Imagine being told that all the things you plan, all the moments you hope to have and all the achievements you aspire to may not happen. That’s what it is like when you hear a doctor say, “You have cancer.”
While many people know others who have battled or are currently battling some form of cancer, hearing those words never gets easier. Just because medical advancements have greatly improved the chances of remission and a long, healthy life doesn’t mean that diagnosis won’t drastically change your life. Because that’s the thing about life-changing diagnoses like cancer: They change everything.
When people imagine the experience of a typical cancer patient, what often comes to mind are physical symptoms like hair loss, nausea and fatigue. However, some of the biggest challenges a patient and their loved ones have to face are mental.
“When I was diagnosed with stage 3 breast cancer, I had a six-week-old baby. I wondered whether I’d see her grow up, whether she’d remember me when I was gone,” my mom explains. “I was told to get my affairs in order and hope for a year. What did that mean for my family? How would my 12-year-old son cope?” Fortunately, my mom beat the odds and is now entering her 24th year of cancer survivorship.
The types of thoughts my mom had after receiving her diagnosis can take a toll on a patient’s mental health and overall well-being, according to Dana Nolan, a licensed mental health counselor in central Florida.
Being diagnosed [with cancer] does not make someone mentally ill. But, in my experience, most cancer patients develop symptoms of anxiety and depression at some point during or after their treatment. While it is normal to experience mental health challenges, it is not necessary to simply suffer through it.
No two people respond the same way to difficult news, but there are several common mental health issues that may develop after any type of cancer diagnosis.
Cancer offers plenty of chances to worry both during and after cancer treatment. After you or someone you love is diagnosed with cancer, anxious thoughts and worries like these may become impossible to ignore:
- Is my prognosis accurate?
- What if I made the wrong treatment decision?
- What if my next scan shows the cancer has grown?
The last question represents a special category of anxiety nicknamed “scanxiety” by the cancer community. In an article on Medscape, author Nick Mulcahy explains, “Scanxiety is cancer patients’ fear and worry associated with imaging, both before and after a test (before the results are revealed).”
It’s normal to worry about the future sometimes, but when those worries begin to impede your ability to fully live your life, it’s time to ask for help.
A mental health counselor or therapist can help you determine what you are dealing with and how you can manage it. They may also recommend anti-anxiety medications such as Ativan or Xanax.
Depression affects an estimated 15% to 25% of cancer patients, according to the National Cancer Institute. Patients and their loved ones may develop depression because of the diagnosis itself, anxiety about the future, a changing self-image or even the side effects of certain cancer treatments.
It’s important to note that depression is not the same thing as feeling sad. Clinical depression often manifests in mood swings, fatigue, feelings of emptiness that last for more than a few days and feelings of helplessness or worthlessness. This may require medical attention.
Depression can affect all those around, not just the patient. Melanie Ball, who lost her dad to mesothelioma in 1993 when she was only 14 years old, also had to witness her mother sink into a deep depression that lasted for years after his death. Melanie’s mother chose to suffer in silence, but no one should have to face a life-changing illness, such as cancer or depression, alone.
If you or someone you love is suffering from depression, there is help. Many kinds of medical professionals can treat this condition through counseling, therapy or medication. Joining a support group can also make a big difference for those affected by cancer. In fact, studies show people with terminal cancers who participate in support groups have higher survival rates and increased quality of life.
People may grieve at many different times during and after a cancer battle, and grief is often shared by a patient’s entire support network. Lorraine Kember, a mesothelioma widow, explains how a cancer diagnosis can start the grieving process:
Anticipatory grief is the name given to the mix of emotions experienced when we are living with the expectation of a personal loss and grieving because of it. Anticipatory grief is particularly relevant to anyone who has received a terminal medical diagnosis and for people who love and care for that person.
Living with the expectation of death or loss can cause us to experience the same array of emotions that develop after the loss actually happens, including shock, denial, helplessness, sorrow, anger and physical pain.
While grief is normal during and after a cancer battle, you don’t have to grieve alone. Spend time with your family; they may be experiencing the same thing. Seek out grief support groups, which are often available at local hospices. And above all, remember to take things one day at a time.
If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HELLO to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.
There are a wide range of thoughts and emotions that accompany a cancer
diagnosis that are completely normal. However, these thoughts and
feelings may not feel normal because you may not have felt them before.
Symptoms of depression, anxiety, sleep problems, and relationship
challenges very typically occur along with all the effects of cancer or
its treatment. However, discussions about sex are often neglected by
health professionals and patients.
Many people are not comfortable discussing sex, especially cancer
patients who are dealing with life-changing issues and have more stressful
and life-threatening concerns on their minds.
But should the topic of sex be equally important to those with cancer?
I have often found in my work as a mental health counselor, that couples
are very interested in learning about how to have sex comfortably and
safely during and after cancer treatment.
A cancer patient and their partner often have questions about sexual
intimacy due to a loss in the cancer sufferer’s libido (sex drive) or
negative sexual functions that can result from the cancer treatment. As
a result, they look for advice from their doctor and/or other health
care professionals to gain a better understanding of the affects of
treatment and how it affects their sex drive so they can continue to
enjoy having sex as they did before diagnosis with cancer.
The difficulty with talking about sex, falls not only upon the patient,
but upon doctors too. Many doctors will often avoid the subject or wait
for the patient to raise it. Yet, a cancer patients and their
caregivers often wants information to understand how treatment will
affect their sexual desire and function.
One study suggests, that: “Health professionals may also believe their
discussions [about sex] may be construed as disrespectful and
inappropriate by the patient, with research suggesting that gender, age,
culture, socioeconomic factors, and religion all contribute to health
professionals’ avoidance of the topic…” (Asia-Pacific Journal of
Clinical Oncology, 2009).
In my experience as a counselor, whom has provided therapy for cancer
patients, it’s easy to understand how concerns about sex may go
unattended to because both patients and physicians are unwilling to
engage in dialogue about the topic.
Raising this issue with your doctor is important because many newly
diagnosed patients and their partners may not be aware of the safety
issues involving sex, cancer, and treatment.
Whether or not your doctor raises the issue, you should be brave and
raise the issues and questions you have about cancer treatment and sex.
As a guide, here are some helpful questions in which you can ask your
doctor about sex and mesothelioma:
Do I need to take precautions during intercourse while I am on
How will treatment affect my energy levels and libido?
How soon after surgery or a procedure can I have sex?
Is it safe for me to physically exert myself during sex while I am on
Have other patients receiving the same treatment reported side effects
that impact sex?
Is oral sex safe during treatment?
How will treatment affect my hormone levels?
Will I be able to have children after I finish treatment?
How will treatment affect my fertility?
When you or a loved one are battling cancer, so many things do not feel
normal. Sometimes, sex can return some sense of normalcy. It can also
improve a couple’s quality of life during this difficult time. It may
take some courage to raise concerns and questions about sex to your
doctor, which may not be easy, but most patients find the payoff in
having discussions about sex while battling cancer is well worth the
The Leukemia and Lymphoma Society presented Dana with the 2013 Healthcare Volunteer of the Year Award. The Leukemia & Lymphoma Society (LLS) is the world’s largest voluntary health agency dedicated to blood cancer. They fund blood cancer research around the world. Their mission is to improve the quality of life for patients and their families who suffer from leukemia, lymphoma, Hodgkin’s disease and Myeloma. Dana, a licensed mental health counselor, who specializes in counseling for cancer patients and other patients with serious illness provides patient and family education programs to the LLS. She is honored to receive such a special thanks from a great organization.
Survivorship 101- “Getting Back to Normal After Cancer Treatment” Seminar in Winter Park Nov 16, 2013
Mental Health Counselor, Dana Nolan will be the guest speaker for the Leukemia and Lymphoma Society on Saturday, November 16, 2013. The “Survivorship 101 Getting Back to Normal After Cancer Treatment” seminar is being held at the Ruth’s Chris Steak House, 610 N. Orlando Ave., Winter Park, Florida.
This is part of an educational program series provided by the Leukemia and Lymphoma Society, that provides mutual support and education for family members. If you or a loved one have a diagnosis of Leukemia, Hodgkins Lymphoma, Non-Hodgkins Lymphoma, Myeloma or Myelodysplastic Syndrome, this seminar will provide you with information about Survivorship and to help you learn strategies to cope with the common emotional, physical, and social challenges that cancer survivors face. This is a great opportunity to discuss anxiety and concern with others who share the same experiences.
Dana Nolan is a Licensed Mental Health Counselor. She is a member of Healthy Living Counseling which provides counseling services for cancer and other serious illnesses.
Pre-registration/RSVP by November 13, 2013 for this FREE Cancer Seminar provided by the Leukemia and Lymphoma Society is required. Please refer to the flyer below for more information.
Therapist Dana Nolan and Dietitian Tejal Parekh will be offering presentations at the Leukemia and Lymphoma Society on Saturday, April 13, 2013. The Blood Cancer Symposium is being held at the Citrus Club in Orlando, Florida.
This is part of an educational program series provided by the Leukemia and Lymphoma Society, that provides mutual support and education for family members. If you or a loved one have a diagnosis of Leukemia, Hodgkins Lymphoma, Non-Hodgkins Lymphoma, Myeloma or Myelodysplastic Syndrome, this symposium will provide you with information about making Healthy Food Choices in the Fight Against Cancer, Cancer Treatment, and Survivorship (getting back to normal after cancer treatment). This is a great opportunity to discuss anxiety and concern with others who share the same experiences.
Dana Nolan is a Licensed Mental Health Counselor and Tejal Parekh is a Registered and Licensed Dietitian. Both professionals are members of Healthy Living Counseling which provides counseling services for cancer and other serious illnesses.
Pre-registration for this FREE Cancer Symposium provided by the Leukemia and Lymphoma Society is required. Please refer to the flyer below for more information.
When we eat food high in simple sugars, our body releases insulin, a growth hormone that takes care of the excess glucose in our body. It is believed that excess insulin may promote the growth of cancer cells and therefore our goal is to stabilize our glucose levels that will in turn, stabilize our insulin levels. How do we do this?
Essentially, we want to follow a diabetic diet. Eat small, frequent meals and snacks every 3 hours or so and avoid excess simple, processed sugars such as sodas, candy, cookies and cakes. We also want to eat more complex carbohydrates, i.e. whole grains. A meal containing protein, fat and/or fiber will help to slow down sugar absorption resulting in a slow rise in blood glucose levels and therefore a slow rise in insulin levels.
For more information or to clarify anything in this article, don’t hesitate to contact your Healthy Living Dietitian, Tejal Parekh, MS, RD/LDN. Tejal provides services related to healthy eating for Cancer Patients, as well as, for people with heart disease, and other serious illnesses.
How do I support my loved one who has cancer?
By Dana Nolan, LMHC
As a counselor who specializes in working with patients struggling with serious illnesses, I get many questions from caregivers about what they should say or do that is helpful and supportive. We are all very different in terms of what we find supportive when we are sick. Some people like a lot of support, reassurance and offers of practical assistance. Other people prefer to be treated completely normal (as if there is no health crisis at all) by their family and friends UNLESS they ask for assistance. There is not one right way to support someone you love when they have cancer. There is just the way that works best for them AND you!
My suggestion is to ask your loved one HOW you can best support them. Then, listen to what they have to say. Another good option is to really think about what you can do for them and offer specifics. Do you have the ability to drive them to a doctor/treatment appointment one day a week? Are you willing to mow their lawn while they are in treatment? Are you able to bring a family meal to them every other week? Are you available for them to call 24/7 if they just want to talk or cry? Many people are reluctant to ask for help when they have cancer because they don’t know how much is too much to ask. If you offer something specific, then there is no question in their mind what help you mean when you make the offer of assistance or support.
One last suggestion is to resist the temptation to tell your loved one with cancer to “always be positive and strong.” It is easy to feel positive when someone gets good news from the doctor or they are having a side-effect free day. But, when they are really struggling with side effects or just got news that their treatment isn’t working as planned, then pressure to “be positive” doesn’t feel helpful and often leads the person with cancer to feel as if they are failing as a patient. Our loved ones with cancer are entitled to every single emotion that accompanies their experience (the good, the bad and the ugly!) We can best support them by just listening to what they are feeling and accepting their sadness, tears or anger at their current situation just as we would listen to them and accept their emotions when they are sharing good news or joy that their cancer is in remission!