vomiting or fever – he should be able to do more!” In the past Gary had been able to participate in his girlfriend’s extremely busy social schedule, but after lymphoma, he asked his girlfriend about limiting their social time to just close friends. His girlfriend insisted on accepting every invitation, and started leaving Gary at home, alone.

Some spouses and partners don’t get it, but they want to, which is huge. If a loved one wants to do better, there is hope for the relationship. If you’re the partner — not the patient — in this scenario, and you’re wondering how to recover from your initial missteps, here’s what I would suggest: Start by setting aside time when there are not any children yelling or bills to be paid or dishes to be done. Begin with a question, “so how are things going for you?“ Wait for an answer. Listen. Then ask “Anything I can do to help?” Breathe, pause, listen. Maybe put your hand on your partner’s shoulder, gently, in order to emphasize you are listening. If you start getting yelled at for being late once 6 months ago, breathe deeply, and respond simply, “I am sorry I was late, but now I really want to help, and do better. Let’s keep talking, but no yelling please.” Make eye contact and smile.

Sally’s partner took the advice above, he set aside the time, took several deep breaths, and listened. He listened closely because he really did love her, and wanted to know how she was doing. He admitted that he had hoped to stop the cancer by controlling everything about her medical care and diet. Sally was able to explain she did appreciate the help with scheduling and tracking her medicines, but she did not want to be treated as an invalid or a small child. Sally’s partner was eventually able to become the partner she needed – a partner interested in caring for her but also respectful of her autonomy.

Gary spent a lot of time after cancer treatment thinking about what kind of life partner he wanted. Reflecting back over the years, he was able to see that his girlfriend had always been self-absorbed. Friday nights, she chose the restaurant; Sunday morning she picked the breakfast; and during the week she rarely asked how Gary was doing at work. Gary realized that he would rather be alone than in a relationship with someone who only cared about herself. “After everything I have been through, I deserve real love.”

Jan always knew that her husband drank too much, but she had hoped he would stop on his own. Through her cancer treatment Jan was terribly embarrassed that her husband was not at appointments. On the day Jan came home to tell her husband that the oncologist told her she was cancer free, he was passed out on the couch. Not being able to share the journey, or the joy in the recovery, pushed Jan to tell her husband that she wanted a divorce. When he realized Jan was actually planning to leave him, he knew he had to get sober. The addiction to alcohol had robbed Jan’s husband of the chance to be a support when his wife really needed him. The only hope for the marriage was for him to get completely sober, and with medical care, Jan’s husband finally stopped drinking. Once sober, he returned to being the kind of husband Jan remembered from when they were first married. He cooked pasta dinners, rubbed her feet in the evening, and actively listened when she talked about her health concerns and hope for the future.

We all hope that our partner will step up and be there for us if we need them, but sometimes they don’t support us as we’d hoped. There are a variety of reasons why a loved one may fail during cancer treatment, and the psychological work is to realize the failure is about their issues, not about you or your self worth. If there is genuine caring, and a real desire for a loving relationship, a couple may get through the challenge of cancer. And if not, there may be grieving process if the relationship fails, but there is great beauty in a cancer survivor taking steps to be in the healthiest, most loving relationship possible. After cancer, you deserve it.

About Dr. Baer

Wendy Baer, MDWendy Baer, MD, is medical director of psychiatric oncology at the Winship Cancer Institute of Emory University, with appointments in the Department of Psychiatry & Behavioral Sciences in the Emory School of Medicine, and the Department of Hematology and Medical Oncology at Winship.

In her work at the Winship Cancer Institute, Dr. Baer helps patients and their families deal with the stress of receiving a cancer diagnosis and subsequent treatment. As a psychiatrist, she has expertise in treating clinical depression and anxiety both with medications and with psychotherapy to help people manage emotions, behaviors, and relationships. The fundamental goal of Dr. Baer’s practice is to promote wellness and maximize patients’ quality of life as much as possible. She believes strongly in the team approach to patient care and collaborates regularly with the doctors, nurses, and social workers that make up a patient’s care team.

Dr. Baer attended medical school at the University of North Carolina at Chapel Hill, where she graduated with honors. From UNC she went to the University of Pennsylvania, where she completed her residency in psychiatry and served as the chief resident in her senior year. Prior to moving to Atlanta, Dr. Baer worked with patients dealing with cancer at the Swedish Cancer Institute in Seattle, WA.

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Key Steps for Coping with Cancer-Related Fatigue

cancer fatigueFatigue is one of the most common side effects reported by cancer patients, and symptoms of cancer- related fatigue differ significantly from the fatigue patients experienced before cancer diagnosis.

Cancer-related fatigue is not only caused by the disease itself, but cancer treatment as well as the emotional and psychological effects of fighting cancer can also contribute. Described by patients as more pronounced during treatment, cancer-related fatigue can leave patients feeling wiped out by simple and small activities. It can also last years after treatment.

According to the American Cancer Society, characteristics of cancer-related fatigue include:

  • Extreme tiredness that may vary in severity from day to day
  • Weakness, weariness or lethargy even after sleep
  • Feeling worn out after simple tasks like standing up from a chair or getting out of bed
  • Heaviness in arms and legs
  • Trouble with concentration and memory

Kay Halbert, Director of Outpatient Services at Emory Johns Creek Hospital, works with cancer patients undergoing cancer treatment on energy conservation. “Energy conservation is coming up with ways to decrease the amount of energy patients use to complete a task while still achieving similar end results so they continue to function in their day-to-day lives.” One energy-conserving technique is using a rolling cart to move heavy dishes rather than carrying them. Another example is prior to getting up from a chair, scoot to the edge, lean forward and push off with the arms and then straighten the legs.

“It’s important for patients and survivors to understand their bodies aren’t the same after cancer treatment,” Halbert explains. “It’s okay for them to modify how they accomplish daily tasks and learn to let go of some things completely.”

Some specific energy-conserving tips are:

  • Keep items within easy reach to limit how often you have to get up.
  • Avoid reaching for items overhead and/or below your knees; keep needed items and work surfaces at a comfortable height.
  • Decide which tasks are absolutely necessary. Let the rest go.
  • Share your workload with family and friends. Remember to delegate.
  • Complete tasks that require the most energy during times throughout the day when you have the most energy. Journaling can help you keep track of these high-energy vs. low-energy periods of time.
  • Alternate between easy and difficult tasks and rest 10 to 15 minutes every hour.
  • Stop before you feel worn out.

“Think about your energy levels as if it were a gas tank. Be economical about the how much energy you use, and make sure you refuel before you’re completely out of gas,” adds Halbert.

It’s very important to note that not all patients experience the same after affects of cancer, such as fatigue, but knowing about ways to help you cope may limit the severity of these after effects with early intervention and modification.

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Prepare for Life after a Diagnosis of Cancer

Coping After Cancer Treatment is Finished

Cancer TherapyA cancer diagnosis can be overwhelming. In fact, many patients have told me that cancer can easily define your life with on-going treatment lasting months and even years. Many patients stop working, limit their social interactions and even change roles within their household as a way to focus on completing treatment. You might think that once chemotherapy, radiation and surgery are over a patient would celebrate and move on, but that’s not always the case. Many patients feel lost and can find themselves asking what now? The intense focus on treatment often overshadows the future.

Here are five tips to help you cope after your treatment is finished:

  1. Consider attending a local support group. They are a great way to connect with others who have a similar diagnosis and have completed treatment. Support groups are a safe place to discuss the feelings that go along with being done with treatment and handling post treatment life.
  2. Reach out to a social worker or counselor. They are often available to provide individual counseling. This is helpful in allowing you an opportunity to identify your strengths and appropriate ways to move forward now that you’re better.
  3. Think of what helped you cope before treatment. Make a list of things that made you feel better when you were having a difficult time before you were diagnosed or treated. Some of those same healthy techniques such as exercise, yoga, or talking to a friend could be useful post treatment.
  4. Don’t rush yourself. Be realistic about your expectations of how you should feel after treatment. Be sure to ask your medical team how you should feel both physically and emotionally post treatment. Remember, you have been through a lot, and it will take time for you to fully recover. Putting additional stress and pressure on yourself to “feel better” because you are finished with treatment can only make this more difficult.
  5. Remind yourself you are a survivor! You have survived your diagnosis and treatment. Positive self-talk is beneficial in reducing stress and decreasing depressive symptoms.

More than 14 million Americans are cancer survivors. No matter what the type or stage of the disease, reaching out for additional support and assistance is just as important after treatment as it is during treatment.

About Joy McCall, LCSW

Joy McCallJoy McCall is a Winship social worker with bone marrow transplant, hematology and gynecologic teams and their patients. She started her professional career at Winship as an intern, working with breast, gynecologic, brain and melanoma cancer patients. She graduated with a Bachelor of Science in Psychology from Kennesaw State University and a Master of Social Work from the University of Georgia. As part of her education she completed an internship with the Marcus Institute working on the pediatric feeding unit, and an internship counseling individuals and couples at Families First, supporting families and children facing challenges to build strong family bonds and stability for their future. She had previously worked with individuals with developmental disabilities for over 4 years, providing support to families and caregivers.

Resources

Living with Cancer

5,000-Mile Bone Marrow Transplant Connection

Bone Marrow Transplant Donor

I just celebrated the 5th anniversary of my bone marrow transplant, and I can’t believe it’s been 5 years. In some ways, it feels like yesterday, but in other ways, it seems like forever ago when I first learned that I would need a life-saving transplant …

I was diagnosed with Acute Myelogenous Leukemia (AML) in 2007, and I underwent six rounds of chemotherapy, which thankfully, resulted in remission. To celebrate the journey and one year of remission, my family and I planned a trip to England, Ireland, Scotland, and Wales. We were so excited to celebrate! We planned to leave on a Sunday in June, and I had one more appointment on the Friday before we left. At that appointment, I found out I had relapsed; the leukemia was back. Absolutely devastated, we decided to postpone the trip and start treatment right away instead.

I was evaluated for a bone marrow transplant, and they found a perfect match who was available and willing to donate. By God’s grace, I received my transplant on August 15, 2009. All I knew at that point was that my donor was male, 21 years old, and from another country. I remember writing him a card and sending it through the Be The Match organization to let him know how my recovery was going. Because he was an international donor, we couldn’t exchange information for two years. After two long years of anonymous letters, my donor Johannes and I were able to learn each other’s names and locations. We immediately made contact and began emailing. It was so incredible to be able to talk with the man who saved my life! How could I even begin to put my gratitude into words?!

My family and I decided to re-schedule the trip we had postponed for summer 2012, and we couldn’t wait to finally go – we had so much more to celebrate! That trip was symbolic of God’s healing and grace, and it became even more significant when Johannes and his dad agreed to meet us in London to spend a few days together.

It was an experience of a lifetime! There I was, sitting in a London pub, anxiously awaiting the arrival of the man who gave me the gift of life. It was so amazing to spend a few days exploring London with Johannes and his dad Bernd. God is so good – He healed me and blessed me with two new family members from Germany. What an incredible gift!

Fast forward three years, a dozen Skype sessions, tons of emails, and countless postcards – Johannes surprised me with the news that he and his girlfriend Tina were coming to Georgia to celebrate the 5-year anniversary of my transplant — I call it my transplantiversary. They arrived on Aug. 15 and we spent the weekend camping out at Lake Lanier with friends and family. I loved every minute of it!

We also took Johannes and Tina to tour Winship and meet some of my doctors and practitioners, which was an amazing experience. We went to the hospital and showed Johannes around the unit where I spent so much of my time surrounding the transplant. God is so faithful – it felt like I had come full circle to be able to return to Emory with my donor and celebrate complete healing. What a beautiful experience!

I will forever be connected to Johannes and his family, and it is all because he joined the bone marrow registry in Germany. Through God’s grace, Johannes gave me the gift of life, for which I could never fully express my gratitude. My prayer and my hope is that others will be inspired to join the registry as well – there are so many people who need this life-saving gift, and you could be the match for them! The registration requires a simple cheek swab, and you can request a kit at BetheMatch.org. You, too, could save a life!

About Erin Blonshine

Erin Blonshine lives in Gwinnett County and works as a hospital teacher in the School Program at Children’s Healthcare of Atlanta at Egleston. She felt called to work with children and families experiencing challenges similar to her own. Erin feels blessed by the unique opportunity to serve others in her role at CHOA.
Erin enjoys spending time with her family, including her one month old niece and her two-and-a-half year old nephew. She also loves to travel, hang out with her friends, and relax at Lake Burton.

Related Resources

Bone Marrow Transplant Patient Story: Georgia Teacher Finds Perfect Match Across the Globe

How Will I Cope with Cancer?

Wendy Baer, MDGetting diagnosed with cancer is a unique experience for every person. It can mean many different things depending on the type of cancer, the stage, the treatment options and the overall health of the person. Regardless of the type of cancer, most people experience a whirlwind of emotions during the time of diagnosis. Uncertainty and loss of control are two common feelings. Uncertainty is especially intense in the work-up phase when you are not sure what kind of cancer you have, what your options are for treatment or who is going to take care of you during treatment. Loss of control may be an issue when you feel your body is broken, tumors may be growing, cells may be multiplying, and you wonder about dying. You may feel loss of control over your energy since you are not able to do activities or work you enjoy. The time needed for appointments may make you may feel as if the medical system has taken control of your entire schedule.

If you are asking yourself the question, “How will I cope?” you are actually in a good starting place. Actively thinking about how to manage emotions such as uncertainty and loss of control is a sign that you will be able to get through your cancer experience.

There are two key questions to ponder as you work through the issue of how to cope during cancer. How have I coped before? And, what do I like?

How have I coped before? When faced with difficult situations in the past, everything from a new school or a new home to a relationship breakup or a job loss, what have I done to get by? What thoughts or behaviors helped me manage my emotions? There are definitely many unhelpful coping strategies during stressful life events, such as becoming isolated, sleeping too much or using more alcohol. Unhelpful coping strategies should be noted and avoided. More helpful coping strategies include being with people who really care about your wellbeing, spending time outdoors, listening to music, breathing deeply and slowly, making lists and schedules and allowing other people to help you with chores.

What do I like? Not just what flavor of ice cream or what kind of movie, but what makes you feel joyful? What do you care about, what do you want to be good at? Who in your life matters to you? Who do you like to be around? Cancer can make your own mortality prominent in your mind on a day-to-day basis. The question, “what do I like?” is essential to consider when you recognize time is limited. Thinking about what matters to you, even writing those things down, encourages you to then take steps to include them in your life. Make a list with specifics. There may be simple pleasures you can enjoy during cancer treatment, and others that will have to wait until after treatment, but plan them, talk about them, work towards getting there. Having both short and long term goals can help you cope with cancer.

Some people are not able to answer these two questions because clinical depression gets in the way of seeing anything pleasant or joyful, or severe anxiety short-circuits the ability to think logically. Drugs and alcohol interfere with the ability to experience pleasure in a meaningful way. Emotional and behavior disturbances can be treated, both with medication and with talk therapy. A comprehensive cancer center offers psychiatrists, psychologists and social workers willing and interested in helping you get your mind in a healthy place to answer the two important questions. Taking care of your brain is critical for overall health.

You can cope. Answering the first question shows that you’ve coped with hard things before. Answering the second question gives you motivation to get through treatment for cancer. There may be challenges, really tough ones, but you can absolutely conquer these challenges. How do I know? I witness people surviving and thriving everyday at Winship.

Wishing you well,

Dr. Baer

About Dr. Baer

Wendy Baer, MD is the Medical Director of Psychiatric Oncology at Winship Cancer Institute of Emory University. In her work at Winship, Dr. Baer helps patients and their families deal with the stress of receiving a cancer diagnosis and subsequent treatment. As a psychiatrist, she has expertise in treating clinical depression and anxiety both with medications and psychotherapy to help people manage emotions, behaviors and relationships. The fundamental goal of Dr. Baer’s practice is to promote wellness and maximize patients’ quality of life as much as possible. She believes strongly in the team approach to patient care and collaborates regularly with patients’ doctors, nurses and social workers.