Each patient will cope in different ways.
The way patients cope is usually linked to their personality traits (such as whether they usually expect the best versus the worst, or if they are shy versus outgoing).
Patients find it easier to adjust if they can carry on with their usual routines and work, keep doing activities that matter to them, and cope with the stress in their lives. Patients who adjust well to coping with cancer continue to find meaning and importance in their lives. Patients who do not adjust well may withdraw from relationships or situations and feel hopeless.
Patients who are having trouble coping with cancer may find it helpful to talk with a professional about their concerns and worries. These specialists may include the following:
- Mental health professionals, including psychologists and psychiatrists.
- Social workers.
- Palliative care specialists.
- Religious counselors.
Patients who are adjusting to the changes caused by cancer may have distress.
Distress can occur when patients feel they are unable to manage or control changes caused by cancer. Patients with the same diagnosis or treatment can have different levels of distress. Patients have less distress when they feel the demands of the diagnosis and treatment are low or the amount of support they get is high. For example, a health care professional can help the patient adjust to the side effects of chemotherapy by giving medicine for nausea.
Cancer patients need different coping skills at different points in time.
Living with a diagnosis of cancer involves many life adjustments. Normal adjustment involves learning to cope with emotional distress and solve problems caused by having cancer.
The coping skills needed will change at different points in a patient's cancer journey. These include the following:
- Hearing the diagnosis.
- Being treated for cancer.
- Finishing cancer treatment.
- Learning that the cancer is in remission.
- Learning that the cancer has come back.
- Deciding to stop cancer treatment.
- Becoming a cancer survivor.
Hearing the diagnosis
The process of adjusting to cancer begins before patients hear the diagnosis. Patients may feel worried and afraid when they have unexplained symptoms or are having tests done to find out if they have cancer.
A diagnosis of cancer can cause patients to have more distress when their fears become true. It may be difficult for patients to understand what the doctors are telling them during this time. For more information, see the Talking with the Health Care Team section in Communication in Cancer Care.
Additional help from health professionals for problems such as fatigue, trouble sleeping, and depression may be needed during this time.
Being treated for cancer
As patients go through cancer treatment, they use coping skills (also known as coping strategies) to adjust to the stress of treatment.
Patients who have comorbidities, a decreased ability to manage their daily routines, or a self-reported diagnosis of depression or back pain may be more likely to experience anxiety during chemotherapy treatment than those who do not.
Coping skills can help patients with certain problems, emotional distress, and cancer by using thoughts and behaviors to adjust to life situations. For example, changing a daily routine or work schedule to manage the side effects of cancer treatment is a coping skill.
Remission after treatment
Patients may be glad that treatment has ended but feel increased anxiety as they see their treatment team less often. Other concerns include returning to work and family life and being worried about any change in their health.
Many patients will feel increased distress after finishing treatment, but this usually does not last long and may go away within a few weeks.
During remission, patients may become distressed before follow-up medical visits because they worry that the cancer has come back. Waiting for test results can be very stressful.
Learning that the cancer has come back
Cancer that comes back after treatment may cause an increase in distress from having:
- A return of symptoms.
- A sense of hopelessness.
- A negative view of the cancer.
The patient's quality of life may be improved if they are able to manage their cancer and have support from friends and family.
Stopping cancer treatment
Sometimes cancer comes back and does not get better with treatment. The treatment plan then changes from one that is meant to cure the cancer to one that gives comfort and relieves symptoms. This may cause the patient to have an increase in anxiety or depression. For more information, see Depression and Cancer-Related Post-traumatic Stress.
Patients who adjust to the return of cancer often keep up hope in meaningful life activities. Some patients look to spirituality or religious beliefs to help keep up their quality of life. For more information, see Spirituality in Cancer Care.
Becoming a long-term cancer survivor
Patients adjust to finishing cancer treatment and being long-term cancer survivors over many years. Some common problems reported by cancer survivors as they face the future include the following:
- Feeling anxious that the cancer will come back.
- Feeling a loss of control.
- Having anxiety and nausea in response to reminders of chemotherapy (such as smells or sights).
- Having symptoms of post-traumatic stress, such as being unable to stop thinking about cancer or its treatment or feeling alone or separate from others.
- Feeling tired all of the time.
- Being concerned about body image and sexuality.
Regular exercise and individual or group counseling may help improve these problems and the patient's quality of life.
Most patients adjust well and some even say that surviving cancer has given them a greater appreciation for life, a better understanding of what is most important in their life, and stronger spiritual or religious beliefs.
Some patients may have more trouble adjusting because of medical problems, fewer friends and family members who give support, money problems, or mental health problems not related to the cancer.