The Typical Distress of Cancer Patients

As patients try to cope with their illness and its repercussions, they may experience a merry-go-round of changes. We will first discuss the most common ones, and later suggest how family members and other primary caregivers can help.


From the moment a lump is spotted, a mysterious and insistent pain nags, or sudden weight loss is noticed, almost everyone experiences some anxiety. First, an unspoken fear nags that it could be cancer. If a doctor confirms it, new fears arise—concerns about treatment, pain, disfigurement, and even death. The anxiety can mushroom into panic or chronic anxiety that can threaten the patient's ability to cope and comply with treatment recommendations.


Some people choose to ignore distressing signs, denying to themselves and those around them that something might be wrong. Although denial can sometimes be a useful coping mechanism, if it is severe or persists, problems can fester until a crisis develops later on.


Fear is pervasive in these circumstances: fear of the unknown, of pain, of mental and physical loss, of rejection by the family, of lingering illness, and of death. Every time a new pain or symptom surfaces, a fresh wave of fear may surge. This is to be expected and is best expressed so that it does not get out of control. Being afraid is bad enough—but handling it alone (perhaps to avoid "burdening" loved ones) makes it especially hard.

Isolation and Detachment

Some people react to cancer by detaching themselves from decisions about their medical treatment, discussions about their illness, and, in the advanced stages of cancer, thoughts of death and dying. This detachment is another form of denial and serves as a buffer for the patient and to protect family members. Like the other negative emotions discussed here, this is normal up to a point. This form of denial may be just another step in coming to terms with a very unpleasant situation, but if it persists, professional counseling can help.


Sometimes patients blame themselves for having caused the cancer in the first place or believe that they are sick or in pain as punishment for something they've done. Smokers, for example, may feel shame and guilt for smoking despite warnings of increased cancer risks. Whether justified or not, this self-punishment does no one any good. Commonly, such guilt can lead to a major depressive disorder.


In addition to pain and other physical problems linked to cancer (such as nausea or vomiting, difficulty in breathing, or weakness), patients worry about losing control over their daily lives, losing their independence and personal freedom, and having to become more dependent on others. They also worry about whether they can continue working or not, finances, and being a burden to their family. All these factors contribute to the patient's overall suffering. These are legitimate concerns that need to be dealt with in a productive way, but worry doesn't help. Instead, constant fretting needs to be talked about with a loved one or mental health professional.


Cancer patients suffer many losses on different levels, and each one needs to be dealt with directly and, when appropriate, grieved for separately.

Use the Timeless Wisdom

May you have the serenity to accept the things you cannot change the courage to change the things you can, and the wisdom to know the difference.

Esteem by others, self-control, future dreams, body image, sexuality, and reproductive abilities are just a few of the highly important attributes upon which we base our well-being, self-esteem, and quality of life, and cancer threatens many of these. Again, such concerns are best faced up front and discussed with a supportive person.


Disfiguring surgery or side effects from treatment (such as hair loss) may trigger despair and depression, causing the patient to withdraw from seeing or even speaking to friends and acquaintances. Those who lose a breast or have had a colostomy, for example, may feel physically mutilated or unattractive and may withdraw from partners and friends.


Patients who are terminally ill and debilitated may pity themselves, and although a certain amount of grumbling and anger may be therapeutic, it can be destructive if sustained. The patient may feel justified in being demanding, in complaining, and in being short-tempered. These behaviors, however, can end up being manipulative and exploitive, turning the patient's powerlessness into a negative form of power. As a result, caregivers and family members may start resenting the patient (and feel guilty as a result). Then the patient can accuse them of not caring or of abandoning him. This negative cycle breeds emotional distance.


An opposite tack to self-pity is the decision to fight the disease and its pain at all costs. By fighting the pain without seeking medical help in controlling it, patients only end up hurting themselves more. By waiting and holding out, they usually end up requiring more medication to relieve the intensified pain when much smaller amounts could have been used to prevent the pain from turning severe. The defiant, fighting spirit, however, if channeled properly, can be a very positive and powerful response. Remember, every good fighter needs a coach.

Information-Seeking and Bargaining Behaviors

Some patients act exactly the opposite of those who deny or avoid; they try to read everything they can about their condition and may panic when the slightest little thing goes wrong or doesn't fit their mental pictures. These patients need to be active members of the medical team so that they can feel they have some input and control in the decision-making process.

Irritability and Anger

Patients fighting cancer may become surprisingly irritable when things don't go as predicted. They may easily come to believe that if something can go wrong, it will happen to them. They may feel they don't deserve their plight, believe that life isn't fair, and feel angry with God, who seems to have deserted them; this often occurs just at a time when faith can be a powerful ally. Many patients seek a sense of meaning for their suffering where none exists, and any expectation of equity and fairness in life is easily shattered. Cancer has no favorites. Typically, cancer patients may lash out at family members and loved ones, the most convenient and forgiving targets and the ones with whom they feel the safest. Though stressful for everyone, fits of anger, even screaming, crying, throwing dishes, or whatever it takes (without becoming a threat or danger) to get the anger out can be therapeutic. After acknowledging anger, patients can more easily harness that energy to fight the cancer.


Some patients reject offers of help, choosing instead to suffer in silence and to be just left alone. It is sometimes hard to distinguish between a defeatist attitude and an approach that is realistic, especially since feelings change from day to day. Although it is hard to listen to expressions of negative or pessimistic thoughts—especially when trying to keep one's own attitude positive—they must be talked out and dealt with. Maintaining a positive attitude can help immeasurably during a crisis. With these and other changes, loved ones must be attentive to whether pessimism is a passing phase or a serious problem that needs professional attention. No matter how bleak the situation may appear, there are always things to be hopeful about.

Hopelessness and Helplessness

Since many patients feel that they have little or no control over the outcome of their illness, they feel helpless. When medical help seems inadequate, feelings of helplessness can evolve into feelings of hopelessness. Both of these feelings can contribute to depression and may make other mental and physical illnesses seem worse.

Hopefulness, as long as it is realistic, can be a very positive response that needs to be encouraged. To counteract feelings of hopelessness, patients need to set realistic goals and feel that their lives have meaning and value. Families can reassure their loved ones that time together is valuable. If cancer has rendered the future uncertain, the patient needs to be encouraged to take one day at a time and to work toward having a good morning, a good night's sleep, or a pain-free day. The more control the patient can have over his life—such as the timing of treatments, baths, or other activities, or being asked about everyday decisions (what to eat, whom to call, where to go, etc.), the less negative and hopeless he may feel. Priorities and goals need to be continually reframed and addressed, especially if the disease is advancing.

10 Ways To Fight Off Cancer

10 Ways To Fight Off Cancer

Learning About 10 Ways Fight Off Cancer Can Have Amazing Benefits For Your Life The Best Tips On How To Keep This Killer At Bay Discovering that you or a loved one has cancer can be utterly terrifying. All the same, once you comprehend the causes of cancer and learn how to reverse those causes, you or your loved one may have more than a fighting chance of beating out cancer.

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