Coping with Cancer - Dr.Kumaresh Krishnamoorthy Column

Introduction

A diagnosis of cancer can be devastating. It is nearly impossible to prepare for and difficult to adequately describe what you may be feeling in response. You might be surprised to learn that you are not alone in your feelings and that many people have the same responses. Having reliable information about your disease and your treatment options is important. Choosing a health care team, knowing which questions to ask, and understanding how to live with and beyond cancer will help you learn to take control of your situation. Understanding your disease is one of the strongest weapons you have in fighting your illness. Gathering information about your cancer and its treatment will reduce uncertainty and assist you in understanding your situation.

Why do I feel this way?

There is no typical way to feel when you are told that you have cancer. Everyone feels and responds differently. Some people experience several emotions at once, ranging from fear, sadness, or even anger, to motivation and determination. There is, however, one feeling that seems consistent for many people who are diagnosed with cancer and that is a loss of control. One way to regain a sense of control in your life is by learning as much as you can about your disease.

Seeking support

Becoming a self-advocate is one way to approach your diagnosis and treatment. Being self-supportive requires that you understand what is best for you. You may want to consider spending some time evaluating your needs to determine how you would like to approach your treatment.
One way to become acquainted with your needs is through self-assessment. Your experience with cancer is a very personal journey, and it is helpful to try to understand your feelings. Getting acquainted with your needs is a good first step in approaching your cancer therapy.
Knowing when to ask for help is another important aspect of being a self-advocate. As the primary supporter of your cause, it is up to you to determine when and whom to ask for help. Consider allowing yourself to depend on others for awhile. Sometimes, learning to ask for help is just as important as receiving it. Accept that people really do want to help you and that by accepting their help, you may both benefit. Save your energy for yourself, your... 
family, and friends. You may want to consider sharing your diagnosis with others. Many people feel comfortable telling family and close friends about their diagnosis of cancer, but choosing to share this information and the people you want to share it with is a personal decision. You may find that an even stronger support system will be available to you once you begin to communicate with others.

Choosing a health care team

Finding the best available health care is crucial. Your oncologist (specialist in cancer care) should be someone who listens carefully to your needs and concerns, relates to you with consideration and respect, and will work with you to select the cancer treatment that is right for you. Remember, building a comfortable relationship with your health care team is an important part of your cancer care.

Some questions to ask when choosing a health care team

  • Am I comfortable with my health care team? Do they make me feel like I am a central part of the decision-making process?
  • Does the doctor communicate to me in terms that I can understand?
  • Am I comfortable with the information that is provided to me?
  • Do I feel comfortable asking questions? Does the doctor listen to my concerns?
  • When and how can I contact my doctor?

Understanding your treatment options

Determining which particular treatment is right for you depend on several factors, including your general physical health, the type of cancer you have and at what stage it was diagnosed, and the goal of therapy that you and your doctor have agreed upon. If your goal of therapy is to treat your cancer as aggressively as possible, your treatment may be different from that of someone whose disease is more advanced or severe or who cannot tolerate certain side effects of therapy. Some people may determine that their goal of therapy is to be as comfortable as possible or to maintain their normal activities of daily living for as long as possible. Choosing a treatment with few side effects or choosing not to receive treatment may also be an option for you to discuss with your doctor. Treatment options could include surgery, chemotherapy, radiation therapy, and hormonal therapy, or a combination of any of these, depending on the type and stage of cancer that you have. With some tumors, surgical removal of all or as much tumor as possible is considered the best treatment depending on the size and location of the tumor and whether the cancer cells have spread to other parts of your body, referred to as metastasis

. If there is evidence that tumor cells have spread or if some of the tumor could not be removed during surgery, then one or more of the other available therapies may be used.

Living beyond a cancer diagnosis

As your treatment nears its end, you may experience many feelings, just as you did when you were informed of your cancer diagnosis. As your last treatment is completed, you may expect that things will suddenly return to normal and you may go back to your life as you knew it before you were diagnosed with cancer. You may discover, as many cancer survivors do, that you need to establish a "new normal."
Of course you would like your daily routine to return to the way it was before your illness, but you may find that you are more likely to have a new set of expectations and priorities as a result of your cancer, its treatment, and redefining your life after diagnosis.

Survivorship issues

As a cancer survivor, you may be introduced to a whole new set of concerns such as fear of cancer recurrence, body image changes, financial, and work-related concerns. A major concern for cancer survivors is that their cancer will return. As your cancer treatment comes to an end and the time for your checkup approaches you may feel anxious. Be sure to ask your doctor what symptoms you should watch for and immediately report anything unusual. Your physical appearance may have changed as a result of your cancer or its treatment. Although these physical changes may be hard to accept at times, it is important for you to try to accept these changes as part of your "new normal".
You do not have to give up intimacy and affection during cancer therapy. Communication with your significant other is extremely important during this time. Providing each other with love, support, and comfort is important at this time in your life. The people you have met along the way, friendships you may have developed, and connections with your family and friends are all a part of your future. Embrace the future.

Tips for communicating effectively

  • Prepare for your appointment. Write down questions when you think of them and take them with you to discuss with your doctor.
  • Be as clear as you can when asking questions or communicating your needs.
  • If you bring articles or information you have printed from the Internet to your appointment, highlight important information that you would like to discuss.
  • Listen carefully to what you are being told. Take notes of your conversation.
  • Do not be afraid to ask for clarification if you do not understand some of the information that you receive. Ask questions until you are satisfied that you understand the information being provided to you

Tips for the Caregiver

Cancer is a twenty-four hour affair. As with other long term illnesses, you may become emotionally drained as you care for your loved one and worry about the changes that may occur in him or her. You can take care of yourself by:
  • Arrange for planned time away from the task of twenty-four hour care
  • Do things just for you!
  • Share your problem with anyone who will listen
  • Avoid isolation, as it may lead to depression.
  • DO NOT cut off ties to non-cancer related activities.
  • You may wish to bring along a list of questions to ask the doctor. Don't leave until you have received understandable answers you feel confident to share with others.
  • Include the patient in daily activities, even if all they can do is watch
  • Stay positive and remember life is precious

Tips for the Patient

  • Be kind to yourself. Focus on what you can do.
  • Reach out to others. Reaching out to someone else can reduce stress.
  • Don't be afraid to say no. Polite but firm refusals help you stay in control of your life.
  • Talk about your concerns.
  • Learn to pace yourself. Stop before you get tired.
  • Give in sometimes. Not every argument is worth winning.
  • Get enough exercise. It's a great way to get rid of tension in a positive way.
  • Take time for activities you enjoy.
  • Set priorities. You can't do everything at once.
  • Take one thing at a time. If you're feeling overwhelmed, divide your list into manageable pieces.
  • Having a plan can reduce the stress of the problem.
  • Eat properly.
  • Get enough sleep.

CONTACT:

Dr.Kumaresh Krishnamoorthy, M.S (ENT)
Head and Neck Surgery Fellowship (Buffalo, USA)
Neurotology & Skull Base Surgery Fellowship (Cincinnati, USA)
Senior Consultant in ENT - Head and Neck Surgeon and Skull Base Surgeon
Apollo Hospitals, 154/11, Bannerghatta Road, BANGALORE 560 076, INDIA
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