A cancer diagnosis comes as a major shock to many people. Suddenly, their lives are turned upside down as they attempt to take in the news and understand the various treatments available.
“People’s first reactions when told they have cancer are shock and fear,” explains Dr Helen Greally, the director of psychology and support services at Cancer Care West - the local charity which supports people affected by a cancer diagnosis. “It is often called the ‘Big C’ because to most people it seems unmanageable and the treatment options seem frightening.”
She says some of her clients describe the day they were told they had cancer as the worst day in their lives. “They were so shocked that once the word cancer was mentioned they heard nothing else.”
Still reeling from the diagnosis there are often many treatments to be faced - surgery, chemotherapy and radiotherapy.
“It is not surprising then that the diagnosis and treatment of cancer is often associated with various types and levels of psychological distress, for example anxiety, depression, fatigue and most commonly a fear of what the future holds to such an extent that patients cannot enjoy the present. Many studies worldwide have reported significant levels of distress in 35 to 40 per cent of patients diagnosed with cancer.
Childcare arrangements
“There are so many issues to deal with. For parents of young children there may be childcare arrangements to sort out while one parent is ill, looking after the house, meal issues - things we take for granted normally - these small issues are often the straw that breaks the camel’s back.
“Some people find relationships difficult as a result of their diagnosis. They may not be able to communicate how they feel and their children may be in distress. Patients may be trying to mind everyone else. They may be feeling guilty about having cancer but it’s not their fault.”
She says families and friends of people with cancer are also affected. A recent Scottish study found that when women were diagnosed with breast cancer, the distress level was significantly higher among partners than it was among the women themselves.
Cancer Care West’s cancer support centre in Westside aims to reach out to patients and their families by offering vital psychological and emotional support.
“Our aim is to support people at whatever stage they are at in their illness,” explains Dr Greally. “It’s a positive service, we are teaching people to live well with cancer. There are about 100 cancers and many people live very well with them and recover. The centre is a haven of peace and quiet whilst also being a hive of activity affording people the opportunity to avail of a variety of individual supports as well as participate in numerous workshops and courses which address different aspects of cancer care.
“We provide a professional but informal atmosphere – the kettle is always on. People are welcome any time to chat, get information or take part in some of our activities at the centre, all of which are free. Our biggest wish is to be over utilised, we don’t mind being busy. We also see people at University Hospital who are not well enough to come here.”
Express feelings
Dr Greally believes it is important for patients to express their feelings. “If you carry around a huge burden, particularly of negative emotions, it can come back at you. Non expressed emotions may come out in irritability and anger at others. You may fly off the handle or have recurring physical illnesses such as tension headaches or nausea which has no physical cause.”
Sometimes just being with patients, offering unspoken support, is enough, she says. “Sometimes we [society] talk too much. The key is to give the patient space to process what is happening to them. The patient has to define the pace.”
There are three peaks in terms of when people seek support from CCW’s psychological and support services. These occur at initial diagnosis, when treatment finishes and people start to worry about recurrence and finally if the disease becomes progressive.
“Of course there are other times when people seek help such as telling their children about the illness or if their communication pattern with their partner becomes difficult.”
Illnesses, such as cancer, bring into sharp focus what is really important in life, according to Helen Greally.
“Nobody wants to be diagnosed with cancer no matter how good or well they make the journey. However, it can have a positive outcome long term in the sense that people may evaluate what is important and may change their priorities. It gives them a jolt. They may look at relationships or unresolved issues. In some ways people say to us ‘I didn’t want to get it but it was not all negative.’ That would be fairly common. They would say it was not the best thing that ever happened but there was something positive in it.”
Fear of treatment
One in four people gets cancer so “no family in the west is not affected”, she says. Is the condition different to other illnesses in terms of psychological distress? “It is and it isn’t. Often there is a huge fear of treatment, chemotherapy, especially. Lots of women with breast cancer are terrified of hair loss, it can be as big a deal as the cancer. The treatment goes on for a long period, too. You are making a long journey.”
What is the key to coping with a cancer diagnosis? Dr Greally says start by trying to live in the present.
“One of the worst things about a cancer diagnosis is you live in an anxious future where the news is not good. When waiting for test results try to live in the present. Tell yourself the evidence today is that I’m well.
“Pick out one good support person, you don’t need 15, just one you can rely on. Sometimes this may not be someone you would have predicted.
“Enjoy every day. Re-prioritise, do things you always wanted to do. Get out, take exercise, talk to people, enjoy life. If you can do that that’s a good day.”
President McAleese to open cancer support centre
President Mary McAleese will open the state-of-the-art cancer support centre at 72 Seamus Quirke Road today (Thursday ).
It was developed by Cancer Care West through major community fundraising efforts. It is one of the first facilities of its kind in the country in that it offers vital psychological and emotional supports to people dealing and living with cancer.
The centre, which is located opposite Westside Shopping Centre, is open on a drop-in and appointment basis to cancer patients and their families from all over the west.
Some 860 people have attended the facility since it opened on May 1. A wide range of free services are offered. A five-day a week drop-in service is available whereby people can call in without an appointment. Individual appointments are available for clinical and counselling psychology; information on benefits and entitlements, reflexology and massage. A variety of courses are offered on topics including stress management, living with cancer, mindfulness, expressive art and expressive writing.
Dr Greally says the services offered are proven to be beneficial to cancer patients.
“We know from the research that psychological and emotional support plays a vital part in coping with cancer. We are delighted to offer a community-based service for everyone affected by cancer - patients, family members and friends.”
CEO of Cancer Care West Richard Flaherty said: “The services the centre provides are essential in handling a cancer diagnosis. We see what we do as complementary to the medical services but quite separate from them.”
The cancer support centre can be contacted by telephoning (091 ) 540040. Cancer Care West is at (091 ) 545000.
Dealing with the emotional distress of a cancer diagnosis
Anne-Marie Cleere was “floored” when she was diagnosed with Non Hodgkin’s lymphoma in 2001.
A teacher from Taylor’s Hill she was in her early forties when she learned she had cancer.
“I hadn’t been well and the doctor thought it was a salivary gland infection. When it didn’t clear up I went back after three months and a biopsy was done.”
The mother of two daughters was “very shocked” and “numbed” to find out she had cancer. It was treated but returned “mildly” in 2004.
“I was treated and recovered Thank God. Inis Aoibheann, [a residential facility on the grounds of UHG which provides accommodation to patients receiving radiotherapy and their families] was just opened and it was providing counselling. I found it fantastic, it really helped me.”
She says this psychological support, which is now available at the cancer support centre in Westside, helps people deal with the emotional distress of being diagnosed with cancer.
“It is a huge shock for the patient. My family, friends and neighbours were so good to me. I used to go to Helen [Greally] and she helped me deal with everything. There is just so much happening. I always thought if I got cancer I’d fall to pieces, that I’d be very scared. But I got through it. The counselling helped me look at life in a better way, it kept my spirits up and gave me a positive outlook.
“I’ve done courses on “Living with Cancer’, nutrition and creative writing. I would say to people don’t be afraid to go to the cancer support centre. I benefited a lot from this support, today I feel like the sun is shining.”